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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by zonked on January 18, 2013, at 1:34:15
I moved to Seattle recently and am scratching my head.
I really don't know what to do; my main concern is that I would prefer to screen ahead of time for "Will this doctor continue me on my existing meds?" rather than waste time, money, and/or insurance claims only to hear "no."
(I have enough of my Nardil, Xanax and Ambien CR, just no more non-refillable Dexedrine, which does two (plus more) things: treats my ADD exceptionally well + absolutely puts the nail in the coffin on my depression. The two effects, I believe, are related.)
So far, I've been steered by someone I trust towards the University of Washington/Harborview psychiatry but this whole process is nerve-wracking.
-z
Posted by SLS on January 18, 2013, at 6:45:27
In reply to Cold-calling shrinks in Seattle.. ugh, posted by zonked on January 18, 2013, at 1:34:15
> I moved to Seattle recently and am scratching my head.
>
> I really don't know what to do; my main concern is that I would prefer to screen ahead of time for "Will this doctor continue me on my existing meds?" rather than waste time, money, and/or insurance claims only to hear "no."
>
> (I have enough of my Nardil, Xanax and Ambien CR, just no more non-refillable Dexedrine, which does two (plus more) things: treats my ADD exceptionally well + absolutely puts the nail in the coffin on my depression. The two effects, I believe, are related.)
>
> So far, I've been steered by someone I trust towards the University of Washington/Harborview psychiatry but this whole process is nerve-wracking.
>
> -z
Make a list of your medications and ask the doctor or his secretary if the doctor would be willing to continue your present treatment regime. A phone call or walk-in will save you time and money.You could email this person and ask for advice and referrals:
Dunner, DL
Center for Anxiety and Depression, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98105, USA.
- Scott
Posted by Phillipa on January 18, 2013, at 10:22:04
In reply to Re: Cold-calling shrinks in Seattle.. ugh » zonked, posted by SLS on January 18, 2013, at 6:45:27
Scott think Jedi could help too? Phillipa
Posted by zonked on January 18, 2013, at 10:42:17
In reply to Re: Cold-calling shrinks in Seattle.. ugh » zonked, posted by SLS on January 18, 2013, at 6:45:27
> > I moved to Seattle recently and am scratching my head.
> >
> > I really don't know what to do; my main concern is that I would prefer to screen ahead of time for "Will this doctor continue me on my existing meds?" rather than waste time, money, and/or insurance claims only to hear "no."
> >
> > (I have enough of my Nardil, Xanax and Ambien CR, just no more non-refillable Dexedrine, which does two (plus more) things: treats my ADD exceptionally well + absolutely puts the nail in the coffin on my depression. The two effects, I believe, are related.)** I'd forgotten to mention the Dexedrine also eliminates my social anxiety, which isn't enough to be clinical S-AD, but given that I know almost no one here, may be a barrier to gaining employment or making friends.
> > So far, I've been steered by someone I trust towards the University of Washington/Harborview psychiatry but this whole process is nerve-wracking.
> >
> > -z
>
>
> Make a list of your medications and ask the doctor or his secretary if the doctor would be willing to continue your present treatment regime. A phone call or walk-in will save you time and money.
>
> You could email this person and ask for advice and referrals:
>
> Dunner, DL
>
> ddunner@u.washington.edu
>
> Center for Anxiety and Depression, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98105, USA.
>
>
> - Scott
>
>
>Scott, helpful as always, thank you, I will contact this person. Where did the referral come from? How have you been, by the way? The last I recall you had finished an unsuccessful trial of Vibryd.
-z
Posted by SLS on January 18, 2013, at 11:23:36
In reply to Re: Cold-calling shrinks in Seattle.. ugh » SLS, posted by zonked on January 18, 2013, at 10:42:17
> > You could email this person and ask for advice and referrals:
> >
> > Dunner, DL
> >
> > ddunner@u.washington.edu
> >
> > Center for Anxiety and Depression, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98105, USA.
> Scott, helpful as always, thank you, I will contact this person. Where did the referral come from? How have you been, by the way? The last I recall you had finished an unsuccessful trial of Vibryd.I can see that you haven't been here in awhile, although you demonstrate an excellent memory. I appreciate that very much. Viibryd was my last chance as far as I was concerned. I had finally run out of ideas. I experienced a mild improvement from it, but it didn't last for more than a week. I had all but given up. I decided to go back to Parnate rather than commit suicide. It was then that my doctor pulled prazosin out of his magic bag of tricks. He thought that there might be a PTSD component to my illness. I wasn't buying it, but I thought that I should humor him at least this once.
Prazosin was certainly safe enough. I had already started Parnate and was at 80 mg/day before introducing the prazosin. Not two weeks had passed before I realized that the stuff was actually working. I remember shaking my head and saying, "Well, I'll be damned." That was about a year ago. Progress was slow, but the trend was towards remission. I have since added minocycline to help speed things up and provide a way to reduce inflammation and free radical damage. Minocycline has antidepressant properties in its own right, and seems to work well in combination with anti-glutamatergic drugs like Lamictal, which I continue to take. Progress remains relatively slow, but I feel qualitatively better on the minocycline than off it. I have been told that minocycline can take as long as a year to bring someone to full remission. I figure I can go back to work sometime this year, hopefully by autumn. I still experience some "mood drift", but that is to be expected in my case. I try to ride out these brief periods of worsening by knowing that they are only temporary, and to be followed by another improvement. One of my NIH doctors likened these periodic episodes to a sort of brain "reset". Another NIH doctor drew a picture of an ascending saw-tooth line that represented the rough ride that some people can experience, even though they are taking the right drugs and are heading towards remission. Improvement is rarely linear in severe or chronic cases.
Today, I'm feeling pretty good.
:-)
- Scott
Posted by zonked on January 18, 2013, at 12:16:01
In reply to Re: Cold-calling shrinks in Seattle.. ugh » zonked, posted by SLS on January 18, 2013, at 11:23:36
> > > You could email this person and ask for advice and referrals:
> > >
> > > Dunner, DL
> > >
> > > ddunner@u.washington.edu
> > >
> > > Center for Anxiety and Depression, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98105, USA.
>
> > Scott, helpful as always, thank you, I will contact this person. Where did the referral come from? How have you been, by the way? The last I recall you had finished an unsuccessful trial of Vibryd.
>
> I can see that you haven't been here in awhile, although you demonstrate an excellent memory. I appreciate that very much. Viibryd was my last chance as far as I was concerned. I had finally run out of ideas. I experienced a mild improvement from it, but it didn't last for more than a week. I had all but given up. I decided to go back to Parnate rather than commit suicide. It was then that my doctor pulled prazosin out of his magic bag of tricks. He thought that there might be a PTSD component to my illness. I wasn't buying it, but I thought that I should humor him at least this once.
>
> Prazosin was certainly safe enough. I had already started Parnate and was at 80 mg/day before introducing the prazosin. Not two weeks had passed before I realized that the stuff was actually working. I remember shaking my head and saying, "Well, I'll be damned." That was about a year ago. Progress was slow, but the trend was towards remission. I have since added minocycline to help speed things up and provide a way to reduce inflammation and free radical damage. Minocycline has antidepressant properties in its own right, and seems to work well in combination with anti-glutamatergic drugs like Lamictal, which I continue to take. Progress remains relatively slow, but I feel qualitatively better on the minocycline than off it. I have been told that minocycline can take as long as a year to bring someone to full remission. I figure I can go back to work sometime this year, hopefully by autumn. I still experience some "mood drift", but that is to be expected in my case. I try to ride out these brief periods of worsening by knowing that they are only temporary, and to be followed by another improvement. One of my NIH doctors likened these periodic episodes to a sort of brain "reset". Another NIH doctor drew a picture of an ascending saw-tooth line that represented the rough ride that some people can experience, even though they are taking the right drugs and are heading towards remission. Improvement is rarely linear in severe or chronic cases.
>
> Today, I'm feeling pretty good.
>
> :-)
>
>
> - ScottYou are one resilient guy, I am genuinely happy for you... Brought a smile to my face to hear that. That you've had a year mostly heading towards remission is incredible, Scott.
Interestingly enough, I was just thinking the other day -- what if prolonged exposure to stresses less intense and immediately disruptive than, say, wars or natural disasters (prolonged depression, and the poverty and loss of self-esteem that often go along with them, etc.) can create a syndrome similar to PTSD? The standard clinical interview screening for PTSD does not, I believe, account for such a syndrome.
Congratulations to you and your doctor, and thanks as always for your wisdom.
-z
>
Posted by SLS on January 18, 2013, at 18:32:23
In reply to Re: Cold-calling shrinks in Seattle.. ugh » SLS, posted by zonked on January 18, 2013, at 12:16:01
> Interestingly enough, I was just thinking the other day -- what if prolonged exposure to stresses less intense and immediately disruptive than, say, wars or natural disasters (prolonged depression, and the poverty and loss of self-esteem that often go along with them, etc.) can create a syndrome similar to PTSD?
You are one smart dude!
http://www.positivehumandevelopment.com/developmental-ptsd.html
- Scott
Posted by bleauberry on January 20, 2013, at 5:01:29
In reply to Cold-calling shrinks in Seattle.. ugh, posted by zonked on January 18, 2013, at 1:34:15
Yes, it is a pain. I've done that before. But your efforts will be worth it. The extra effort to be sure of the right choice will be critical, I believe. Definitely worth it. Not fun, not easy, but worth it. The wrong choice will punish you, the right choice will reward you.
Posted by zonked on January 22, 2013, at 16:16:38
In reply to Re: Cold-calling shrinks in Seattle.. ugh, posted by bleauberry on January 20, 2013, at 5:01:29
I am pleased to report that the health plan I am almost set on joining has plenty of outstanding psychiatrists - as evidenced by web reviews. I try to control for fake reviews posted by doctors themselves or their staff, as shrinks are a crafty bunch. :-)
Even if I stick to my existing insurance, it looks like I'll be seen at the UWMC residency clinic -- if the residents give me a blank stare or are otherwise unsatisfactory, I could always ask to speak to someone on the faculty... =]
Mood is bright. I am addressing my ADD with caffeine for now, which has awful side effects (repeated doses necessary, an awful afternoon crash that I do not get with Dexedrine, etc), but I can certainly hold out for a bit.
Thanks all for your advice and support, as always :-)
-z
This is the end of the thread.
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