![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Elizabeth on July 20, 2002, at 2:24:11
Hi everyone. I've been struggling onward, working with a new pdoc who is, shall we say, less open-minded than the ones I'm used to. (I posted about this a while back.) It seems to be working out okay, but I'm left feeling frustrated that I have to be dependent on a doctor to get the medication I need. You know?
I'm pretty sure that I know more than my doctor does about my own psychiatric history, present symptoms, and response to medications. I'm also pretty sure that I understand at least as well as she does how the medications I take work, on the molecular level and otherwise. She does have important knowledge of things like pharmacokinetic interactions which I might miss, but it just doesn't seem right that it should ultimately be her decision whether to permit me to take a particular remedy. It seems to me that this impinges on a very basic freedom of mine, the right of self-determination.
At one time I was faced with a doctor who refused to prescribe the medication that -- according to records to which he had access -- would help me. As far as I could tell, he would rather see me continue to be depressed than take a "bad" drug, and I narrowly escaped being committed by this bastard (refusing to treat me, to the end). To this guy, the thought of prescribing Buprenex for depression -- even on a trial basis -- was so repulsive that he would rather cause a depressed person's suffering to continue (although, to tell you the truth, I didn't get the impression that my well-being was a very high priority for him). And I didn't have the option of saying no to him. His opinion was law. It was a terrifying experience, and even now, months after, I'm disturbed just thinking about it. *shudder*
We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.
Anyone else having similar thoughts and feelings?
-elizabeth
Posted by fachad on July 20, 2002, at 3:27:47
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Of course you knew I couldn't possibly leave this one alone. I doubt if I'll even be able to keep myself to just one post...
When my previous pdoc closed his practice, I made one last appointment with him to go over a list of pdocs on my insurance plan.
I remember him giving descriptions of each doc, their styles, etc. Of the doc I am now seeing, he said, "he doesn't do much in the way of psychotherapy. He's strictly a psychopharmacologist."
Then I remember saying, "Oh, that's fine. I can do cognitive therapy on my own, I can read Jung and other depth psychology things by my self, I can use reason and insight to make my life better, all I need a pdoc for is to write for meds."
I later felt bad about saying that, because in a way it put down the wonderful insight based psychotherapy that that he did in the 15 minute med check appointments he was forced into.
We might talk about nothing but neurotransmitter receptor affinities, and second messenger systems, but I always ended up laughing my ass off and I always left his office feeling better about myself. He was a truly amazing physician in the classical sense of the word, and a true healer of the soul.
But back to your frustration. I saw it as clear as day back then - the only reason I see a pdoc at all, ultimately, is to get prescriptions.
Like you, I have come far enough along that I have no use for diagnostic cubbyholes, or treatment algorithms, or any sort of moralizing. I don't want to be subjected to first line treatments again. All I need is my scripts filled. And the only way to get that done is by an M.D.
As you said, "this impinges on a very basic freedom of mine, the right of self-determination." It assumes we are stupid and must be protected from ourselves. It's a very unfortunate consequence of a parental, authoritarian government reflected in a parental, authoritarian medical system.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
> Hi everyone. I've been struggling onward, working with a new pdoc who is, shall we say, less open-minded than the ones I'm used to. (I posted about this a while back.) It seems to be working out okay, but I'm left feeling frustrated that I have to be dependent on a doctor to get the medication I need. You know?
>
> I'm pretty sure that I know more than my doctor does about my own psychiatric history, present symptoms, and response to medications. I'm also pretty sure that I understand at least as well as she does how the medications I take work, on the molecular level and otherwise. She does have important knowledge of things like pharmacokinetic interactions which I might miss, but it just doesn't seem right that it should ultimately be her decision whether to permit me to take a particular remedy. It seems to me that this impinges on a very basic freedom of mine, the right of self-determination.
>
> At one time I was faced with a doctor who refused to prescribe the medication that -- according to records to which he had access -- would help me. As far as I could tell, he would rather see me continue to be depressed than take a "bad" drug, and I narrowly escaped being committed by this bastard (refusing to treat me, to the end). To this guy, the thought of prescribing Buprenex for depression -- even on a trial basis -- was so repulsive that he would rather cause a depressed person's suffering to continue (although, to tell you the truth, I didn't get the impression that my well-being was a very high priority for him). And I didn't have the option of saying no to him. His opinion was law. It was a terrifying experience, and even now, months after, I'm disturbed just thinking about it. *shudder*
>
> We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.
>
> Anyone else having similar thoughts and feelings?
>
> -elizabeth
Posted by cybercafe on July 20, 2002, at 9:01:15
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Yes, I have for a long time suspected that while we who suffer from real, major depression know that what we are going through is hell, those who have not experienced it think we are dealing with some kind of minor inconvenience or mild annoyance.
It's like there are two possible hypothesis about depression1. people who are depressed feel the same things as everyone else, but have hyper-sensitive whine and complain neural circuits ... or are lazy ...
2. people who are depressed do actually suffer
I would say that my behaviour would throw hypothesis 1 out the window -- and any "normal" people who doesn't buy that can come to the weight room with me or we can do a little boxing ...... i would also submitt to you elizabeth that, were depression based on a model of individuals who have hyperactive whine-and-complain circuits, those who experienced bipolar disorder would not report feeling drastic mood changes, but would instead report "last week i really felt like complaining, but this week i don't feel like complaining at all"
.... i think PET/MRI etc brain scans also show that the areas effected by depression are primarily pleasure centers, ...... in fact... i think brain scans would show that the same brain centers increase and decrease activity depending on the feeling of the bipolar individual...
... now if we believed in the "depressed people just like to complain" hypothesis of depression, we would expect one brain area (vocal whine-and-complain motor area) to increase in depression and another (vocal tell-everyone-i'm-wonderful motor area) to decrease in depression.... and the opposite to be true during episodes of euphoria....
.. but since it seems to be the stimulation of the nucleus accumbens ALONE that seems to be responsible for such behavioural effects, i think there is good reason again to reject hypothesis 1
Posted by hildi on July 20, 2002, at 10:33:32
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
This is a very important topic and really hits home with me-especially right now. In the midst of medical runaround, paronizing doctors, lack of choices, and being made to feel like my opinion doesn't count and that I'm an imbicile, I count on this website to point me in the right direction to find real answers to my problems.
I found this website out of desperation-
New reactions to my mind and body were occurring and I found everyone around me-friends, family, doctors, very condescending, not really understanding the depth of the problem and treating me as if I could make this all go away if I really wanted to. As if all I needed to do was try harder . . .This kind of treatment added to my recent breakdown- then I found you guys on this site.
All I can say is that I finally feel like I met people who truly understand. Not only I have found kindred spirits, but I get very useful information- info on what is going on in my body and mind from the meds, things to try, etc. . .
I trust in you guys here, on this site, much more than my doctor. At least I get real information here and am not treated like an idiot with no real say in her treatment.
Hildi
Posted by katekite on July 20, 2002, at 11:36:39
In reply to Re: frustration - the medical monopoly, posted by cybercafe on July 20, 2002, at 9:01:15
Pdoc Rules:
1. Do not give patient any drug they specifically ask for.
2. Always offer patient drugs they have tried before that have had adverse effects (especially ones that caused seizures or hypertensive crises). Do not note in records.
3. If in doubt, reach hand into drawer or cabinet and pull out shiny starter pack, look at it to see what it is, then extoll its virtues.
Posted by Ritch on July 20, 2002, at 12:31:12
In reply to rules, posted by katekite on July 20, 2002, at 11:36:39
> 3. If in doubt, reach hand into drawer or cabinet and pull out shiny starter pack, look at it to see what it is, then extoll its virtues.
Kate,This is a little away from the thread, but it also *is* frustrating if this is true. Anyhow, I had a pdoc appointment a few months back and I remembered something that was said when I asked about a certain med and the response (kind of under the breath) was "oh, that's a different company..." I am beginning to really wonder.. is my pdoc getting *paid* under the table for writing prescriptions for certain companies??? The only reason I just thought of that now was a story I read in the Kansas City Star a few weeks back. It had to do with a notorious case where a pharmacist was diluting an expensive cancer drug so he could make more profits from it. Well, the weird part is that the pharmaceutical company that makes the cancer drug *knew* how many prescriptions were being written for the med and also by *which doctors*. Anyhow, the drug manufacturer is facing some kind of possible trouble because they had the information (doctor's scripts) which would have shown the pharmacist wasn't ordering enough of the drug to match up with the quantity of the drug being *dispensed* at the pharmacy. Weird, huh? Well, what gets me to wondering is.. if the drug co.'s *know* what drugs your pdoc is writing for, who's to say they couldn't engage in kicking back money to the pdoc for the scripts? I really didn't think the drug co's had access to that information, but evidently they do.
Mitch
Posted by may-b on July 20, 2002, at 12:51:02
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Hi Elizabeth
(Forgive me if two version of this message appear; my first post didn't show up so I tried again...)
Although I have an excellent doctor at the moment, I have experienced disrespectful treatment such as you describe.
>We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.The doctors' behaviours you describe in your post seem driven more like an impulse like 'cya' than by any 'morals'. As you say,
>I didn't get the impression that my well-being was a very high priority for him).
Not very 'moral'. [rueful grin.]
Hope you find a doctor who respects your vast experience and self-knowledge.
best wishes,
may-b
Posted by mist on July 20, 2002, at 13:22:00
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
If you call the company that manufactures the medication you need, would they refer you to doctors in your area that have prescribed it for your diagnosis? Do they have that kind of information? Maybe one would be on your insurance plan. It seems your only recourse is to somehow find a doctor who you know would prescribe what works for you, and go to them wherever they are (ideally not too far from where you live).
The whole system needs to be overhauled.
Posted by cybercafe on July 21, 2002, at 1:53:40
In reply to Re: frustration - the medical monopoly, posted by mist on July 20, 2002, at 13:22:00
> If you call the company that manufactures the medication you need, would they refer you to doctors in your area that have prescribed it for your diagnosis? Do they have that kind of information? Maybe one would be on your insurance plan. It seems your only recourse is to somehow find a doctor who you know would prescribe what works for you, and go to them wherever they are (ideally not too far from where you live).
Damn that is a really good idea .. I never thought of that... and I have always had the problem that I did not want to wait 4 months for an appointment to simply ask "have you any experience with lamictal, gabapentin, stimulant augmentation, etc etc" .....
I'm thinking now it might be wise to talk to the pharmacy and see if I can get a doctor's name (is this confidential?) or some governing body...
Posted by tabitha on July 21, 2002, at 2:25:04
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Elizabeth,
Ever consider going to med school? You could eliminate the middle-man once and for all. (At least I assume doctors can write their own scrips.)
Posted by cybercafe on July 21, 2002, at 3:11:12
In reply to Re: frustration - the medical monopoly, posted by tabitha on July 21, 2002, at 2:25:04
> Elizabeth,
> Ever consider going to med school? You could eliminate the middle-man once and for all. (At least I assume doctors can write their own scrips.)hmmmm... is being hyper-squeemish related to bipolar or affective/anxiety disorders at all?
Posted by fachad on July 21, 2002, at 9:38:40
In reply to Re: frustration - the medical monopoly, posted by cybercafe on July 21, 2002, at 1:53:40
> > If you call the company that manufactures the medication you need, would they refer you to doctors in your area that have prescribed it for your diagnosis? Do they have that kind of information? Maybe one would be on your insurance plan. It seems your only recourse is to somehow find a doctor who you know would prescribe what works for you, and go to them wherever they are (ideally not too far from where you live).
>
> Damn that is a really good idea .. I never thought of that... and I have always had the problem that I did not want to wait 4 months for an appointment to simply ask "have you any experience with lamictal, gabapentin, stimulant augmentation, etc etc" .....
> I'm thinking now it might be wise to talk to the pharmacy and see if I can get a doctor's name (is this confidential?) or some governing body...It's a great idea for on-label uses for medications, but I think Elizabeth is using a narcotic pain medication for depression, and that's definitely off-label.
I'm not sure, but I think the pharmaceutical companies are forbidden by law from promoting off label uses for their products.
The same consideration applies to stimulant augmentation.
Also, there is the "drug seeking" consideration whenever you are dealing with controlled substances (e.g. benzodiazepines, stimulants, steroids, narcotic analgesics.) There is always some desperate addict who is willing to deliberately dislocate his shoulder to get some Percocet. And doctors, pharmacists, and other medical professionals are required by law to be "on the lookout" for that sort of thing.
Posted by jane d on July 21, 2002, at 12:11:00
In reply to Prescription payola? » katekite, posted by Ritch on July 20, 2002, at 12:31:12
>Well, the weird part is that the pharmaceutical company that makes the cancer drug *knew* how many prescriptions were being written for the med and also by *which doctors*. Anyhow, the drug manufacturer is facing some kind of possible trouble because they had the information (doctor's scripts) which would have shown the pharmacist wasn't ordering enough of the drug to match up with the quantity of the drug being *dispensed* at the pharmacy. Weird, huh? Well, what gets me to wondering is.. if the drug co.'s *know* what drugs your pdoc is writing for, who's to say they couldn't engage in kicking back money to the pdoc for the scripts? I really didn't think the drug co's had access to that information, but evidently they do.
Mitch,
They've got that information. I was shocked when I first heard that because it really does make direct payoffs practical since the companies can monitor that they get what they pay for. Even if they just use it to up the psychological pressure "hey buddy, why did you only prescribe my drug 2 x, I thought you agreed with me that it was a good idea" complete with sad looks it's a scary idea. I don't know exactly how they get the information. I assume that either the drug store chains or the insurance drug management companies sell it to them since both now have that information on their computers. Computer technology has a lot to answer for. We probably need to make this information confidential as well.Jane
Posted by jane d on July 21, 2002, at 12:12:53
In reply to Drug companies track doctors' prescribing » Ritch, posted by jane d on July 21, 2002, at 12:11:00
Or I suppose we could insist that their prescribing records be released for all of us to see. A web site where you could sort their prescriptions by maker, cost, etc. and judge for yourself whether they were unduly influenced.
Posted by mist on July 21, 2002, at 13:10:45
In reply to Re: frustration - the medical monopoly » cybercafe, posted by fachad on July 21, 2002, at 9:38:40
> I'm not sure, but I think the pharmaceutical companies are forbidden by law from promoting off label uses for their products.
Although it wouldn't really be promotion. Just providing information in response to a private request. You would think it would be the companies' right to do that, especially with the doctor's permission. But maybe not.
In any case, wouldn't the doctors most likely to prescribe that type of med for depression be found in a cutting-edge, research-oriented setting, where experimental treatments might be more accepted?
Posted by McPac on July 21, 2002, at 21:58:06
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Elizabeth
I also had a-holes like that jackass that you described (very similar experience)!
I'd like to burn those a-holes alive.
Posted by Ritch on July 22, 2002, at 10:30:07
In reply to Drug companies track doctors' prescribing » Ritch, posted by jane d on July 21, 2002, at 12:11:00
> >Well, the weird part is that the pharmaceutical company that makes the cancer drug *knew* how many prescriptions were being written for the med and also by *which doctors*. Anyhow, the drug manufacturer is facing some kind of possible trouble because they had the information (doctor's scripts) which would have shown the pharmacist wasn't ordering enough of the drug to match up with the quantity of the drug being *dispensed* at the pharmacy. Weird, huh? Well, what gets me to wondering is.. if the drug co.'s *know* what drugs your pdoc is writing for, who's to say they couldn't engage in kicking back money to the pdoc for the scripts? I really didn't think the drug co's had access to that information, but evidently they do.
>
> Mitch,
> They've got that information. I was shocked when I first heard that because it really does make direct payoffs practical since the companies can monitor that they get what they pay for. Even if they just use it to up the psychological pressure "hey buddy, why did you only prescribe my drug 2 x, I thought you agreed with me that it was a good idea" complete with sad looks it's a scary idea. I don't know exactly how they get the information. I assume that either the drug store chains or the insurance drug management companies sell it to them since both now have that information on their computers. Computer technology has a lot to answer for. We probably need to make this information confidential as well.> Or I suppose we could insist that their prescribing records be released for all of us to see. A web site where you could sort their prescriptions by maker, cost, etc. and judge for yourself whether they were unduly influenced.
>
> Jane
Wow, thanks for responding! I wonder if the drug mfg.'s are privy to the information because of some regulation loop-hole? I could see where the information could be useful in an investigation. If they couldn't track it-they wouldn't have the information available for the DEA or FBI, i.e. However, the mfg's *could* abuse that knowledge. When I was first prescribed Neurontin, my pdoc (a different one), told me that "I like Neurontin because I have had success with it and they (Parke-Davis) aren't pushing it like other companies are pushing their products". Well... in light of the recent scandal surrounding how Neurontin was being marketed back in 1999, 2000, etc., it looks like they *were* pushing it very, very agressively. That is very suspicious.Your idea about the website is interesting, but I wonder if there would be privacy issues. Also, I might add that many of the "pushed" off-label meds *do* have some utility. Unfortunately, some people who *are* benefiting from off-label polypharmacy will probably get hurt by more public exposure about these scandals. Everyone *is* scandal conscious nowadays.
Mitch
Posted by Dr. Bob on July 23, 2002, at 8:06:26
In reply to Re: frustration - the medical monopoly, posted by McPac on July 21, 2002, at 21:58:06
> I also had a-holes like that jackass that you described (very similar experience)!
>
> I'd like to burn those a-holes alive.Could you please rephrase that, taking into account the civility guidelines here?
http://www.dr-bob.org/babble/faq.html#civil
Thanks,
Bob
Posted by velaguff on July 23, 2002, at 13:43:01
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Hello Elizabeth, I'm new here, name's Velaguff. I've enjoyed your informative postings for a long time before I actually registered with Dr. Bob. About six months ago, I asked shrink #37 or so, for Buprenex. He sneered at me. His counter-suggestion? That I take a four-hour drive (8 hours round trip!) once-a-week to the nearest research hospital with an electroshock device, and pay a FORTUNE for electroshock therapy, as my health insurance doesn't cover it. I would have loved to snap his pencil neck like a twig. I would have done a great service to humanity by doing so. Unfortunately, as a "crime of passion", so to speak, this action would not have won me the death penalty (which, ironically, would, presumably, relieve my depression). I restrained my trembling hands, thus enabling me to remain depressed in my own house, as opposed to the big house.
> Hi everyone. I've been struggling onward, working with a new pdoc who is, shall we say, less open-minded than the ones I'm used to. (I posted about this a while back.) It seems to be working out okay, but I'm left feeling frustrated that I have to be dependent on a doctor to get the medication I need. You know?
>
> I'm pretty sure that I know more than my doctor does about my own psychiatric history, present symptoms, and response to medications. I'm also pretty sure that I understand at least as well as she does how the medications I take work, on the molecular level and otherwise. She does have important knowledge of things like pharmacokinetic interactions which I might miss, but it just doesn't seem right that it should ultimately be her decision whether to permit me to take a particular remedy. It seems to me that this impinges on a very basic freedom of mine, the right of self-determination.
>
> At one time I was faced with a doctor who refused to prescribe the medication that -- according to records to which he had access -- would help me. As far as I could tell, he would rather see me continue to be depressed than take a "bad" drug, and I narrowly escaped being committed by this bastard (refusing to treat me, to the end). To this guy, the thought of prescribing Buprenex for depression -- even on a trial basis -- was so repulsive that he would rather cause a depressed person's suffering to continue (although, to tell you the truth, I didn't get the impression that my well-being was a very high priority for him). And I didn't have the option of saying no to him. His opinion was law. It was a terrifying experience, and even now, months after, I'm disturbed just thinking about it. *shudder*
>
> We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.
>
> Anyone else having similar thoughts and feelings?
>
> -elizabeth
Posted by Alan on July 23, 2002, at 15:54:47
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
> We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.
>
> Anyone else having similar thoughts and feelings?
>
> -elizabeth
===============================================Sorry you're having so much trouble elizabeth. I've enjoyed your posts over many months and remember the last one concerning your move and finding a new doc.
The suggestion about contacting the drug Co. seems to be a good one but you may run into resistance (if you haven't already) for not being able to identify yourself as a doc. Drug seeking behaivor? I remember the post almost verbatium that faschad went on about titled "The Controlled Substance Catch-22" Remember that one? Sounds like you're there in a certain kind of way.
I've had the exact same experience with BZD's and pdocs. I know more about them vis-a-vis my health than any doc could ever know and the present pdoc is my 4th! And all over the evil seed, BZD's. I lost 5 years of my life because the first three docs wouldn't listen to what I was telling them - that AD's did not feel right for my GAD and when they added BZD's, I felt better!
Finally I found a doc that was highly regarded amongst their peers (ironiy of ironies) for "thinking outside of the box". Why does someone have to think outside of the box to prescribe a medicine in monotherapy that the patient tells them works and is designed explicitly as an anxiolytic?
Prejudice, ideology, or just plain rigidity and stupidity. Those that refuse to or are incapable of, for instance, making the distinction between "addiction" and medical dependence. I don't know how many times I heard from the first 3 docs that word - "addictive." Totally out of place for the term and inappropriately explained to me vis-a-vis BZD's. I was so conflicted about a med that made me feel better that was going to put me in the same class as "drug addicts" that the anxiety was greatly worsened and THAT is what almost left me with nothing. Literally nothing.
Much I found is a problem with the doc, while perhaps having best intentions in mind, is certainly ego driven and under the constraints of limited information that has been manipulated by commercial interests. That was the case with my first 3 docs.
I wish that I could offer some advice. I can only offer empathy because of a system that is really broken when you examine it with any scrutiny at all. Individual cases are treated with no respect for the individual much of the time. Hence your feelings re: loss of your individual freedom I suspect.
My very best to you,
Alan
Posted by McPac on July 23, 2002, at 21:16:52
In reply to Re: frustration - the medical monopoly, posted by velaguff on July 23, 2002, at 13:43:01
Velaguff " I would have loved to snap his pencil neck like a twig."
>>>>You should have.
I only wish that I had been there to help you (not that you needed it).
Posted by cybercafe on July 24, 2002, at 20:46:52
In reply to Re: frustration - the medical monopoly » Elizabeth, posted by Alan on July 23, 2002, at 15:54:47
> I wish that I could offer some advice. I can only offer empathy because of a system that is really broken when you examine it with any scrutiny at all. Individual cases are treated with no respect for the individual much of the time. Hence your feelings re: loss of your individual freedom I suspect.
Alan -- I have had the same problem with benzodiazpines and used to feel the same way you did
I even had docs try to give me antipsychotics from the '60s instead...
but as I have tried attending support groups, I have come to learn that there are really quite a lot of patients out there that abuse benzodiazepines. Admittedly perhaps this wouldn't happen if they had decent access to the health system -- but that is the health ministry's, not the psychiatrist's, fault. There are quite a few patients out there that just don't feel like dealing with the day and so they take 20 pills so they can sleep through it. This just doesn't seem like the best solution to me -- I'm thinking antipsychotics might be a nicer way to sleep the day away (i.e. non-addictive).
.. having said that... i also find that most docs are open to perscribing benzos if you're an aggressive type with a career that you aren't going to risk with overdosing or if you know enough about medication to make it seem like you are interested in getting better -- not just in numbing the pain with no concept of long term consequences ...
obviously your experiences weren't quite as positive ... but i would like to believe that if i was able to present a decent case to every family doctor i saw and get benzos, you would be able to as well.....
.... i don't see anything unreasonable about the "i'd like to take benzos, but if you've got a better idea i'd be happy to hear it" attitude...
i dunno man, i eventually became anti-benzo, after 2 or 3 years i gradually had to increase my dose :( .... now i'm a pseudo-salesman for gabapentin (hmm.. i wonder if they're hiring?)
Posted by cybercafe on July 24, 2002, at 20:58:08
In reply to Velaguff, posted by McPac on July 23, 2002, at 21:16:52
> Velaguff " I would have loved to snap his pencil neck like a twig."
>
> >>>>You should have.
> I only wish that I had been there to help you (not that you needed it).hmmm... i agree that psychiatrists are somewhat cold and apathetic, but i'm sure you have to be to see suffering all day long for years and not go nuts...
however i feel it is totally unreasonable for these government officials to be decreasing funding on mental health, when it is already so inadequate ... like hello! people don't committ suicide because their lives are wonderful and full of joy ...
now if we were to go out there and kill a few psychiatrists the only result is that
a. the public opinion of the mentally ill is going to go down and this along with
b. less people will admitt to being mentally ill with this worsened stigma means that
c. spending on mental health will really shrink ..
not to mention less interest by doctors on pursuing a career in mental health (probably the only residency that actually goes unfilled) ....... what would be much more productive is if people would demand an explanation from the gov't for spending so much more money on untreatable illnesses while we have people killing themselves in their teens when they could so easily go on to lead long and healthy lives ....
Posted by LostBoyinNC1 on July 27, 2002, at 22:26:16
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
> Hi everyone. I've been struggling onward, working with a new pdoc who is, shall we say, less open-minded than the ones I'm used to. (I posted about this a while back.) It seems to be working out okay, but I'm left feeling frustrated that I have to be dependent on a doctor to get the medication I need. You know?
Welcome to ultra conservative North Carolina. Where a doctor is not even legally required to give you copies of your medical records if they dont want to. And oh BTW the psychiatrists in Winston Salem are among the very worst Pdocs in the state, even by North Carolina standards.
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> I'm pretty sure that I know more than my doctor does about my own psychiatric history, present symptoms, and response to medications. I'm also pretty sure that I understand at least as well as she does how the medications I take work, on the molecular level and otherwise. She does have important knowledge of things like pharmacokinetic interactions which I might miss, but it just doesn't seem right that it should ultimately be her decision whether to permit me to take a particular remedy. It seems to me that this impinges on a very basic freedom of mine, the right of self-determination.
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> At one time I was faced with a doctor who refused to prescribe the medication that -- according to records to which he had access -- would help me. As far as I could tell, he would rather see me continue to be depressed than take a "bad" drug, and I narrowly escaped being committed by this bastard (refusing to treat me, to the end). To this guy, the thought of prescribing Buprenex for depression -- even on a trial basis -- was so repulsive that he would rather cause a depressed person's suffering to continue (although, to tell you the truth, I didn't get the impression that my well-being was a very high priority for him). And I didn't have the option of saying no to him. His opinion was law. It was a terrifying experience, and even now, months after, I'm disturbed just thinking about it. *shudder*Was this guy another Winston Pdoc? He kind of sounds like my former Winston Pdoc. His last name doesnt happen to start with "J" does it? I am really curious who this guy is for real, cause i probably know him or heard of him.
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> We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.They think you have substance abuse problems, in addition to depression problems Elizabeth. Think about it. You take buprenex, benzos and Ambien at twice the normal strength. Thats alot of addictive stuff. And remember where you are Geographically located now to keep things in perspective. You are in ultra conservative North Carolina where drug abuse is not tolerated, but everybody does drugs except for the Bible thumpers. Get caught here and you WILL go to jail. NC aint California. If Morton Downey JR. was a coke addict in NC and not California, he would have been a convict a long time ago and not in drug rehab like they do in California.
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> Anyone else having similar thoughts and feelings?Ive complained about the backward, anti-consumer laws regarding medical things in NC for five years now. People have called me crazy for complaining about it so much and now it sounds like you are experiencing somewhat the same thing. Try and get FULL copies of your medical records from that guy...bet you wont get them without a major lawsuit. I bet all he'd give you is a "summarized" statement of your records, ommitting stuff he knows you wouldnt like. In most other states, all youd have to do is request it in writing and the doctor would be legally required to give you full copies with no lip or attitude.
I would seriously suggest you consider finding a Pdoc outside of Winston Salem. There are no good Pdocs in Winston. For some reason, the mental health climate in Winston is super uptight. I dont know why but I found that out the hard way when I used a guy from Winston a few years ago and was hospitalized the only time Ive ever been over in WS. I have actually used two Pdocs from Winston, saw the second one recently once for a SS disability exam. He was the same. Rigid, arrogant...no good. He was a Wake Forest psychiatry graduate. Wake Forest psychiatry is no good, although Baptist hospital overall is a fine, outstanding hospital. But their psychiatry department totally sucks. Id use Baptist hospital as my number one choice for sports medicine, their Neurology department is good, cancer department is good, many departments at Baptist are outstanding. But not the psychiatry department, its below average.
I decided I will never again use a Winston Salem psychiatrist, as I dont like the general climate over there. Which is as you describe...rigid. Id recommend getting out of your area, maybe trying to find a Pdoc in Greensboro which is a more liberal city. Or maybe consider UNC psychiatry. Ive heard some decent things about UNC psychiatry. Ive told you about Duke psychiatry...its arrogant and the psychiatry department there is not up to Duke's overhyped reputation. Duke has a good ECT unit, but other than that I avoid the place.
Could you move back to New England? Boston? I really dont think you will find a psychiatrist you are crazy about in NC.
This is the end of the thread.
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