![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 43. Go back in thread:
Posted by ChicagoKat on October 11, 2012, at 13:09:00
In reply to Last time I Ask for Med Advise As Know Some Get Fr, posted by phillipa on October 11, 2012, at 12:26:46
Oh Phillipa, your post made me feel so sad for you :( It really sucks you've lost your sense of taste and smell, and I certainly know of no med that could help with that. But I am gonna offer some advice as to your other issues.
1. You need a new pdoc, no doubt about it. Your current one sounds like an uncaring idiot.
2. Do you get your thyroid levels checked regularaly? If not, you really should, levels can change a lot, and as you probably know, your thyroid pill (is it synthroid=levothyroxine? I'm guessing it is, if not, it should be), but anyways, your thyroid pill has a very narrow therapeutic index. Given the symptoms you are describing it sounds like it's possible your levels are too high. Is there a reason you can't take it in the morning? Cos it can really wreck sleep. And fyi, you probably know this, but if your levels ARE too high, it can be contributing to anxiety. And if the levels go too low, that can make depression worse. So it's really important to have levels checked regularly, But I have just remembered that you are a nurse and you probably already know all this, if so, I apologize! :P
3. Have you ever tried Nardil? It's an MAOI that blows anxiety out of the water, for me at least,and I've heard others say the same. I think it was Scott who told me the mechanism of how this works; something to do with GABA, and I was told it's the only MAOI that does this. Point is it really helps with anxiety, and it helps a LOT with depression too. Only problem is, MAOIs like Nardil are a pain in the *ss, what with washouts and food and drug iinteractions. But IMO Nardil is WELL worth the trouble.
4. What do you take for your arthritis? Have you tried Mobic? I've taken it before for my arthritis and it really helped. Yes, I am 20yrs younger than you and I already have arthritis. Unfortunately, it runs in the family and gets pretty severe by the time one gets older. But, no matter; above all, I SO wish I could give you those 20yrs you want back!
5. I'm sorry, that's the only advice I have. Hopefully one of our resident experts like Scott will chime in. But I am curious...you mentioned Greenville...do you live in Mississippi? My Dad used to live there; he was in Starkville, and I always loved so much to visit him there, especially during the winter!!!
I really hope you can find some answers. I hope my post helped, even if only a little bit. Hang in there and take care of yourself.
Kat
Posted by gadchik on October 11, 2012, at 13:49:25
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » phillipa, posted by ChicagoKat on October 11, 2012, at 13:09:00
P,I think Kat made some great points. And my heart is breaking for you. I also would love to give you 20 yrs. But none of us can get that. Doesnt cymbalta help with pain? I just dont know.I would try cognitive behavorial therapy just a few sessions to see if it can help. Also have you ever gotten a massage? Its a small thing,but could help with pain,hot stone massage is truly helpful to me.I have also been reading about acupuncture really helping with pain.And soak in a hot epson salt bath at night,after your exercise.
Posted by phillipa on October 11, 2012, at 20:50:30
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by gadchik on October 11, 2012, at 13:49:25
Thanks guys. I kindda had to say what I'm feeling. With taste & smell Maois would be out as would restrict too much. No this is NC and Greenville is there. Also one in SC.
I know that cymbalta is there. And the same with the minocycline despite the dizziness and I forgot the other side effect of the 4 doses. Don't want to get graphic but first normal BM in years yes also IBS.
Cymbalta before I knew too much but not enough didn't bother me a bit. I have a facebook friend from HS whos husband is a pdoc and uses a lot of natural products in his practice. I also will write her and see what her husband would advise. He did advise going to Duke as seems they are also going natural. Arthritis stinks and will have to look up mobic. Thanks Guys!!!
Posted by Twinleaf on October 12, 2012, at 9:28:36
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » gadchik, posted by phillipa on October 11, 2012, at 20:50:30
I think most people here on Babble would breathe a sigh of relief if you got rid of your present pdoc. He doesn't have any creative prescribing ideas, and sounds very difficult to talk to. Just because you ruminate about medications or negative issues in your life doesn't mean you have OCD - it is what happens to all of us when we are depressed. It sounds like a moderate degree of depression and a lot of situational anxiety are your main issues ( as they are with most of us)
I think it would be great to try to find a good pdoc at Duke. They have an outstanding reputation, and are leaders in neuropsychiatry. It would be great to find a pdoc and just form a relationship first- maybe talk over the medications and natural supplements but not rush into too many changes. I think you really do need a doctor you can respect, trust and develop a relationship with. Once that happens, other good things can start to happen.
How far away is Duke from you?
Posted by brynb on October 12, 2012, at 10:15:26
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by Twinleaf on October 12, 2012, at 9:28:36
Posted by Beckett on October 12, 2012, at 16:50:13
In reply to I second Twinleaf's suggestion (nm), posted by brynb on October 12, 2012, at 10:15:26
Me too Phillipa. I really wish you the best.
Posted by Beckett on October 12, 2012, at 16:54:05
In reply to I second Twinleaf's suggestion (nm), posted by brynb on October 12, 2012, at 10:15:26
Me too Phillipa. I really wish you the best.
Posted by phillipa on October 12, 2012, at 20:35:33
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by Twinleaf on October 12, 2012, at 9:28:36
About 4 hours away. If only my old pdoc didn't retire. I liked her as she collaborated with me. Would let me try whatever I wanted.I seriously hate this state and always have. Phillipa
Posted by CaffeinePoet on October 13, 2012, at 7:37:36
In reply to Last time I Ask for Med Advise As Know Some Get Fr, posted by phillipa on October 11, 2012, at 12:26:46
> Well here goes I know I've asked many times about meds and haven't listened. I admit this. No excuses just the reason. First OCD leaves me feeling I must be in Control. Fear Is a Large Component. That dates back to docs that took me off meds that worked and then gave me meds that ended up causing side effects that were intolerable to me. And then when tried to return to the one that worked it didn't. Now after 43 years I keep cutting down on the xanax & valium at night. .25mg xanax & 5mg of valium. And the forever luvox 50mg as this is the only ad that never caused a side effect for me. Been on low dose for I would guess 11 years top. I did add the 2.5mg of lexapro which I go off and on as note nothing. I'm getting old 66. Got the aches & horrific pain of arthritis in back and osteoporosis. Still test positive for lymes but as dumb as it sounds here they will not recognize it. Doc in Greenville does but 6 hours away. So I don't know if all these things factor in. The biggest factor is the thyroid pill I take during the night when wake. Until then I'm okay. But when get up feel so horrible I can barely function. I blow things so out of proportion it's not funny. As the day goes on if I leave and get out with husband as get so fearful without him I can't. I've tried. So if I take no meds during the day and ride bike in early evening. Get pain then. But still feel relieved the day is almost over. Add to this the 9 years of no taste & smell and yes 4 specialists there is absolutely no pleasure in my life. As eat the same things daily and then get so depressed brush teeth to wipe the thought of food away. So I stick with what I know. I cancelled pdoc appointment today as why go he doesn't care and offers nothing but do the same. And reenforces in me I have ocd. Only the anxiety part with ruminating. So I ask for last time that maybe I missed something and someone will pick it up. Still have minocycline here and yes it's fresh. Did get dizzy and since hasimotos thyroiditis I read that a false lupus and black skin can occur with that. Also think of cymbalta. But then remember the two weeks with no sleep on high doses of benzos when the other pdoc here took me off luvox for a baseline and only when I went back on the luvox did I sleep.Any thoughts. If I could have anything it would be to be 20 years younger and again have the luxary of being able to taste food and eat chips & salsa and read. Now it grief over losses of this and life getting shorter. Thanks enough of your time. Thanks Phillipa
I have read about lost of taste and smell as a symptom of depression. I know that you trust the Luvox, but maybe it has worn off or needs a higher dose?
Best of luck with finding a new health care practitioner. I know what it's like to have those stubborn ones.
Posted by Twinleaf on October 13, 2012, at 9:58:19
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » Twinleaf, posted by phillipa on October 12, 2012, at 20:35:33
Four hours sounds like it would be worth it. You only need to go a few times a year. Isn't Duke in the forefront of safe, promising developments such as TMS? They might have some good ideas about effective treatments which would include your need for safety - a very important consideration when you have symptoms of only moderate severity.
Are you considering looking for a pdoc who is on the faculty there?
Posted by SLS on October 13, 2012, at 10:11:19
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by Twinleaf on October 13, 2012, at 9:58:19
I like the Duke idea.
Phillipa, at the very least, you could go for a consultation and also ask for recommendations of physicians in your area. The doctors at Duke may know someone located closer to where you live.
Of course, you could live out the rest of your days as you are now. Perhaps this isn't such a bad thing. Perhaps it is best to leave things as they are. Things could be worse, right?
You could lose another 20 years if you allow it.
- Scott
Posted by phillipa on October 14, 2012, at 0:31:48
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » Twinleaf, posted by SLS on October 13, 2012, at 10:11:19
Sorry haven't been here all day went to the Mountains to drive and look at things. It was a pretty good day. I would be fine if could taste and smell and after two hospitals and two ENTS and MRI's there is nothing to be done about it. That is what is depressing. Loss of senses is horrible. Not going to Duke unless they can give me back taste and smell. 20 years from now I'll be dead. Short lifes in family most died of heart attacks and strokes and all had anxiety. Took benzos also. Phillipa
Posted by SLS on October 14, 2012, at 2:11:19
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » SLS, posted by phillipa on October 14, 2012, at 0:31:48
From what you have written, it sounds to me like your depression is being driven largely by psychological issues, and not by biological ones. This could account for the failure of antidepressants to help you. You may have some very destructive psychological habits that need to be addressed professionally. They will have been in place for years, so it would be unrealistic for you to think that one or two visits to a psychologist is going to treat them successfully. Your anxiety is perhaps more biological. It is appropriate to treat it aggressively pharmacologically. However, it is very likely that psychotherapy can ease your anxiety along with treating more directly the depression that you report. I can't be sure of anything, of course.
Do you feel helpless?
How long ago did you finally give up?
- Scott
Posted by Willful on October 14, 2012, at 12:17:37
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » phillipa, posted by SLS on October 14, 2012, at 2:11:19
I'm sorry about your situation, too, Phillipa, but maybe you should gird yourself and try Duke.
You're depressed and hopeless and imagining that having taste and smell would somehow make you feel better. But my guess is that is wouldn't. It would be great-- of course-- but it wouldn't change your hopelessness, your sense that no one cares, that you can't find understanding or help anywhere.
You could wonder why you don't try this idea about Duke. You said have you missed something, and I think Twinleaf's suggestion is an extremely good one. Go to Duke, meet with them and see what they have to offer, including meetings at intervals to review and monitor and discuss any changes they've been able to offer-- which you really really need to TRY-- and also see if they can refer you to a therapist in your area.
I agree with Scott that a lot of your suffering comes from long-standing and deeply rooted psychological problems that would only be alleviated by some time of working on them with someone. Even if it's more expensive than you like, if it would make you feel that your life is worth living, isn't it worth the money?
I think that you really have a hard time investing yourself in feeling better. I'm not sure why; I think those of us who are depressed have a tendency to make ourselves suffer. I say this because it that weren't true, there would be no hope of alleviating it. If the suffering is biological, then only drugs will help. But in your case, that may not be true. It seems that you do keep yourselves in this hopeless position-- whether it's to punish yourself or because you're afraid of change, or for whatever reason. And only if you begin to make some positive change-- with help--- will it change.
You could for example try to think about the good things in your life-- the blue sky, the good weather, a drive in the mountains, even a few minutes when riding your bike gave you a good feeling. I try to do this, and I know it works, even if only when you're writing it down. You can try meditating. I find this immensely helpful and you can do it at home. And there are no negative side effects. There are lots of things-- but I wonder if you can begin to have faith in them without some psychological counseling. And dont' say there's no one in your area. That cant' be true. You can find someone who can help-- if you don't give up and say things like-- well if only I could taste chips-- as if that's the best you can hope for.
You want help-- I totally believe that. But when it's offered , you don't reach out to grasp it. I think you need to figure out why you reject all efforts to help-- why no one can help you. I know I've also suffered from this problem. Others can't help if you don't let them. So you have to just go through the motions-- do some things, even if you don't believe in them-- and see if Duke, or someone in your area, or someone you have to travel to see, can make a difference. It is never too late.
Posted by jono_in_adelaide on October 14, 2012, at 18:22:17
In reply to Last time I Ask for Med Advise As Know Some Get Fr, posted by phillipa on October 11, 2012, at 12:26:46
Phillips, I dont know if this would suit you, but its an idea to chew over
For deoression/OCS, increase Luvox to 100mg/day.
If you need some more "kick" add nortriptyline or desipramine or WelbutrinFor anxiety, change your benzo to Ativan 1mg twice a day
For the arthritic pain, start taking Mobic 15mg once a day, and have Extra Strength Tylenol on hand for breakthrough pain
Best of luck
Jon
Posted by phillipa on October 14, 2012, at 21:38:32
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by Willful on October 14, 2012, at 12:17:37
I'm not imagining a thing. One of my greatest joys in life was eating simple things especially things no one else seems to like as raw cauliflower, peaches, grapes, salsa and chips reading a good book. Most of the things society revolves around is food. I dread holidays as have to pretend to taste then quickly brush teeth use dental floss and then get quickly involved in something that takes my mind off food. I'm tired of sucking on lindtt dark chocolate truffles as no taste from them anymore either. I've boiled it down to either the fact I'd just stopped biaxin xl after two years for lymes, got the lasix surgery on eyes and it jarred the encapsulated lymes cysts to attack the nueurons in nose and that is the time period it diminished day by day.I was sent to an ENT doc immediately by the lasix doc who sent me for an MRI of brain and sinuses. That's when pituitary microadenoma picked up but sinuses fine. So referred to Wake Forrest Taste & Smell Center where after all of the two days of testing completed that I should never be left alone as the example given if a a gas leak occurred I wouldn't know as I wouldn't be able to smell it. Spoiled food would never know either if ate it til got sick. I was given prednisone for two weeks to try to stimulate the neurons to regrow. Didn't work. So went to Washington DC to another Taste & Smell Center. Repeat of first only added 24 hour urine. Same results same advise. I then waited til this summer again saw an ENT and he did another MRI, scoped my nose and basically said sorry both smell & taste are gone. So take away the option of enjoying Mexican food my favorite, no restaurants no beer no corona. Zinch nothing. So when I state that taste and smell are what is depressing it's fact. As for anxiety it results from the pdoc that convinced me that what I loved nursing was too stressful for me. No what's stressful is being home. I hate being at home as it is completly boring. Add aging and the pain and the cup is full. Phillipa
Posted by phillipa on October 14, 2012, at 21:44:30
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr, posted by Willful on October 14, 2012, at 12:17:37
You have senses in your life sight, hearing, smell, touch, if you google loss of taste which is really smell as if you can not smell you can't taste you will see it's I think number 2 for senses lost and depression. I kind of chuckle as I see so many thread on libido. I could care less. That would be about the l0th thing of my list of enjoyable things. Google Anosomnia. Hold you nose for one day only and eat. Then what back how it was. Phillipa ps I will now list ebay items for the night. At least I have that it diverts me
Posted by Twinleaf on October 14, 2012, at 23:13:49
In reply to Re And, posted by phillipa on October 14, 2012, at 21:44:30
I think it is easy for each of us to imagine how terrible it is not to be able to taste or small - you have everyone's empathy and understanding on that. But everyones life, including yours, is so much more complex; many things have undoubtedly contributed to your present distress, and a number of them happened to you before you lost your taste and smell. Some things, like your anxiety and depression, and your interpersonal issues (your mother's illness and death, your estrangement from your children and the issues with your husband), you can make much better through proper medication and psychotherapy. The other issues, like aging and losses to your health can not be - not for you, and not for anyone. I am very sad to see that you can't see the difference between the real things which you can personally do to give yourself a good life, and the basic facts of aging which everyone faces. But you have shown, over and over, that you can't. So much good, caring advice has been given to you here, because you seemed to be requesting it. I think you have turned down every suggestion which was ever made! I keep thinking that, with your training and knowledge, you will readily see that the way forward for you is primarily through therapy, with the support of medications which are reasonably safe and effective. But, sadly, this is just not the case. Maybe it is better if you don't ask for advice which you have no intention of taking, or even considering.
Posted by Beckett on October 15, 2012, at 11:59:49
In reply to Re: Re And, posted by Twinleaf on October 14, 2012, at 23:13:49
Phillipa, going back to Twinleaf's first post, so much could come from replacing your current pdoc. I remember when you asked him about therapy and he said no, no therapy for you. I was shocked. Think about the Duke idea. I looked at their website. It seemed very service oriented and patient friendly. Even if you decide against Duke, I really think you need a new pdoc.
Posted by Twinleaf on October 18, 2012, at 6:30:22
In reply to Re: Last time I Ask for Med Advise As Know Some Get Fr » SLS, posted by phillipa on October 14, 2012, at 0:31:48
Looking back over this thread, I see that it started out with Phillipa explaining that she wanted to take some of the suggestions she has been given, but that fear of side-effects and of doctors making poor choices had prevented her from doing so. Several posters responded very positively to this, suggesting finding a really good pdoc, perhaps at Duke, and building a trusting relationship without making much in the way of med changes, at least at first. This really did seem to address Phillipa's real fears, and show that we understood and respected them. We have all had many of the same fears and experiences with pdoc's that she has.
I think Phillipa's fears took over once again, even with the very benign suggestions she was given, causing her to reject them.
Phillipa, would you be willing to think over the advantages for you of finding a doctor you could trust, who would understand you and work with you?
Posted by zazenducke on October 18, 2012, at 6:36:18
In reply to Re: Last time I Ask for Med Advise As Know ..., posted by Twinleaf on October 18, 2012, at 6:30:22
Posted by Twinleaf on October 18, 2012, at 6:45:29
In reply to Hi Twinny!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!. (nm) » Twinleaf, posted by zazenducke on October 18, 2012, at 6:36:18
Posted by SLS on October 18, 2012, at 8:05:49
In reply to Re: Last time I Ask for Med Advise As Know ..., posted by Twinleaf on October 18, 2012, at 6:30:22
Twinleaf:
Thanks for this.
Phillipa:I'm afraid that some of us have been very frustrated by your not finding health and happiness through what is perceived as perpetual inaction. I don't know of a single person who wishes bad upon you. The whole board cares about you - each of us in our own way. I apologize that my frustration has shown so much. I would love to somehow light a fire under your butt to motivate you seek changes in your life that will bring you happiness - if not blissful content. As Twinleaf has suggested, it may not be a lack of motivation that discourages you from making changes in your treatment, but rather, fear. I can see how fear of medication side effects would trump any motivation you have for making changes. I guess trying to light a fire under you butt accomplishes very little but to burning and hurt you. I can't promise you that I won't say the wrong things to you in the future. I can see myself continuing to be frustrated. Sorry...
:-)
- Scott
------------------------------------
> Looking back over this thread, I see that it started out with Phillipa explaining that she wanted to take some of the suggestions she has been given, but that fear of side-effects and of doctors making poor choices had prevented her from doing so. Several posters responded very positively to this, suggesting finding a really good pdoc, perhaps at Duke, and building a trusting relationship without making much in the way of med changes, at least at first. This really did seem to address Phillipa's real fears, and show that we understood and respected them. We have all had many of the same fears and experiences with pdoc's that she has.
>
> I think Phillipa's fears took over once again, even with the very benign suggestions she was given, causing her to reject them.
>
> Phillipa, would you be willing to think over the advantages for you of finding a doctor you could trust, who would understand you and work with you?
Posted by zazenducke on October 18, 2012, at 8:14:20
In reply to Re: Last time I Ask for Med Advise As Know ..., posted by SLS on October 18, 2012, at 8:05:49
Please leave your fantasies concerning Miss Phillipa's butt in the gutter where they belong. Blissfulness indeed. As if. Your frustration is no excuse. Get a grip man. This is a married lady.
>
> I'm afraid that some of us have been very frustrated by your not finding health and happiness through what is perceived as perpetual inaction. I don't know of a single person who wishes bad upon you. The whole board cares about you - each of us in our own way. I apologize that my frustration has shown so much. I would love to somehow light a fire under your butt to motivate you seek changes in your life that will bring you happiness - if not blissful content. As Twinleaf has suggested, it may not be a lack of motivation that discourages you from making changes in your treatment, but rather, fear. I can see how fear of medication side effects would trump any motivation you have for making changes. I guess trying to light a fire under you butt accomplishes very little but to burning and hurt you. I can't promise you that I won't say the wrong things to you in the future. I can see myself continuing to be frustrated. Sorry...
>
> :-)
>
>
> - Scott
>
>
> ------------------------------------
>
>
> > Looking back over this thread, I see that it started out with Phillipa explaining that she wanted to take some of the suggestions she has been given, but that fear of side-effects and of doctors making poor choices had prevented her from doing so. Several posters responded very positively to this, suggesting finding a really good pdoc, perhaps at Duke, and building a trusting relationship without making much in the way of med changes, at least at first. This really did seem to address Phillipa's real fears, and show that we understood and respected them. We have all had many of the same fears and experiences with pdoc's that she has.
> >
> > I think Phillipa's fears took over once again, even with the very benign suggestions she was given, causing her to reject them.
> >
> > Phillipa, would you be willing to think over the advantages for you of finding a doctor you could trust, who would understand you and work with you?
>
>
Posted by ChicagoKat on October 18, 2012, at 9:48:47
In reply to Sir have you no shame? » SLS, posted by zazenducke on October 18, 2012, at 8:14:20
Dear Phillipa,
I don't know you well enough to know whether anything that has been said about you is true or not. But I wanted to tell you that I care, and to let you know that I hate to see people arguing over what is best for you. I hope it doesn't upset you too much. But, whether one of the posters is right or wrong, I just truly wish for you a solution to end your suffering. I am here if you need to talk.Katxxxxx
> Please leave your fantasies concerning Miss Phillipa's butt in the gutter where they belong. Blissfulness indeed. As if. Your frustration is no excuse. Get a grip man. This is a married lady.
> >
> > I'm afraid that some of us have been very frustrated by your not finding health and happiness through what is perceived as perpetual inaction. I don't know of a single person who wishes bad upon you. The whole board cares about you - each of us in our own way. I apologize that my frustration has shown so much. I would love to somehow light a fire under your butt to motivate you seek changes in your life that will bring you happiness - if not blissful content. As Twinleaf has suggested, it may not be a lack of motivation that discourages you from making changes in your treatment, but rather, fear. I can see how fear of medication side effects would trump any motivation you have for making changes. I guess trying to light a fire under you butt accomplishes very little but to burning and hurt you. I can't promise you that I won't say the wrong things to you in the future. I can see myself continuing to be frustrated. Sorry...
> >
> > :-)
> >
> >
> > - Scott
> >
> >
> > ------------------------------------
> >
> >
> > > Looking back over this thread, I see that it started out with Phillipa explaining that she wanted to take some of the suggestions she has been given, but that fear of side-effects and of doctors making poor choices had prevented her from doing so. Several posters responded very positively to this, suggesting finding a really good pdoc, perhaps at Duke, and building a trusting relationship without making much in the way of med changes, at least at first. This really did seem to address Phillipa's real fears, and show that we understood and respected them. We have all had many of the same fears and experiences with pdoc's that she has.
> > >
> > > I think Phillipa's fears took over once again, even with the very benign suggestions she was given, causing her to reject them.
> > >
> > > Phillipa, would you be willing to think over the advantages for you of finding a doctor you could trust, who would understand you and work with you?
> >
> >
>
>
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