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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by stjames on May 30, 2000, at 0:36:05
In reply to Seeing new psychiatrist #17, posted by kellyR. on May 29, 2000, at 19:02:18
After going thru so many doc's, why make it hard for this one to help you by not being honest ?
Tell your doc everything, about your fears of going into the hospital and what is really going on in your head. Good luck and check in with us to tell how things went, if you would like.james
Posted by ChrisK on May 30, 2000, at 6:52:12
In reply to Seeing new psychiatrist #17, posted by kellyR. on May 29, 2000, at 19:02:18
Kelly,
I agree with the above notes. You need to tell him for two reasons:
1) he can help a lot quicker if he knows how severe your condition is.
2) You can make a contract with him to protect yourself from harm without going to the hospital.
Tell him,
Chris
Posted by kellyR. on May 30, 2000, at 11:08:07
In reply to Seeing new psychiatrist #17, posted by kellyR. on May 29, 2000, at 19:02:18
> I'm going to see my new dr. tomarrow this well be #17 of dr.'s I've seen in the last 14yrs,not having any luck keeping any for a long time(the last one died).should i tell him how suicidal i am or just tell him that i'm very depressed,Don't want to go in the hospital again,I know at the point i am now i do need to be there but my feeling is i'm not walking in & asking for help,If i overdose & someone finds me still alive then i geuss i have no choose.Just wanted to say thank you all for writing me & it did help me stay around one more day.
**************************************************
Well just got back from seeing my new dr. he was ok kinda business like,almost like i was going for a job.Had a hard time telling him that i was going to kill myself,just told him that i had suicidal thoughts.He upped my prozac to 40mg & wants to try some different antipsychotic drugs.Told me to stay on klonopin and he might change it to something else forgot the name.
I see him again in 5wks & i see what he is really like without having to fill out my life of psychological problems & hospitals stays.
Posted by Noa on May 30, 2000, at 13:26:00
In reply to saw new psychiatrist #17, posted by kellyR. on May 30, 2000, at 11:08:07
Are you starting on a different antipsychotic right away? or waiting till next visit?
I don't know, 5 weeks seems like too long an interval between visits for someone in crisis.
Did he know you had a lapse in meds for a few days and how you felt during that time?
Posted by kellyR. on May 30, 2000, at 15:55:13
In reply to Re: saw new psychiatrist #17, posted by Noa on May 30, 2000, at 13:26:00
> Are you starting on a different antipsychotic right away? or waiting till next visit?
>
> I don't know, 5 weeks seems like too long an interval between visits for someone in crisis.
>
> Did he know you had a lapse in meds for a few days and how you felt during that time?Do you think they care?I told him that i hadn't taking meds for 2wks & that i was suicidal.But the inrs. com. make the rules of how many times you can see them,I see someone to talk to saw why should he bother.
Posted by Noa on May 30, 2000, at 18:47:14
In reply to Re: saw new psychiatrist #17, posted by kellyR. on May 30, 2000, at 15:55:13
Did you start the new antipsychotic yet? How often do you see your therapist?
Posted by kellyR. on May 30, 2000, at 19:05:45
In reply to Re: saw new psychiatrist #17, posted by Noa on May 30, 2000, at 18:47:14
> Did you start the new antipsychotic yet? How often do you see your therapist?
Noa,no didn't start taking any new antipsychotic yet. I see my therapist every other week,I saw him on thursday & he did want to see me this week but i told him that i would be ok,i hate to bother him, he says that i'm not a bother.
Posted by Gordon on May 30, 2000, at 20:03:21
In reply to Re: saw new psychiatrist #17, posted by kellyR. on May 30, 2000, at 19:05:45
> > Did you start the new antipsychotic yet? How often do you see your therapist?
>
> Noa,no didn't start taking any new antipsychotic yet. I see my therapist every other week,I saw him on thursday & he did want to see me this week but i told him that i would be ok,i hate to bother him, he says that i'm not a bother.You're posts are more positive. Sounds like you're getting more cheerful. Is that so? When do you start you new med? Sounds to me like you're making progress already. Does it feel like the world is opening up to you a little?
Posted by Noa on May 31, 2000, at 8:27:32
In reply to Re: saw new psychiatrist #17, posted by Gordon on May 30, 2000, at 20:03:21
Kelly,
If you therapist offers an extra session, I encourage you to take him or her up on it. You are not a bother. Sometimes you have more need, and the therapist is there to help.
I am feeling better, except yesterday I had a lousy day, as I was grumpy all day.
I have not started a new med, just made changes in doses, etc. Have been on this particular recipe for about a month and it seems to be holding fairly well.
Posted by kellyR. on May 31, 2000, at 11:13:52
In reply to Re: saw new psychiatrist #17, posted by Noa on May 31, 2000, at 8:27:32
> Kelly,
>
> If you therapist offers an extra session, I encourage you to take him or her up on it. You are not a bother. Sometimes you have more need, and the therapist is there to help.
>
> I am feeling better, except yesterday I had a lousy day, as I was grumpy all day.
>
> I have not started a new med, just made changes in doses, etc. Have been on this particular recipe for about a month and it seems to be holding fairly well.Had a real bad night my husband wanted me to go in the hospital,couldn't stop crying feels like I'm lossing my mind.Didn't go to work today was to down & tired.I was thinking maybe that i should go but i'm always going to be like this so what can they do for me?Sorry i can't help you right now,can't even help myself.
Posted by Noa on May 31, 2000, at 15:14:33
In reply to Re: saw new psychiatrist #17, posted by kellyR. on May 31, 2000, at 11:13:52
Kelly, sorry you are feeling so low.
Listen, you had a interruption of meds, and I am assuming you are starting to get your meds back on track. What are you taking right now? Do you think you can hold it together until you are back up to speed on all your doses?
Posted by Janice on May 31, 2000, at 17:15:13
In reply to Re: saw new psychiatrist #17, posted by kellyR. on May 31, 2000, at 11:13:52
Hello Kelly,
I've been following your postings lately and I hate to see you this way. I'm sorry you feel so bad. I wanted to share with you my story of abruptly stopping all my medications--I very quickly became suicidal and impulsively and briefly acted on these suicidal urges.
The moral of the story, dear Kelly, don't abruptly stop your medications. please.
what about e-mailing the pharmacist?
the very best of luck, Janice
Posted by JohnL on June 1, 2000, at 5:19:42
In reply to saw new psychiatrist #17, posted by kellyR. on May 30, 2000, at 11:08:07
> Well just got back from seeing my new dr. he was ok kinda business like,almost like i was going for a job.Had a hard time telling him that i was going to kill myself,just told him that i had suicidal thoughts.He upped my prozac to 40mg & wants to try some different antipsychotic drugs.Told me to stay on klonopin and he might change it to something else forgot the name.
> I see him again in 5wks & i see what he is really like without having to fill out my life of psychological problems & hospitals stays.I'm glad things went fairly well. I have to admit though, for someone with your history his approach right from the getgo seems way too conservative. I mean, upping Prozac to 40mg and waiting 5 weeks? Heck, that's something a Nurse Practitioner at my local family clinic could do blindfolded any day of the week. No specialist needed for that kind of mainstream approach.
I do like the idea of antipsychotics a lot. Not just because they often work very well for stubborn depressions, but because it is a whole different class of medication. That is definitely warranted in your case, and I like the idea. But waiting until 5 weeks?? I don't like that.
I would have been much more pleased to see him take some actions that are appropriate for people who have a resistent history and are currently feeling suicidal. What might those actions be? ....Stimulants. That's right. Stimulants like Ritalin or Adderall can totally relieve depression in 24 to 72 hours. THAT makes sense to me in your case, and in my opinion should have been at the top of the priority list. Stimulants in the old days were antidepressants. They work fast and have far fewer side effects that today's antidepressants. They are especially good for resistant, apathetic, withdrawn type depressions.
But like I said, you now have to wait 5 weeks after simply raising the Prozac dose? With your history? And your current condition? I dunno, I think I might be inclined to put some pressure on this new doc to aggressively pull out all the tricks, or else seek psychiatrist #18.
In situations like yours, there is no physician that I know of in the world who is more capable or faster at getting people with your history completely well...FAST. He is Dr. Martin Jensen. That's his specialty. I repeat, people like you are his specialty. That's where he shines. That's what he loves to do. You're right up his alley. You might want to browse through www.drjensen.com to ponder yet another avenue. That is, if you want to get well FAST. In my opinion, you definitely qualify with flying colors for treatment more aggressive than mainstream general psychiatry. I mean, let's face it, if general mainstream psychiatry was to work with you, it certainly would have already with one of the prior 16 pdocs. Right? The last thing you need is yet another carbon copy of a doc you've already had, not to mention being treated in a way that any nurse practitioner could do.
JohnL
Posted by Noa on June 1, 2000, at 16:24:03
In reply to Re: saw new psychiatrist #17, posted by JohnL on June 1, 2000, at 5:19:42
Thing is, I believe Kelly reported good results with zyprexa, it's just that she had to discontinue it when her previous doc (the one right after her doc that died) refused to prescribe it, and she was on it for a relatively short time this time around when she discontinued it again. I don't think it is established that she isn't responding to the meds, just that she hasn't had the opporutnity for consistent follow up.
Posted by Noa on June 1, 2000, at 16:24:49
In reply to Re: saw new psychiatrist #17, posted by kellyR. on May 31, 2000, at 11:13:52
Kelly, how ya doing today? Been thinking of you.
Posted by kellyR. on June 1, 2000, at 18:41:30
In reply to Re: saw new psychiatrist #17 » kellyR., posted by Noa on June 1, 2000, at 16:24:49
> Kelly, how ya doing today? Been thinking of you.
Noa,missed work today again,didn't get out of bed til 11am,I was going to check myself in the hospital today but was scared.
My husband said to me it seems that the only meds that work well for me are the ones the that make me so out of it that i not realy there.so i could be happier & not there or be sad & know it.I'm going to try real hard to go to work tomarrow.
Posted by JohnL on June 2, 2000, at 3:44:13
In reply to Re: saw new psychiatrist #17, posted by kellyR. on June 1, 2000, at 18:41:30
> > Kelly, how ya doing today? Been thinking of you.
>
> Noa,missed work today again,didn't get out of bed til 11am,I was going to check myself in the hospital today but was scared.
> My husband said to me it seems that the only meds that work well for me are the ones the that make me so out of it that i not realy there.so i could be happier & not there or be sad & know it.I'm going to try real hard to go to work tomarrow.Kelly,
As Noa reminded me, didn't Zyprexa work at one time? But the doctor took you off it?
If that is true, and the med really zonked you out also, then it makes even more sense than ever to return to the antipsychotic category BUT add a stimulant with it. Drop the antidepressants. Top APs to choose from would be Zyprexa, Risperdal, and Trifluoperazine (Stelazine, similar to Amisulpride). Risperdal is similar to Zyprexa, but with less sedation and less weight gain.
Top stimulants during the day (for both depression efficacy and to counter AP sedation) would be Adderall or Ritalin. There are others as well, but these two seem to be the most popular. Adderall is the smoother of the two, though I have to admit Ritalin had a much more pronounced good mood effect with me. But its short halflife makes for a roller coaster ride.
Antipsychotics + Stimulants = Cool combination for tough cases like yours.
If I were you, I would definitely not wait 5 weeks. I would get on the phone and contact your new pdoc TODAY. If he's any good, he'll find a way to squeeze you in. He needs to know how bad you feel right now. If he is made aware how bad off you are right now, almost suicidal, and yet cannot find a few minutes to squeeze you in to the schedule this very day, then in my opinion he sucks and you should definitely seek pdoc#18. I don't know, to me one of the most important characteristics of a GOOD pdoc is accessibility. In my mind it is MANDATORY, not just desirable, that they have the ability to see me on an emergency basis, one way or the other...come in early, leave the office late, squeeze 15 minutes out of lunch, whatever. If they can't do that, forget it. If they can't do whatever is needed to treat the tough desperate cases, then they aren't worth the money they're paid and would be better suited to be nurse practitioners working bank hours at the local health clinic.
The premium price we pay for the pdoc's care deserves premium service in return. In my world anyway.
Call him. Please?
JohnL
Posted by kellyR. on June 2, 2000, at 5:37:16
In reply to Re: saw new psychiatrist #17, posted by JohnL on June 2, 2000, at 3:44:13
> > > Kelly, how ya doing today? Been thinking of you.
> >
> > Noa,missed work today again,didn't get out of bed til 11am,I was going to check myself in the hospital today but was scared.
> > My husband said to me it seems that the only meds that work well for me are the ones the that make me so out of it that i not realy there.so i could be happier & not there or be sad & know it.I'm going to try real hard to go to work tomarrow.
>
> Kelly,
>
> As Noa reminded me, didn't Zyprexa work at one time? But the doctor took you off it?
>
> If that is true, and the med really zonked you out also, then it makes even more sense than ever to return to the antipsychotic category BUT add a stimulant with it. Drop the antidepressants. Top APs to choose from would be Zyprexa, Risperdal, and Trifluoperazine (Stelazine, similar to Amisulpride). Risperdal is similar to Zyprexa, but with less sedation and less weight gain.
>
> Top stimulants during the day (for both depression efficacy and to counter AP sedation) would be Adderall or Ritalin. There are others as well, but these two seem to be the most popular. Adderall is the smoother of the two, though I have to admit Ritalin had a much more pronounced good mood effect with me. But its short halflife makes for a roller coaster ride.
>
> Antipsychotics + Stimulants = Cool combination for tough cases like yours.
>
> If I were you, I would definitely not wait 5 weeks. I would get on the phone and contact your new pdoc TODAY. If he's any good, he'll find a way to squeeze you in. He needs to know how bad you feel right now. If he is made aware how bad off you are right now, almost suicidal, and yet cannot find a few minutes to squeeze you in to the schedule this very day, then in my opinion he sucks and you should definitely seek pdoc#18. I don't know, to me one of the most important characteristics of a GOOD pdoc is accessibility. In my mind it is MANDATORY, not just desirable, that they have the ability to see me on an emergency basis, one way or the other...come in early, leave the office late, squeeze 15 minutes out of lunch, whatever. If they can't do that, forget it. If they can't do whatever is needed to treat the tough desperate cases, then they aren't worth the money they're paid and would be better suited to be nurse practitioners working bank hours at the local health clinic.
>
> The premium price we pay for the pdoc's care deserves premium service in return. In my world anyway.
>
> Call him. Please?
>
> JohnLI'm up & out of bed & going to work,i'll probley get yelled at by my boss today for calling out 2days,Since they know about my problems already,do i tell them the real reason why i was out or it was sometime i got from the kids?Wish me luck today at work because i'm feeling very panic about going in.
Posted by Noa on June 2, 2000, at 9:42:52
In reply to Re: saw new psychiatrist #17, posted by kellyR. on June 2, 2000, at 5:37:16
Good luck, Kelly. Let us know how it went.
Posted by Noa on June 2, 2000, at 9:44:18
In reply to Re: saw new psychiatrist #17, posted by JohnL on June 2, 2000, at 3:44:13
I agree with John that is is worth inquiring into adding a stim to your antipsychotic. It is the kind of med that you will either see results with or not within a few days or so.
Posted by kellyR. on June 2, 2000, at 15:38:03
In reply to Re: saw new psychiatrist #17, posted by Noa on June 2, 2000, at 9:42:52
> Good luck, Kelly. Let us know how it went.
Well i went & everyone was asking if i was ok,by the middle of the day i was feeling a little better.Got called to the office about me calling out she said that i've been calling out alote since i've been back to work.She knows about my problems to a point so i can tell her whats going on,she asked about my meds & i told her what was going on about that.she said i hopes that the meds start working & we can get the old kelly back. So all in all i got a verble warning in my file.I'm glade that she understands being that she from the old school of nursing & was a army nurse so you see we all at work walk on egg shells when she comes around our floor. feeling little better thank you for helping me get back from "HELL".(meds for life)
Posted by Noa on June 2, 2000, at 18:01:55
In reply to Re: saw new psychiatrist #17 » Noa, posted by kellyR. on June 2, 2000, at 15:38:03
Kelly--good for you, getting to work, being strong during the meeting with Nurse drill seargent.
Can you try to hold onto the feeling of starting to feel better once you are there and involved in work? Maybe that is something you can remind yourself of to help get yourself out of bed. You are good at what you do, and you get pleasure, I think, from helping the people you help. If you can access that, maybe you can get past the morning blues and panic.
I know....easier said than done. And always easier to recommend this stuff to someone else. =0)
Posted by kellyR. on June 3, 2000, at 9:50:11
In reply to Re: saw new psychiatrist #17 » kellyR., posted by Noa on June 2, 2000, at 18:01:55
> Kelly--good for you, getting to work, being strong during the meeting with Nurse drill seargent.
>
> Can you try to hold onto the feeling of starting to feel better once you are there and involved in work? Maybe that is something you can remind yourself of to help get yourself out of bed. You are good at what you do, and you get pleasure, I think, from helping the people you help. If you can access that, maybe you can get past the morning blues and panic.
>
> I know....easier said than done. And always easier to recommend this stuff to someone else. =0)Nurse Drill Seargent that's funny,I don't think she would like that but I know my coworkers would. I can say this about her she very tough but fair.She make all the nurse wear that nursing hat.
I have the weekend off & the weather is great need to do something to get me out of the house & stop these panic attack about going outside.What can i do w/ 3 kids that not going to cost me anything,& don't have alote of people there?
Posted by Tina1 on June 3, 2000, at 12:35:07
In reply to YES DRILL SEARGENT!!! » Noa, posted by kellyR. on June 3, 2000, at 9:50:11
Going fishing tends to be solitary and cheap. just a suggestion kell...
> > Kelly--good for you, getting to work, being strong during the meeting with Nurse drill seargent.
> >
> > Can you try to hold onto the feeling of starting to feel better once you are there and involved in work? Maybe that is something you can remind yourself of to help get yourself out of bed. You are good at what you do, and you get pleasure, I think, from helping the people you help. If you can access that, maybe you can get past the morning blues and panic.
> >
> > I know....easier said than done. And always easier to recommend this stuff to someone else. =0)
>
> Nurse Drill Seargent that's funny,I don't think she would like that but I know my coworkers would. I can say this about her she very tough but fair.She make all the nurse wear that nursing hat.
> I have the weekend off & the weather is great need to do something to get me out of the house & stop these panic attack about going outside.What can i do w/ 3 kids that not going to cost me anything,& don't have alote of people there?
Posted by Noa on June 3, 2000, at 14:08:08
In reply to YES DRILL SEARGENT!!! » Noa, posted by kellyR. on June 3, 2000, at 9:50:11
Hey, Kelly, hope you enjoy your day off with the kids. Keep it simple. How about a walk in the woods. Feeding ducks. A trip to the local airport to watch the planes take off and land. The local library (my favorite!!). If it is warm out, setting up the sprinkler for the kids and a wading pool for your feet. Washing the car together? Making lemonade to sell out front? Planting some flowers?
Enjoy. Take it easy.
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