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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by zonked on May 31, 2011, at 20:01:40
Does anyone ever feel weird or guilty continuing to go into the doctor's office when treatments haven't worked?
I know you're not supposed to feel guilty if treatment hasn't worked, and I have seen no outward signs of frustration from my doctor, but I can't help but feel sorry for this person. I just keep coming back, and I'm still not well. I wonder what doctors make of treatment resistant patients.
Then again, "pathological guilt" is a symptom of depression. Argh.
-z
Posted by Phillipa on May 31, 2011, at 21:59:50
In reply to Guilt, wrt: repeated treatment failures, posted by zonked on May 31, 2011, at 20:01:40
Don't feel guilty if you followed the plan. If you were like me you should feel guilty but I don't as don't follow the docs advise. I'm very med phobic. And it's not your fault. Phillipa
Posted by floatingbridge on June 1, 2011, at 3:35:13
In reply to Guilt, wrt: repeated treatment failures, posted by zonked on May 31, 2011, at 20:01:40
Zonked, I always feel guilty. I actually have apologized when treatments fail. My pdoc has tried to help me with this, but right now, I think he is frustrated beyond his usual range. I guess I am very difficult. I tried to tell him in advance, but he insisted on learning through experience.
I'm hoping his frustration (if that's what it is) can clear up soon. He's either trying to get something through my tough skull or it's possible he's just had it. I mean, I think he thought I'd have 100% remission at one point. It's tough not to feel disappointed w/a goal like that :-/
Posted by SLS on June 1, 2011, at 5:38:36
In reply to Re: Guilt, wrt: repeated treatment failures » zonked, posted by floatingbridge on June 1, 2011, at 3:35:13
> Zonked, I always feel guilty. I actually have apologized when treatments fail. My pdoc has tried to help me with this, but right now, I think he is frustrated beyond his usual range. I guess I am very difficult. I tried to tell him in advance, but he insisted on learning through experience.
>
> I'm hoping his frustration (if that's what it is) can clear up soon. He's either trying to get something through my tough skull or it's possible he's just had it. I mean, I think he thought I'd have 100% remission at one point. It's tough not to feel disappointed w/a goal like that :-/It is polite not to disappoint people, especially doctors.
I am sure doctors become frustrated with certain cases of illness, but not necessarily with the person presenting with it. A good doctor knows the difference. They are human, though. Their frustration can sometimes leak out for the patient to see. Of course, it often happens that we manufacture reasons to believe we are guilty of disappointing when no disappointment exists. A depressive illness is capable of warping perceptions. So is the history of psychosocial stresses that influence one's personal growth and maturation. Do you really see frustration in your doctors countenance? Perhaps you are seeing a reflection of your own fears and insecurities.
Reality check!
- Scott
Posted by floatingbridge on June 1, 2011, at 6:01:35
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by SLS on June 1, 2011, at 5:38:36
I see him Thursday. Have reviewed a letter and have finally boiled the query down to something like 'is there something you are trying to tell me that I am missing?
I don't mind frustration half as much as miscommunication.
Wish me Luck--and Thanks for the reality check :-)
Posted by SLS on June 1, 2011, at 7:35:05
In reply to Re: Guilt, wrt: repeated treatment failures » SLS, posted by floatingbridge on June 1, 2011, at 6:01:35
> I see him Thursday. Have reviewed a letter and have finally boiled the query down to something like 'is there something you are trying to tell me that I am missing?
>
> I don't mind frustration half as much as miscommunication.
>
> Wish me Luck--and Thanks for the reality check :-)
LUCK!I agree that it is important that you clear up any miscommunications. I hope that your planned query yields understanding.
- Scott
Posted by europerep on June 1, 2011, at 8:17:26
In reply to Re: Guilt, wrt: repeated treatment failures » zonked, posted by floatingbridge on June 1, 2011, at 3:35:13
If I were a doctor, treatment-resistant patients (who do cooperate) would be my favorite patients. Just handing out Prozac or Zoloft scripts all day would feel so boring. I would want to work with patients, take time to hear their experience with drugs - both prescribed, non-prescribed and illicit -, read journal articles to come up with new ideas and all that.
But I admit, if real docs like those exist, they are probably rare.
Posted by floatingbridge on June 1, 2011, at 10:57:46
In reply to Re: Guilt, wrt: repeated treatment failures, posted by europerep on June 1, 2011, at 8:17:26
europerep, did you manage to slip the yoke of guilt? :-)
Posted by Solstice on June 1, 2011, at 12:42:49
In reply to Re: Guilt, wrt: repeated treatment failures » zonked, posted by floatingbridge on June 1, 2011, at 3:35:13
fb - maybe when you see him next, just tell him plainly that you feel guilty about the treatment failures, and are worried that he is frustrated with you. Most probably, he is frustrated that he hasn't found the answer - and it's NOT directed at you. He likely doesn't even realize that his frustration (with his own limitations) is being felt by you... and it hasn't even occurred to him that his not putting words to it is leaving you to your own devices to interpret what his frustration means. If you tell him very plainly and simply how you're interpreting what you sense in him, you'll be able to walk out of there feeling much better! Let us know how it goes when you see him next!Solstice
> Zonked, I always feel guilty. I actually have apologized when treatments fail. My pdoc has tried to help me with this, but right now, I think he is frustrated beyond his usual range. I guess I am very difficult. I tried to tell him in advance, but he insisted on learning through experience.
>
> I'm hoping his frustration (if that's what it is) can clear up soon. He's either trying to get something through my tough skull or it's possible he's just had it. I mean, I think he thought I'd have 100% remission at one point. It's tough not to feel disappointed w/a goal like that :-/
Posted by floatingbridge on June 1, 2011, at 13:06:30
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by Solstice on June 1, 2011, at 12:42:49
Sol, thanks!
:-)
Posted by floatingbridge on June 1, 2011, at 13:13:35
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by Solstice on June 1, 2011, at 12:42:49
Sol, this seems so much like a basic parenting skill. Life skill I suppose with anyone.
My cbt coach was very, very good at reducing 'problems' back to basic communication glitches. After a moment's thought, I really want to thank you again.
fb
Posted by europerep on June 1, 2011, at 13:32:32
In reply to Re: Guilt, wrt: repeated treatment failures » europerep, posted by floatingbridge on June 1, 2011, at 10:57:46
> europerep, did you manage to slip the yoke of guilt? :-)
Haha, I guess I prefer to distribute it rather than take it on me:
that university doctor who didn't even know, and refused to believe, that buprenorphine was used in treatment-resistant depression ---> idiot
that professor who told me they stopped prescribing MAOIs 20 years ago ---> not worthy of neither her MD nor her professorshipand so on...
Matter of fact though, these doctors *really* were idiots. I have had an email correspondence with a very friendly Harvard psychiatrist who I asked for advice based on a paper he published, and he was very nice and helpful. If I was actually being treated by him, or someone like him, I might well be feeling differently about the treatment and how it went.
Thus, in a way, I can be thankful for the fact that the doctors I have had were ignorant jerks ;-).
Posted by sigismund on June 1, 2011, at 14:31:14
In reply to Re: Guilt, wrt: repeated treatment failures, posted by europerep on June 1, 2011, at 8:17:26
>if real docs like those exist, they are probably rare.
I have met one. Absolutely not a psychiatrist but an integrative doctor. He likes solving puzzles, or (as often as not) not explaining them away.
Posted by zonked on June 1, 2011, at 15:15:03
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by SLS on June 1, 2011, at 5:38:36
Scott,
That post really resonates. I actually left the doctor's office feeling hopeful, he's a compassionate guy and actually thinks my goals (a life not on disability, returning to a normal level of functioning) are attainable. I don't know if I get that kind of encouragement from anyone else in my life. Perhaps this is a wake up call--I need some more supportive people in my life, or perhaps the very people I withdraw from, whom I assume to be "fair weather" friends, would offer more support than I think.
I always assume everyone in my life is as sick of hearing about my depression as I am of experiencing it.
-z
> I am sure doctors become frustrated with certain cases of illness, but not necessarily with the person presenting with it. A good doctor knows the difference. They are human, though. Their frustration can sometimes leak out for the patient to see. Of course, it often happens that we manufacture reasons to believe we are guilty of disappointing when no disappointment exists. A depressive illness is capable of warping perceptions. So is the history of psychosocial stresses that influence one's personal growth and maturation. Do you really see frustration in your doctors countenance? Perhaps you are seeing a reflection of your own fears and insecurities.
>
> Reality check!
>
>
> - Scott
>
>
Posted by floatingbridge on June 1, 2011, at 15:19:40
In reply to Re: Guilt, wrt: repeated treatment failures » SLS, posted by zonked on June 1, 2011, at 15:15:03
Zonked,
((Yay))
fb
Posted by SLS on June 1, 2011, at 16:49:14
In reply to Re: Guilt, wrt: repeated treatment failures » SLS, posted by zonked on June 1, 2011, at 15:15:03
Zonked.
> I always assume everyone in my life is as sick of hearing about my depression as I am of experiencing it.
Ain't that the truth.
- Scott
Posted by floatingbridge on June 1, 2011, at 22:40:52
In reply to Guilt, wrt: repeated treatment failures, posted by zonked on May 31, 2011, at 20:01:40
Today I saw my new gp. She oversees my pain medication, norco, and has placed a workable cap on it. Good. She was going to oversee my xanax usage. Valium was added for emsam/general sleep issues when xanax began failing.
Previously we tried a round of doxepin which failed. Valium was her suggestion. I get pretty hysterical about
sleep--let me be up front, and I consider myself difficult.O.K. Today she tells me that I am just a person who can't take medicine. My journal book is open before us, and I say well, I tolerate these. The emsam getd me out of bed. We come to this
same place every visit.When I told her I was concerned the norco was slowly escalating, she daid, well you're not getting anymore for the month. I know, I told her, I understand. I'm not asking for more. I can make
do. What I want to ask you is what I should do if I have a pain spike. I get the same answer. Then she says, go out in nature, meditate, stop reading the blogs you read.*Sigh*
Yes, I say, I'm working on these things. But the doctor you sent me to for my back and fibro told you I would need medication going forward and that I have more pain than I can manage alone. By now she's walking out the door on to the next patient. Well, she says over her shoulder, pain can
remit.She capped my Valium script for ten pills, to take one or two as needed. She didn't renew because on two nights I had taken two. She held me to ten days. I don't know what to do. My benzo use hasn't been an issue for over ten years. I haven't abused. I tried seroquel, doxepin, amitrytline was nixed. Ambien nixed.
Why isn't my pdoc managing this anymore? Nor my emsam? I have
gotten into a ridiculous situation. How? [Rhetorical ]I tried to be clear, honest, as skillful as I could remember to be today, inspired by this thread. I did tell her I was not ready to give up xanax. That maybe it is best to
have my pdoc oversee everything except
the pain med. Fine she said. You have one emsam patch for tomorrow, right?I have never been truly afraid of doctors until I had physical pain. My self-esteem has taken some real hits. I feel like I'm
being treated like a child, and I feel
afraid like one. When my husband says,
well did you say this, it seems so clear. Like Sol's and Scott's advice. But I get thrown off. Scared.I think I need to go back to my old, disinterested gp. He didn't have much
curiosity, but he didn't have this agenda of getting me off medication. He was more sad, sort of, like oh well, some people need it. At the time I found that intolerable. I was going to whip depression. I only had intermittent pain back then.O.K. So tomorrow my pdoc. Geez. I will just carry the wisdom and skills from this thread--and my husband.
Posted by zonked on June 1, 2011, at 22:57:19
In reply to Re: Guilt, wrt: repeated treatment failures » zonked, posted by floatingbridge on June 1, 2011, at 22:40:52
fb:
Perhaps you need new doctors.
To be clear: you have the same MD treating both your fibro and your psych issues?
I don't know what kind of insurance you have, or if you have the energy to hit the web for this, but you may want to consider calling around if your doc is failing to understand your pain (physical and emotional) and treat them appropriately.
You deserve better. Hang in there!
-z
Posted by floatingbridge on June 2, 2011, at 0:42:14
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by zonked on June 1, 2011, at 22:57:19
Hi zonked,
I talked to hubby, panicked, felt scared, rode the wave and came to some decisions.
My pysch will be my pysch if he's willing.
My gp I will be slowly transitioning. She's an addiction specialist--story is she
became addicted to some of her own meds and cleaned herself up. It's not my agenda.In large part this happened because of my own ambivalence about needing and taking medication. Three months off convinced me to get back on. My
husband said, just remind her of what her osteopath reported and that you don't agree. He does it with smooth force. Much more assertive. Doesn't go to the fear place I suspect triggers reactions in others.She's not all bad. She's trying to get me to Stanford's fibro doctor. I think she just has some blind spots.
Still, going round this :you can't take meds thing'.... I'm not sure I'm interested enough to take up the conversation again. I might go to my old gp for regular maintenance issues. Fingers crossed get to Stanford for pain &fibro supervision.
Thanks for speaking up. I'm feeling better now.
fb
> fb:
>
> Perhaps you need new doctors.
>
> To be clear: you have the same MD treating both your fibro and your psych issues?
>> I don't know what kind of insurance you have, or if you have the energy to hit the web for this, but you may want to consider calling around if your doc is failing to understand your pain (physical and emotional) and treat them appropriately.
>
> You deserve better. Hang in there!
>
> -z
Posted by floatingbridge on June 2, 2011, at 9:17:17
In reply to Re: Guilt, wrt: repeated treatment failures » zonked, posted by floatingbridge on June 2, 2011, at 0:42:14
You guys, this belongs on the psych web.
I just woke up from a dream about my pdoc. First ever. Not even a crazy dream.
I could see him as a person.
It was like looking at the sun. The way it is for me to really consider a person.
It's difficult for me because sometimes people are so strong yet so frail.
I know it's total projection. It was my dream, and I was the dreamer.
This also means I slept.
Posted by floatingbridge on June 2, 2011, at 19:13:23
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by floatingbridge on June 2, 2011, at 9:17:17
I am sitting in my car having finished crying. Pdoc asked me to stay so he could see me after his last session. I don't get it. Why emsam isn't a good thing? Why stick with xanax when it doesn't work? I leave town for vacation.
There is something so enormous that I am not getting. Maybe that I really need another pdoc.
I was so full of optimism today, feeling I had found my feet somewhat. Maybe my dream was misinterpreted by me. It surely was iconic.
Cr*p. Three years. Sometimes I think he walked me to the door but is not going to go through the doorway with me.
Great. What will 5:30 bring? The need for another pdoc?
My posts seem to be like this, up down. I drive myself crazy.
Posted by Phillipa on June 2, 2011, at 19:51:11
In reply to this is not going well...., posted by floatingbridge on June 2, 2011, at 19:13:23
FB what ended up happening and don't get the emsam not good for you comment as you say it helps with depression. Confused. Phillipa
Posted by floatingbridge on June 2, 2011, at 22:49:10
In reply to Re: this is not going well.... » floatingbridge, posted by Phillipa on June 2, 2011, at 19:51:11
Life is complicated. People are complicated. I really love resolution writ in capitals.
I have a pdoc that is so concerned as to what to do, treatment almost comes to an absolute standstill.
Here's the rub. He is thinking so big picture now and very concerned with the ramifications of medication on my health. He is not convinced emsam is the best drug because it's relationship to amphetamines (probably why I respond) not because of abuse but long term affect on sleep and fibromyalgia.
To make a long story short, he sat and listened to me just talk about things he hadn't heard before. I just talked and he really listened. He seems to be reassessing in a triage way. Sleep trumps panic. I reset by sleeping. We finally got that information. Before I ever took any medication, I held out to my late thirties he asked how did I manage. Sleep. I would get so overwhelmed, if I could sleep, everything would be better. So he began to understand my desperation around having any f*cking sleep aid. And he got me to see that my desperation alarmed him and that it drives much of my decision making.
When I told him about walking me to the door but not going through, he asked me what was there. I said I don't know, I haven't been through. He said now we're getting closer to partnership. *Sigh* And amitrptilyne is not out of the picture anymore.
Signing off after one hell of a day.
Posted by zonked on June 2, 2011, at 23:03:42
In reply to well, it went, posted by floatingbridge on June 2, 2011, at 22:49:10
Just curious, did you ever write professionally for a living? Your posts have a poetic touch - I wanted to let you know that =)
Hang in there...I'm pulling for you.
-z
> Life is complicated. People are complicated. I really love resolution writ in capitals.
>
> I have a pdoc that is so concerned as to what to do, treatment almost comes to an absolute standstill.
>
> Here's the rub. He is thinking so big picture now and very concerned with the ramifications of medication on my health. He is not convinced emsam is the best drug because it's relationship to amphetamines (probably why I respond) not because of abuse but long term affect on sleep and fibromyalgia.
>
> To make a long story short, he sat and listened to me just talk about things he hadn't heard before. I just talked and he really listened. He seems to be reassessing in a triage way. Sleep trumps panic. I reset by sleeping. We finally got that information. Before I ever took any medication, I held out to my late thirties he asked how did I manage. Sleep. I would get so overwhelmed, if I could sleep, everything would be better. So he began to understand my desperation around having any f*cking sleep aid. And he got me to see that my desperation alarmed him and that it drives much of my decision making.
>
> When I told him about walking me to the door but not going through, he asked me what was there. I said I don't know, I haven't been through. He said now we're getting closer to partnership. *Sigh* And amitrptilyne is not out of the picture anymore.
>
> Signing off after one hell of a day.
Posted by floatingbridge on June 2, 2011, at 23:32:46
In reply to Re: Guilt, wrt: repeated treatment failures » floatingbridge, posted by floatingbridge on June 2, 2011, at 9:17:17
I am sitting in my car having finished crying. Pdoc asked me to stay so he could see me after his last session. I don't get it. Why emsam isn't a good thing? Why stick with xanax when it doesn't work? I leave town for vacation.
There is something so enormous that I am not getting. Maybe that I really need another pdoc.
I was so full of optimism today, feeling I had found my feet somewhat. Maybe my dream was misinterpreted by me. It surely was iconic.
Cr*p. Three years. Sometimes I think he walked me to the door but is not going to go through the doorway with me.
Great. What will 5:30 bring? The need for another pdoc?
My posts seem to be like this, up down. I drive myself crazy.
This is the end of the thread.
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