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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Messy on May 12, 1999, at 14:50:02
A 71-year-old male I know had heart surgery
(a balloon angioplasty and stent). Afterwards,
he changed his diet and increased his exercise,
and now does the equivalent of climbing stairs of
10 or 20 story buildings, although his aorta is
still enlarged and there is still a small block
somewhere. After the heart surgery, he was put
on some drug to lower cholesterol, which worked,
and on atenolol, a beta blocker. He was also
taking Wellbutrin (not SR) for depression, without
reported side-effects, since well before the heart
surgery. Other members of same family have also
been diagnosed with depression and have responded
well to medication.Some of us who read drbob's web-site know beta
blockers can cause depression for those with a
history. Patient is pessimistic and tired.
Patient also suffers from interrupted sleep
apparently due to repeated need to use the
bathroom at night. Told this is normal aging.He is also dealing with situational issues on
what to do with his time if he retires, and
that the job is no longer fun. He feels his
emotions are situational rather than the results
of internal chemistry, but according to the
personal story on drbob's one cannot always tell
from inside. Also, according to the discussion
on drbob's, atenolol is one of the less
bad beta blockers for causing depression,
which implies that the patient may well be correct
in his belief.Both psychologist and cardiologist have been asked
about the situation. The cardiologist seems to view
that emotional health is not his department, and
that the state of the cardiac system suggests beta
blockers still advisable. The psychologist seems
to view that the cardiac medications are not his
department but that one could increase the dosage
of Wellbutrin. (This psychologist does not trust
Wellbutrin SR.)How would one go about finding an M.D. in the
Northeastern U.S., with expertise BOTH in cardiology
and in depression? Are there any groups of doctors
that work together on this combination? Would an
external (more integrated) opinion on this
case be useful? How would one find it?Thanks.
Posted by saintjames on May 12, 1999, at 20:09:10
In reply to A Combination Cardiology and Psychology Doctor?, posted by Messy on May 12, 1999, at 14:50:02
> A 71-year-old male I know had heart surgery
> (a balloon angioplasty and stent). Afterwards,
> he changed his diet and increased his exercise,
> and now does the equivalent of climbing stairs of
> 10 or 20 story buildings, although his aorta is
> still enlarged and there is still a small block
> somewhere. After the heart surgery, he was put
> on some drug to lower cholesterol, which worked,
> and on atenolol, a beta blocker. He was also
> taking Wellbutrin (not SR) for depression, without
> reported side-effects, since well before the heart
> surgery. Other members of same family have also
> been diagnosed with depression and have responded
> well to medication.
>
> Some of us who read drbob's web-site know beta
> blockers can cause depression for those with a
> history. Patient is pessimistic and tired.
> Patient also suffers from interrupted sleep
> apparently due to repeated need to use the
> bathroom at night. Told this is normal aging.
>
> He is also dealing with situational issues on
> what to do with his time if he retires, and
> that the job is no longer fun. He feels his
> emotions are situational rather than the results
> of internal chemistry, but according to the
> personal story on drbob's one cannot always tell
> from inside. Also, according to the discussion
> on drbob's, atenolol is one of the less
> bad beta blockers for causing depression,
> which implies that the patient may well be correct
> in his belief.
>
> Both psychologist and cardiologist have been asked
> about the situation. The cardiologist seems to view
> that emotional health is not his department, and
> that the state of the cardiac system suggests beta
> blockers still advisable. The psychologist seems
> to view that the cardiac medications are not his
> department but that one could increase the dosage
> of Wellbutrin. (This psychologist does not trust
> Wellbutrin SR.)
>
> How would one go about finding an M.D. in the
> Northeastern U.S., with expertise BOTH in cardiology
> and in depression? Are there any groups of doctors
> that work together on this combination? Would an
> external (more integrated) opinion on this
> case be useful? How would one find it?
>
> Thanks.James here
a psychologist is not a medical doc. Get a consult with a pdoc.
j
Posted by anne on May 12, 1999, at 23:06:42
In reply to A Combination Cardiology and Psychology Doctor?, posted by Messy on May 12, 1999, at 14:50:02
It should not be that difficult to find and internist who also has done a psychiatry residency. Depending on his insurance, if he is in managed care, call their number and ask which docs in their plan fit this profile. Another option is to call major teaching hospitals in your area and ask for a referral. Most hospitals do this now in my area to attract patients to docs with priveledges in their hospital.
What you want is out there, you just have to find it.
Posted by andrew on May 13, 1999, at 14:07:35
In reply to A Combination Cardiology and Psychology Doctor?, posted by Messy on May 12, 1999, at 14:50:02
Take a look at the site www.heartinfo.org/reutersnews/t0305-2f.htm
You should be able to dig up a name or two off the site to follow up on. The site
has some interesting info. on heart disease and depression.
Posted by Dr. Bob on May 14, 1999, at 18:03:33
In reply to A Combination Cardiology and Psychology Doctor?, posted by Messy on May 12, 1999, at 14:50:02
> After the heart surgery, he was put
> on some drug to lower cholesterol, which worked,
> and on atenolol, a beta blocker.Sometimes drugs that lower cholesterol can cause depression, too...
Bob
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