![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Karen44 on July 23, 2006, at 23:07:52
I am not sure what to do about my medications as my psychiatris is saying that maybe I should find someone else. I am not sure where to even look as everyone I have checked so far is booked up. Is it safe to just go off of Lamictal cold turkey if I run out and don't have anyone to prescribe it?? Isn't it unethical for a psychiatrist to just abandon a patien without a referral????
Karen
Posted by UgottaHaveHope on July 24, 2006, at 2:12:09
In reply to What to do about med's when Pdoc abandons you, posted by Karen44 on July 23, 2006, at 23:07:52
Sounds like you and your xpoc have had a challenging relationship. I would just walk away and dont look back. If you didnt like he or she, you would probably not like their recommendation either.
what major city do you live near? perhaps ppl on here can help. or look in the phone book. or call someone in your community and ask them.
Posted by SLS on July 24, 2006, at 3:39:56
In reply to What to do about med's when Pdoc abandons you, posted by Karen44 on July 23, 2006, at 23:07:52
If you don't have refills on your prescriptions, and you have no intention of returning to this doctor, I would call the doctor's secretary, explain the situation, and ask that prescriptions be called into the pharmacy until you can find a new doctor. You could, of course, use a GP to prescribe these medications by showing him the presription bottles or by having him consult with your ex-pdoc. The GP might also be a source of a referral.
Lamictal, being an anticonvulsant, carries the risk of producing a seizure if discontinued abruptly. I have seen it tapered rapidly, though. The problem with this, though, is that it often produces a rebound depression or worsening of depression. Still, you can use all the help you can get, and cannot afford to make things worse. It is difficult to know whether or not Lamictal is helping.
What other drugs are you taking?
Perhaps you don't have to cut off your relationship with this doctor just yet. Maybe you can use him as a sort of home-base until you find someone else. In the meantime you can begin the process of searching for another doctor. People here can advise you on how to go about doing that.
- Scott
Posted by Crazy Horse on July 24, 2006, at 8:44:29
In reply to Re: What to do about med's when Pdoc abandons you, posted by SLS on July 24, 2006, at 3:39:56
> If you don't have refills on your prescriptions, and you have no intention of returning to this doctor, I would call the doctor's secretary, explain the situation, and ask that prescriptions be called into the pharmacy until you can find a new doctor. You could, of course, use a GP to prescribe these medications by showing him the presription bottles or by having him consult with your ex-pdoc. The GP might also be a source of a referral.
>
> Lamictal, being an anticonvulsant, carries the risk of producing a seizure if discontinued abruptly. I have seen it tapered rapidly, though. The problem with this, though, is that it often produces a rebound depression or worsening of depression. Still, you can use all the help you can get, and cannot afford to make things worse. It is difficult to know whether or not Lamictal is helping.
>
> What other drugs are you taking?
>
> Perhaps you don't have to cut off your relationship with this doctor just yet. Maybe you can use him as a sort of home-base until you find someone else. In the meantime you can begin the process of searching for another doctor. People here can advise you on how to go about doing that.
>
>
> - ScottYUP...everything Scott just said i agree with 100%. Be aggressive when you call your pdoc's secretary (get someone to help you if you can't, i.e., spouse, parent, sibling, etc.). Good Luck!
Monte
Posted by Phillipa on July 24, 2006, at 11:28:53
In reply to Re: What to do about med's when Pdoc abandons you » SLS, posted by Crazy Horse on July 24, 2006, at 8:44:29
I thought this was abandonment and against the medical laws? I thought a pdoc had to set you up with referrals. This subject touches a nerve with me. Love Phillipa
Posted by Karen44 on July 24, 2006, at 23:09:04
In reply to Re: What to do about med's when Pdoc abandons you, posted by SLS on July 24, 2006, at 3:39:56
> If you don't have refills on your prescriptions, and you have no intention of returning to this doctor, I would call the doctor's secretary, explain the situation, and ask that prescriptions be called into the pharmacy until you can find a new doctor. You could, of course, use a GP to prescribe these medications by showing him the presription bottles or by having him consult with your ex-pdoc. The GP might also be a source of a referral.
>
> Lamictal, being an anticonvulsant, carries the risk of producing a seizure if discontinued abruptly. I have seen it tapered rapidly, though. The problem with this, though, is that it often produces a rebound depression or worsening of depression. Still, you can use all the help you can get, and cannot afford to make things worse. It is difficult to know whether or not Lamictal is helping.
>
> What other drugs are you taking?
>
> Perhaps you don't have to cut off your relationship with this doctor just yet. Maybe you can use him as a sort of home-base until you find someone else. In the meantime you can begin the process of searching for another doctor. People here can advise you on how to go about doing that.
>
>
> - ScottI have only got part of a starter packet. I don't have a script, and so I am worried about what could happen when that is done. He won't take any messages from me, but I am supposed to see him on August 4th. He does therapy with me as well, or at least tries. I think he should stick to medications and consultation-liason psychiatry. He's not the best therapist in the world, not even close, but I have borne my soul to him and discussed things I never discussed before, and so it is very difficult for him to say we are at an impasse, and so I should find someone else to see. This is the same person who several months ago said I was working really hard and had made progress faster than he would have expected. I am really confused and feel like sh*t because the Lamictal is not helping. I am on the second week of 25 mg. per day. Perhaps that won't cause problems if I have to quit. He told me to go to the University of Chicago Hospital if I thought I needed to be in the hospital. He used to be there, and I was there for one week a year ago. He knows how horrible the experience was, given that they had sex offenders on the unit who were scaring the crap out of the students from U of C who were patients there. I reported it, and things did change, but the nursing staff were pissed with me for making sure their little darlings were removed from the unit. Enough. I am off topic. I was thinking I would beg and not let him ever see my anger (the reason he thinks we are at an impasse - becuase of my strong feelings toward him. It is just hard to change and basically have a doctor say, I don't want to work with you anymore. You put me in a bind, and so I can't help you. If he is going to do therapy, then he should understand what that is all about. Thanks to all; I may have to see if another doctor will prescribe something. In the meantime, I am so damn depressed I can hardly stand it, and I have to go into the University of Chicago Hospital Thursday for a broncoscopy because I have been coughing up blood. CT says not cancer. Thanks to all; my psychiatrist just has bad timing--starting a new med and extremely depressed, my brohter died last week, and I am going in for this damn procedure, and now my psychiatrist says don't darken my doorstep. He told me if this new doctor can't work with me, then I need to find someone who can.
Posted by Karen44 on July 24, 2006, at 23:13:08
In reply to Re: What to do about med's when Pdoc abandons you, posted by Phillipa on July 24, 2006, at 11:28:53
> I thought this was abandonment and against the medical laws? I thought a pdoc had to set you up with referrals. This subject touches a nerve with me. Love Phillipa
I thought so too; I'm supposed to find someone on my own. Found one who might be able to see me; that remains to be seen. Med's will run out in three weeks, and if he doesn't give me a prescription then, what??? I know one doctor at University of Chicago who might prescribe med's and who could do therapy with me too, but I am damned if I will go all the way from the Illinois-Wisconsin State line all the way down to the South side of Chicago to see someone weekly. It has been bad enough going to the north side of Chicago to see this psychiatrist.
Karen
Posted by UgottaHaveHope on July 25, 2006, at 1:32:51
In reply to Re: What to do about med's when Pdoc abandons you, posted by Karen44 on July 24, 2006, at 23:13:08
Hes great at referrals. Ask him who he knows in your area. He responds to emails
Posted by SLS on July 25, 2006, at 6:47:17
In reply to Re: What to do about med's when Pdoc abandons you, posted by Karen44 on July 24, 2006, at 23:09:04
> He won't take any messages from me, but I am supposed to see him on August 4th.
Has he taken messages from you in the past?
> I am really confused and feel like sh*t because the Lamictal is not helping. I am on the second week of 25 mg. per day. Perhaps that won't cause problems if I have to quit.
Yeah. I think you can just stop taking it if that is your wish.
What was the rationale for going with Lamictal? Are you taking anything else?
> He told me to go to the University of Chicago Hospital if I thought I needed to be in the hospital.
Do you think that this was his way of relieving himself of you?
> In the meantime, I am so damn depressed I can hardly stand it,
Even if you were to continue with the Lamictal, it is unlikely that you would feel any persistent improvement for several weeks, although some people do experience brief bursts of improvements at 50mg. Unfortunately, you are at a point in pharmacotherapy where just about any antidepressant you start is going to take a minimum of 3 weeks to work if you are lucky. If you are nearing a crisis point and need something that will give you some relief immediately, you can go with Zyprexa temporarily. The other thing I had thought is to go with Emsam. It seems to provide a very quick energizing effect that begins within days of starting treatment. If you are not nearing a crisis point, however, it might be better for you to allow yourself more time to more carefully plan treatment strategies.
> and I have to go into the University of Chicago Hospital Thursday for a broncoscopy because I have been coughing up blood.
I hope it is just a simple and passing viral infection.
I'm sorry about your brother.
I get the impression that your depression has been exacerbated by the situational stresses that have been placed upon you. The world has become a much more desolate place for you to live in. This is a time when it is critical to open up your bag of coping tools and use them as best you can. It would be convenient if an antidepressant were to begin working right now, as it would make things much easier to deal with, but this is not the case. Know that you have people you can rely on for support and advice. You don't have to go through this alone.
- Scott
Posted by Karen44 on July 25, 2006, at 22:41:32
In reply to Re: What to do about med's when Pdoc abandons you, posted by SLS on July 25, 2006, at 6:47:17
> > He won't take any messages from me, but I am supposed to see him on August 4th.
>
> Has he taken messages from you in the past?
>
> > I am really confused and feel like sh*t because the Lamictal is not helping. I am on the second week of 25 mg. per day. Perhaps that won't cause problems if I have to quit.
>
> Yeah. I think you can just stop taking it if that is your wish.
>
> What was the rationale for going with Lamictal? Are you taking anything else?
>
> > He told me to go to the University of Chicago Hospital if I thought I needed to be in the hospital.
>
> Do you think that this was his way of relieving himself of you?
>
> > In the meantime, I am so damn depressed I can hardly stand it,
>
> Even if you were to continue with the Lamictal, it is unlikely that you would feel any persistent improvement for several weeks, although some people do experience brief bursts of improvements at 50mg. Unfortunately, you are at a point in pharmacotherapy where just about any antidepressant you start is going to take a minimum of 3 weeks to work if you are lucky. If you are nearing a crisis point and need something that will give you some relief immediately, you can go with Zyprexa temporarily. The other thing I had thought is to go with Emsam. It seems to provide a very quick energizing effect that begins within days of starting treatment. If you are not nearing a crisis point, however, it might be better for you to allow yourself more time to more carefully plan treatment strategies.
>
> > and I have to go into the University of Chicago Hospital Thursday for a broncoscopy because I have been coughing up blood.
>
> I hope it is just a simple and passing viral infection.
>
> I'm sorry about your brother.
>
> I get the impression that your depression has been exacerbated by the situational stresses that have been placed upon you. The world has become a much more desolate place for you to live in. This is a time when it is critical to open up your bag of coping tools and use them as best you can. It would be convenient if an antidepressant were to begin working right now, as it would make things much easier to deal with, but this is not the case. Know that you have people you can rely on for support and advice. You don't have to go through this alone.
>
>
> - Scott
ScottYes he has taken messages from me in the past, even emails. No more.
Yes; going off Parnate, my brother dying, the pulmonary problems have contributed to stress, and now I feel I am being kicked when I am down. I would rather be dead than ever go back to the psy unit at the Univ of Chicago. It sucks big time. And my current doctor knows it. He used to be at Univ of Chicago. My husband says I am probably better off with out him. He does tend to be rather condesending about other psychiatrists as if he is supererior to them. This includes pdocs at the University of Chicago. I think my telling him he was narcissistic and not a team player, that he doesn't stay anywhere very long pissed him off even though he denys it. Thanks for the support. I am doing better. Time and distance heals. unfortunately what I am doing is just numbing myself. Thanks to all.
Karen
Posted by Dinah on July 26, 2006, at 7:54:33
In reply to What to do about med's when Pdoc abandons you, posted by Karen44 on July 23, 2006, at 23:07:52
It's just a short term fix, but when I lost most of my doctors recently, the remaining ones agreed to prescribe my ongoing meds until I could find replacements. If you call your internist and tell him/her that you need a Lamictal prescription until you're able to find a new pdoc, it should work. It worked for me. They know that pdoc waiting lists aren't short, although maybe that's different where you are.
Posted by Enigma on July 26, 2006, at 12:12:04
In reply to What to do about med's when Pdoc abandons you, posted by Karen44 on July 23, 2006, at 23:07:52
> I am not sure what to do about my medications as my psychiatris is saying that maybe I should find someone else. I am not sure where to even look as everyone I have checked so far is booked up. Is it safe to just go off of Lamictal cold turkey if I run out and don't have anyone to prescribe it?? Isn't it unethical for a psychiatrist to just abandon a patien without a referral????
>
> KarenI've been dumped by at least 2 doctors now, and have horror stories about other doctors. Some seem to actually "take offense" at my being treatment resistant, among other things.
If I say what I really thought about these "doctors", I'd get banned from the board. I'm just getting ripped thinking about these "people".
Anyway, I urge *everyone* with a bad experience to do all of the following. Enough is enough already.
1) Ask their office for a review form for that doctor and rip them a new one on the review
2) Ask to speak to their boss. They most likely have one, depending if is a large office or not. Some small private practices don't apply of course (they are their own boss)
3) Register a formal complaint with the medical board in your area and/or find other ways to register a complaint.
4) If you have a valid case of neglect, and such, sue the pants off them. I normally hate our "sue everyone for everything" culture here in the U.S., but some doctors really deserve it - malpractice is REAL.
5) Keep good notes of your visits - keep a log of everything - when you got meds, what you got, why you got it, what you told them, what they told you, etc. (this should be #1).
Again, enough is enough. p-docs, from my experience, well, like I said, I'll get banned if I really say how I feel. I've been to enough of them that it makes my arguments against them statistically valid. e.g. I'm not complaining about *1-2* bad doctor here...
Posted by Phillipa on July 26, 2006, at 12:33:35
In reply to Re: What to do about med's when Pdoc abandons you » Karen44, posted by Dinah on July 26, 2006, at 7:54:33
I'm in the same position. Mine gave me a script for 30 days and said I could call him with any problems. But to get a second opinion. He wanted to dump me as he wanted to give me 80mg of geodon and I've not taken an antipsychotic. I said no the rest is history. And with medicaire the wait is six weeks after you find one for an appointment. My only option is driving 5 hours each way to my old pdoc in Greenville. Oh and that means finding someone to walk the dog and we're supposed to get the pup this weekend now what? And for it to be medical malpractice it must result in permanent and lasting damage I used to do it when working as a nurse. So in essence I agree with Dinah. As lamictal isn't a controlled substance. Love Phillipa
Posted by Karen44 on July 26, 2006, at 22:39:34
In reply to Re: What to do about med's when Pdoc abandons you » Karen44, posted by Dinah on July 26, 2006, at 7:54:33
Just to let everyone know; I am not concerned about getting a rx for the Lamictal. Worst comes to worst, I may forgo medication and seeing anyone. I am feeling less in a panic now; just said if he decides to dump me for sure. I have two more appointments scheduled with him before he goes on vacation and then I go on vacation (August 4th and August 11th for appointments). I also have an appointment with anohter psychiatrist for July 30th, this Sunday. He is someone I might be able to see or at least use as a consultant as suggested by my current psychiatrist. The issue is not so much the medications, I guess, as it is that I have been seeing him weekly for therapy as well for the past year and three months. I worked hard in therapy and made progress faster than he expected I would--he said so; now he says my strong feelings about him are getting in the way of therapy, and we are at an impasse. He is right, I hate to admit, and says if we cannot get past the impasse, then I need to find someone else. He tells me I need to get help for myself, if not from him than from someone else. He is not a complete a-hole but I would think he could figure out what my anger and demeaning of him has been about. I have figured it out--trusted him, said too much too fast, and then got scared and had to push him away. I have had some time to distance myself from what has happened as he won't let me email him anymore. I needed that so I could quit unraveling. Enough said. I think I could be okay without therapy and med's. It would just be better in the long run to do both.
Karen
This is the end of the 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.