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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Racer on July 6, 1999, at 17:25:39
Hi again.
I've been transferred to the general practice physician for the county now. I spoke with her, and she's not comfortable with treating me, but will if she can't find a way to get me back into the mental health system. She says that she knows something about anti-depressants, but not much.
I also called the patient's rights advocate, who is also working on my behalf to get me in to see a psychiatrist. He says that he doesn't think it'll help, though.
Anyway, since I apparently won't be able to see a doctor who knows much about anti-depressants, I wonder if anyone here would be willing to recommend a next step drug? I will tell you anything, either on this board or via email, about my responses to prior meds, and my fears currently about meds, and give you any information I can. I don't know what else to do. I need help, but can't seem to get it through the county health system. I can't afford to see a private doctor, and anyway can't afford to pay for the medications if I could find one, so I may be stuck with this doctor. Maybe if I could have someone with experience in these drugs making suggestions, that might help.
Anyone willing to try? Or anyone willing to offer any other suggestions? Please, I'm so desperate! I don't necessarily want to die, but I can't take this sort of despair much longer. I'm just drained.
Posted by JohnL on July 6, 1999, at 20:49:30
In reply to Please, Doctors, Urgent Help Needed, posted by Racer on July 6, 1999, at 17:25:39
> Hi again.
>
> I've been transferred to the general practice physician for the county now. I spoke with her, and she's not comfortable with treating me, but will if she can't find a way to get me back into the mental health system. She says that she knows something about anti-depressants, but not much.
>
> I also called the patient's rights advocate, who is also working on my behalf to get me in to see a psychiatrist. He says that he doesn't think it'll help, though.
>
> Anyway, since I apparently won't be able to see a doctor who knows much about anti-depressants, I wonder if anyone here would be willing to recommend a next step drug? I will tell you anything, either on this board or via email, about my responses to prior meds, and my fears currently about meds, and give you any information I can. I don't know what else to do. I need help, but can't seem to get it through the county health system. I can't afford to see a private doctor, and anyway can't afford to pay for the medications if I could find one, so I may be stuck with this doctor. Maybe if I could have someone with experience in these drugs making suggestions, that might help.
>
> Anyone willing to try? Or anyone willing to offer any other suggestions? Please, I'm so desperate! I don't necessarily want to die, but I can't take this sort of despair much longer. I'm just drained.So the new doc isn't an expert on ADs. That pretty much rules out combinations. You will most likely have to choose one of the more common choices of SSRIs, Wellbutrin, or TCAs, Serzone, or Remeron as monotherapy. Often simpler is better. There are some powerful experienced minds at this site. I bet if you laid out your history of drugs (what, dose, how long, why quit) and side effects you can and cannot tolerate, folks here could put two and two together and give logical suggestions to discuss with the doc. Would advice making your case as clear, concise, and to-the-point as possible (that will also be important when facing the doc). Right off the bat I like Remeron because you have insomnia real bad, and I think you mentioned somewhere you are skinny (?) so gaining a few pounds shouldn't be a huge concern. Without knowing more, that makes sense to me. But with more info, you can probably get great insight from folks here.
First things first though. The whole lousy situation has been based on SUBJECTIVE opinions. As soon as you sit down in the office request to take the Becks Depression Inventory Test, or some similar multiple choice questionnaire designed to determine OBJECTIVELY degree and type of depression. Maybe call ahead to make sure they have a depression screening test on hand. In my opinion it is crucial at this point to start a clean slate and get something objective in your records. If you take the test and your score shows you are moderately or severely depressed, then there is no way in hell any doctor can say you are doing OK. The doc should be quite willing and capable of giving this test, it only takes a couple minutes. But if there is any resistance at all, remind them that you need your test score reflecting how you feel right now today so we can measure progress in the future. Can't sail the seas with opinions can you? Nope, need a compass. Insist on it. We've been lost at sea too long already. JohnL.
Posted by Cynthia on July 6, 1999, at 21:54:37
In reply to Re: Please, Doctors, Urgent Help Needed, posted by JohnL on July 6, 1999, at 20:49:30
Hi Racer,
John, you always have so many great ideas and are so creative with your own health care. I agree with his ideas racer. I can't help you with the medicines, but I'm sure many people on this site could give you ideas to take to the doctor.
Does your depression go up and down in one day, or within a few hours? Is it a reactive type of depression? Is it seasonal, or rhythmic? Or is it one of those that just seems to have a life of its own?
Cynthia
Posted by Janet on July 6, 1999, at 22:15:19
In reply to Re: Please, Doctors, Urgent Help Needed, posted by JohnL on July 6, 1999, at 20:49:30
John makes sense. Here's my opinion also, even though I doubt if you want to hear it:
Let's just say ,oh for the heck of it, you had this really bad disease that left you incapcitated, confused, even suicidal, wouldn't you do all you could to survive? People come down with cancer and can't give up hope just because they don't have a few hundred thousand dollars for chemo. Sell the horse, that could give you a couple visits with a private psychiatrist to get you started on the meds. Forget the county for now, they are no help. Sell your computer if you have to. Contact every church in town for $10 for meds. Beg some money from your relatives. Come on here, we're talking life and death here.If you are suicidal, no hospital can legally turn you away ,I don't think. I went to Belmont Hills south of South San Fransisco and got excellent care. There was a patient in there that had no insurance and they took her and set up a payment plan and was helping her to get the meds. she needed. I was diagnosed on my first interview there after spending a week of MANIA at a psychologist's house.He was a friend of mine. He didn't know what was going on. He had the book learning but hadn't seen it in an all blown bipolar episode. We all learned a lot that week.This is all I'm saying, I'm on your side. Don't let the system beat you. Go around it. Go to another general practioner until you find one that has a lot of experience in depression and mental illnesses. They'll tell you on the phone if they really do, quiz the nurse first to eliminate a lot.
There is probably a support group in your area that can give suggestions about doctors in your area. Remember, the doctor doesn't have to be THE ONE forever, just until you can get your head about you. AND DON'T WORRY ABOUT THE MONEY .
> >
> > I've been transferred to the general practice physician for the county now. I spoke with her, and she's not comfortable with treating me, but will if she can't find a way to get me back into the mental health system. She says that she knows something about anti-depressants, but not much.
> >
> > I also called the patient's rights advocate, who is also working on my behalf to get me in to see a psychiatrist. He says that he doesn't think it'll help, though.
> >
> > Anyway, since I apparently won't be able to see a doctor who knows much about anti-depressants, I wonder if anyone here would be willing to recommend a next step drug? I will tell you anything, either on this board or via email, about my responses to prior meds, and my fears currently about meds, and give you any information I can. I don't know what else to do. I need help, but can't seem to get it through the county health system. I can't afford to see a private doctor, and anyway can't afford to pay for the medications if I could find one, so I may be stuck with this doctor. Maybe if I could have someone with experience in these drugs making suggestions, that might help.
> >
> > Anyone willing to try? Or anyone willing to offer any other suggestions? Please, I'm so desperate! I don't necessarily want to die, but I can't take this sort of despair much longer. I'm just drained.
>
> So the new doc isn't an expert on ADs. That pretty much rules out combinations. You will most likely have to choose one of the more common choices of SSRIs, Wellbutrin, or TCAs, Serzone, or Remeron as monotherapy. Often simpler is better. There are some powerful experienced minds at this site. I bet if you laid out your history of drugs (what, dose, how long, why quit) and side effects you can and cannot tolerate, folks here could put two and two together and give logical suggestions to discuss with the doc. Would advice making your case as clear, concise, and to-the-point as possible (that will also be important when facing the doc). Right off the bat I like Remeron because you have insomnia real bad, and I think you mentioned somewhere you are skinny (?) so gaining a few pounds shouldn't be a huge concern. Without knowing more, that makes sense to me. But with more info, you can probably get great insight from folks here.
>
> First things first though. The whole lousy situation has been based on SUBJECTIVE opinions. As soon as you sit down in the office request to take the Becks Depression Inventory Test, or some similar multiple choice questionnaire designed to determine OBJECTIVELY degree and type of depression. Maybe call ahead to make sure they have a depression screening test on hand. In my opinion it is crucial at this point to start a clean slate and get something objective in your records. If you take the test and your score shows you are moderately or severely depressed, then there is no way in hell any doctor can say you are doing OK. The doc should be quite willing and capable of giving this test, it only takes a couple minutes. But if there is any resistance at all, remind them that you need your test score reflecting how you feel right now today so we can measure progress in the future. Can't sail the seas with opinions can you? Nope, need a compass. Insist on it. We've been lost at sea too long already. JohnL.
Posted by ruth on July 7, 1999, at 8:02:16
In reply to Re: Please, Doctors, Urgent Help Needed, posted by Janet on July 6, 1999, at 22:15:19
If I were suicidal I sure wouldn't have the energy
for all that. First I'd have to get motivated to
get out of bed. It's hard to think clearly and
make good decisions (or any decisions) when you're
depressed. How about sitting down, making a list
of what you've tried, and what you haven't, and just
try a new med that you've never tried before in hopes
that it might work. If you are extremely resistent
to most meds, or have unbearable side effects with
most of them, I wonder if checking yourself in, and
maybe getting ECT would help.
Posted by Elaine on July 10, 1999, at 0:17:24
In reply to Please, Doctors, Urgent Help Needed, posted by Racer on July 6, 1999, at 17:25:39
It is almost incomprehensible what you have been through with the County system. It is bad enough to feel as you do, but to have to bang your head against a wall trying to get "help". After all this, I wonder if it really is help...
Sorry, I can't help on meds. If you were able to get to a private pdoc for meds, as suggested, then what? S/he could prescribe for several months, then what? I don't think any competent pdoc would just see you once every six months to renew meds - if they happen to work. I hope you find a private or public pdoc who can help you.
I mostly agree with Janet, about doing what you need to in order to get help. But I don't agree with selling the horse. Horses have obviously meant a lot to you. Possibly you could find someone to underwrite the cost for awhile, or find another way to board it? I know you have had a couple of questions about your animals. I know how important my cat is to me. He's not just an animal, he's not just a pet, he's like family. And I could never give him away just so I wouldn't have to buy cat food. One of the reasons I wouldn't want to die is because I would be afraid of what would happen to him and how traumatized he would be. I know non-animal lovers can't sympathize, but I just wanted to support your keeping your animals because I know how much they can mean. I think if I were depressed and lost my cat, it would make it easier for me to consider suicide. Fur-children are important!
I hope you get out of this nightmare. Have you put anything in writing? If you want to document any case, you should leave a paper trail. Like letters saying how suicidal you are and how you're NOT stable and need immediate care, starting with a change in pdoc. If you keep telling them on paper how suicidal you are, they should start getting a little nervous...
Good luck to you, Racer.
Posted by Janet on July 18, 1999, at 20:04:22
In reply to Re: Please, Doctors, Urgent Help Needed, posted by Elaine on July 10, 1999, at 0:17:24
> It is not uncommon for a private pdoc or gp to only see you once every six months if your meds are working. If you need therapy, then of course you would go very often. I've been on the same dosage for 8 months now and am in complete normal mental health.
>
> Sorry, I can't help on meds. If you were able to get to a private pdoc for meds, as suggested, then what? S/he could prescribe for several months, then what? I don't think any competent pdoc would just see you once every six months to renew meds - if they happen to work. I hope you find a private or public pdoc who can help you.
>
> I mostly agree with Janet, about doing what you need to in order to get help. But I don't agree with selling the horse. Horses have obviously meant a lot to you. Possibly you could find someone to underwrite the cost for awhile, or find another way to board it? I know you have had a couple of questions about your animals. I know how important my cat is to me. He's not just an animal, he's not just a pet, he's like family. And I could never give him away just so I wouldn't have to buy cat food. One of the reasons I wouldn't want to die is because I would be afraid of what would happen to him and how traumatized he would be. I know non-animal lovers can't sympathize, but I just wanted to support your keeping your animals because I know how much they can mean. I think if I were depressed and lost my cat, it would make it easier for me to consider suicide. Fur-children are important!
>
> I hope you get out of this nightmare. Have you put anything in writing? If you want to document any case, you should leave a paper trail. Like letters saying how suicidal you are and how you're NOT stable and need immediate care, starting with a change in pdoc. If you keep telling them on paper how suicidal you are, they should start getting a little nervous...
>
> Good luck to you, Racer.
This is the end of the thread.
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