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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by MidnightBlue on April 5, 2005, at 17:03:42
To begin with, like Spriggy I am scared to death to take "new" medicine. I have been on Depakote, Wellbutrin, Prozac, Valium, and Ambien to name a few. SSRIs kill my stomach--I have GERD--and give me migraine headaches. In the past I have been diagnosed as having severe recurrent depression. I have had many bouts through the years.
I lost all medical insurance and access to health care for the last year and a half. I weaned myself off Depakote and Wellbutrin and have made a 90 days supply of Ambien last a year. I fought to buy enough Bextra for my arthritis and Prilosec for my stomach, but could not afford psych meds. There have been many sleepless nights.
I tried to get into clinical trials to get some treatment that way, but my EKG showed frequent early ventricular beats (I had NO IDEA about this)and I was put on hold for a rTMS trial. I asked the pdoc if it could be anxiety or stress and he said no.
The research pdoc noted I had never been on an MAOI and seemed to imply that might help. When I asked him why I was never tried on that med, he said only pdocs prescribe them. Well, I have been to pdocs in the past--4 or 5. It was never suggested.
I started myself on OmegaBrite about a month ago and I'm finally up to 3 a day. My heart seems to be pounding less. I may be a bit less depressed. But I'm scared to even take fish oil!
I am hoping to have insurance again soon. It will not pay for pre-existing conditions for a year, but MIGHT if I haven't been treated for them in the last 6 months. Talking to a pdoc and having him tell you he can't treat you doesn't count does it?
Anyway, I'm guessing my internist will probably have to prescribe for me. Last time I saw him he wanted me to try Zyprexa. I couldn't make myself do it. I think I am now considered "resistant" to treatment.
As far as I know I have unipolar depression. I took 1000 mg Depakote only for migraine prevention. It never made me feel better mood wise. Two pdocs thought it was a "good" idea I take it for mood, (to provide a floor). The Wellbutrin lifted me out of a very serious depression years ago when 325 mg. desipramime couldn't. I no longer respond well to Wellbutrin. I have "turned down" Lithium and a host of other suggestions that would have packed on the pounds. If I am bipolar, it would have to be something like bipolar 2 or 3. It is hard to remember an "up" day though I have had racing thoughts and enhanced creativity in the distant past.
I'm now panicked that my husband will lose his new job and source of insurance before we even get the insurance cards. There is some basis to that in that the company he has been loaned to just bought another company and there is talk of lay offs. We have really been through the ringer with negative events the last few years.
How can you tell if you are strictly unipolar, atypical (which I think I might be--I self-medicate with sugar and caffine), or part of the bipolar spectrum? The docs don't even seem to know. And if you were afraid your spouse was going to lose his job again (he has 6 times in the past) wouldn't your mood be reactive to that?
There are so many bright, funny, and intelligent people on here. I am in awe of your knowledge. Please forgive any misspellings. My "mind" is only hitting on half the cylinders. What info can I give my internist and what can I do in the meantime? He will at least listen to me if I can ever get in to see him.
Posted by Phillipa on April 5, 2005, at 18:25:50
In reply to Where to start? (long), posted by MidnightBlue on April 5, 2005, at 17:03:42
I'm so sorry so many things are going wrong for you. I guess you want to stay away from the mental health system for insurance purposes so I can't suggest that. I guess your internist who knows you so well will be the best person to RX for you. Especially since you also have medical problems. I, too, am afraid of medications. I only trust benzos as they don't have longterm side effects. Doesn't your internist know where you might be tested for bipolar since you think you are and avoid the mental health system? Fondly, Phillipa
Posted by MidnightBlue on April 5, 2005, at 20:29:46
In reply to Re: Where to start? (long) » MidnightBlue, posted by Phillipa on April 5, 2005, at 18:25:50
Phillipa,
I don't really think I am bipolar. One pdoc said "maybe a possibility." The last one I saw (before the research guy) didn't think I was bipolar at all. I've been depressed for years. I think the research guy thinks I am atypical. I re-gained a LOT of weight the last couple of years because of depression and all the stress. And I wouldn't have qualified at all for the rTMS study (which I didn't get to actually do) if I had been bipolar. It was a resistant unipolar study.
Eventually I will probably get to see a pdoc, but it could be many months. If I can convince insurance to pay it, I'm limited to their list.
I may have to pay the entire costs of meds even if my Internist writes the RX. It could take a month or more to get in to see the internist. Sorry, fighting a migraine now and no meds to stop it! LOL Tylenol only does so much.
Thank you for responding. I have been reading this site for many weeks and just now got the courage to post.
> I'm so sorry so many things are going wrong for you. I guess you want to stay away from the mental health system for insurance purposes so I can't suggest that. I guess your internist who knows you so well will be the best person to RX for you. Especially since you also have medical problems. I, too, am afraid of medications. I only trust benzos as they don't have longterm side effects. Doesn't your internist know where you might be tested for bipolar since you think you are and avoid the mental health system? Fondly, Phillipa
Posted by Phillipa on April 5, 2005, at 20:47:24
In reply to Re: Where to start? (long), posted by MidnightBlue on April 5, 2005, at 20:29:46
Just a thought! But, I've read on here and I had a pdoc tell me also that the drug companies will assist people to buy or obtain meds if they don't have insurance and need the medications. I know my pdoc always sends me home with sample bottles of zoloft to last a month, and my last pdoc supplied all the cymbalta I took while I was on it. I'll start a Thread and ask others for the info for you. Fondly, Phillipa
Posted by Phillipa on April 5, 2005, at 20:52:13
In reply to Re: Where to start? (long), posted by MidnightBlue on April 5, 2005, at 20:29:46
I just started a Thread on obtaining meds without insurance for you. It's at the bottom of the Board now at l0pm. Hope you get some good responses. I care. Fondly, Phillipa
Posted by MidnightBlue on April 5, 2005, at 21:08:26
In reply to Re: Where to start? (long), posted by Phillipa on April 5, 2005, at 20:52:13
Thanks, but if he can KEEP it, my husband now has a good paying job and we wouldn't qualify. For the 2 1/2 years he didn't have one I tried to get meds, but was too depressed to "work the system" right.
State Rehab sent me to one pdoc who was the scourge of the earth. He tried to make my answers fit in his little tiny boxes, declared I was obese, demanded I start an Atkins diet, tried to put me on Effexor when I have borderline high blood pressure, was angry I couldn't go to a regular doc because I had no insurance and didn't qualify for medicaid, and basically was a first class turkey just like the real stuffed one he had in his office.
I begged them to send me to someone else and they wouldn't. My case worker then either quit or was fired. Never found out which. My depression worsened and that was when I started trying to get into clinical trials. Then I failed that and it got worse again. It is a BIT better on Omegabrite fish oil, but I am still plenty depressed.
Posted by Phillipa on April 5, 2005, at 21:13:42
In reply to Re: Where to start? (long), posted by Phillipa on April 5, 2005, at 20:52:13
In reply to Fellow Babbler Needs Med Help!, posted by Phillipa on April 5, 2005, at 20:50:38
> There is a Thread further up the Board that was started by a fellow Babbler. She needs help in figuring out how to obtain meds without insurance. She can't see a pdoc but must see her internist for insurance purposes. I know I've seen it posted before how someone can get assistance with obtaining p meds. Thanks, Phillipa
I don't know which of the dozens of other threads you're talking about, so I'll answer here. One stop shopping, this site includes information and applications and all you need for every low or no cost drug program in America.Best,
Lar
Posted by Racer on April 5, 2005, at 21:39:17
In reply to Where to start? (long), posted by MidnightBlue on April 5, 2005, at 17:03:42
Oh, I've got all too much to say about all this -- and am happy to compare notes on idiot pdocs who work through the county! ('Sides, I remember Midnight Blue, so had to jump in...)
Anyway, MAOIs come with a lot of lifestyle alterations -- dietary restrictions, hypo- and hyper-tensive reactions, and a host of other potentially unpleasant things. If they work for you, and they are said to be good for atypical depression, then it's worth it. If there are alternatives that work, that might be worth investigating first -- which is likely why other pdocs hadn't brought them up.
Also, a lot of younger pdocs just plain don't know enough about them anymore! MAOIs were introduced in the 1950s, and they're "dirty" drugs -- they are the hammers of the anti-depressant world, instead of the carefully calibrated socket wrenches we have now. (How did I get onto that metaphor? NOT a good one...) They hit all of the major monoamines, rather than the more selective ADs we have now.
There are a lot of meds out there, which may be very good for you. And the programs through the drug companies are cumbersome, although that's supposed to change soon, but worth it.
And the good news: at least according to my insurance -- after ten years uninsured, by the way -- depression is not considered a preexisting condition, and therefore is not excluded. The preexisting condition exclusions have specific dxs that are excluded -- not just anything you have. For instance, the ingrown toenail that has been driving me nuts for a decade was not excluded; my arthritis is not excluded; my husband's diabetes is not excluded; etc. Check with your insurance before you give up on getting it covered.
Oh, yeah, and my husband works for a company in Texas that keeps playing PacMan -- running around gobbling other companies. I think they do it because they can have so much fun laying people off... That worry sucks a lot.
Posted by MidnightBlue on April 5, 2005, at 22:20:14
In reply to Re: Where to start? (long) » MidnightBlue, posted by Racer on April 5, 2005, at 21:39:17
Oh Racer,
You are giving me a bit of hope! Depression NOT pre-existing? I hope, I hope! NOW MAIL ME MY INSURANCE CARD or at least give me the group number! (Not you of course--hee-hee) I am supposedly "covered" right now. Just can't convince a doctor of that.Question: you remember Midnight Blue? Was there someone else here by that name? If so, I apologize, it didn't show the name as taken and I didn't see any posts under it.....
I know a good bit about MAOIs--I already pretty much follow that diet since most of those are the don't eat migraine foods. Not that I especially want to be on an MAOI, I just don't know what else to try. SSRIs and I don't seem to get along at all. Wellbutrin quit working, desipramine never did work, had bad side effects from other TCAs. I've been "playing this game" almost thirty years.
I used Christmas and birthday gift money to buy Bexta-- I have major back problems and arthritis.
I just want to go on the record as saying my husband is a loving, hard working, guy who has been chewed up and spit out by too many PacMan companies. It isn't his fault at all.
Posted by Racer on April 6, 2005, at 1:24:45
In reply to Re: Where to start? (long) » Racer, posted by MidnightBlue on April 5, 2005, at 22:20:14
LOL! No, if there had been a Midnight Blue here, you couldn't have used the name. It was a TV show in New York, years back, late night -- naughty TV show...
And I do understand about your hubby. Mine hadn't had to look for a job since he was 18! And we is middle aged now. Since then, he's only changed jobs under two circumstances: About a decade and a half ago, he was "poached" by a company -- which probably wouldn't have happened if this job hadn't been in the US, when he wanted to move here -- and when the company he worked for was acquired by another. Those are the only job changes he'd made since 18. Being laid off was a real shock to the system, let me tell you.
And, since we're talking high-tech, about half the people I know in this area have had the same experience -- right down to the new jobs that last three months or less. (My hubby's first new job lasted six weeks -- until the parent company found out what health insurance would cost in the US and shut the office that day!)
Sorry about what you're going through. I can only say that the preexisting condition list didn't seem to have any chronic problems on it -- mostly acute things.
To keep this med related, have you tried Effexor or Cymbalta? Or maybe Remeron? Or a combination that might target specfic symptoms? You said that Wellbutrin had worked, maybe combining it with something else would help it kick in again?
Take care.
Posted by MidnightBlue on April 6, 2005, at 10:54:56
In reply to Re: Where to start? (long) » MidnightBlue, posted by Racer on April 6, 2005, at 1:24:45
I've had a couple of people mention Effexor. One is a psychologist friend. The last was this wacky pdoc. My concern with Effexor is that it can raise blood pressure and mine is already on the high side. In fact they will probably put me on blood pressure meds whenever I can get a doc to see me.
One pdoc wanted to put me on Remeron but I was really fighting weight loss at the time. I had struggled to lose 80 pounds and didn't want to pile it back on. End result was I became so depressed I regained the 80 lost pounds plus a few more. Then, too, like Spriggy I was scared to death to swallow something new.
I don't know much about Cymbalta. I think it is too new since I haven't seen a doctor in 18 months. We tried combinding Wellbutrin with SSRIs and I just can't take them.
Sorry, I don't know anything about a tv show Midnight Blue. I picked the name because I'm a night person and it seems like I'm always blue!
Posted by Racer on April 6, 2005, at 15:11:22
In reply to Re: Where to start? (long), posted by MidnightBlue on April 6, 2005, at 10:54:56
Cymbalta is very new -- approved in August 2004. Like Effexor, it is a dual action NE/5HT reuptake inhibitor, but unlike Effexor it's more balanced. For me, it's worked about as well as Effexor -- thankfully at much lower doses! -- but I've still needed augmentation. In fact, I'm not sure that it's doing much of anything, but my pdoc likes it so...
There's no word yet on whether Cymbalta raises BP, but I know that it's being watched for. I'm sure by now someone has some idea about it. The good news, of course, is that if you have any anxiety problems the BP meds may help with it. (I took propranalol for a while -- LOVED it! Miracle drug, for my anxiety.)
Good luck.
Posted by MidnightBlue on April 6, 2005, at 15:50:49
In reply to Re: Where to start? (long), posted by Racer on April 6, 2005, at 15:11:22
Racer,
I absolutely HATED propranalol. I took it many years ago to try to prevent migraine headaches. It drastically lowered my top blood pressure number, but didn't touch the bottom one. I felt dizzy and like I was walking slow motion through molasses. It also made my depression worse. Calcium chanel blockers were similiar.
I seem to be VERY sensitive to anything that even "might" cause depression. That includes most blood pressure medications. Provera, the hormone sometimes given to women, makes me want to jump right out a window. I have to be very careful about meds.
I might be willing to try Cymbalta as long as I can sit in the parking lot of an ER like Spriggy!I have heard it can help with chronic pain and I am always hurting somewhere.
Posted by ed_uk on April 6, 2005, at 16:05:19
In reply to Re: Where to start? (long), posted by MidnightBlue on April 6, 2005, at 15:50:49
>I absolutely HATED propranalol.
LOL I also hated propranolol, it made me soooo fatigued I could hardly move! It didn't help my anxiety one bit!
Ed.
Posted by Racer on April 6, 2005, at 17:41:20
In reply to Re: Where to start? (long), posted by MidnightBlue on April 6, 2005, at 15:50:49
>>I have heard it can help with chronic pain and I am always hurting somewhere.
Yes, it can help with pain. I have arthritis, and it helps with the joint pain. It hasn't helped the other kind of pain I get, which is more like nerves being irritated? Can't describe it, but it's yucky. The joint pain, though, is a nice thing to have it help with...
This is the end of the thread.
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