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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 46. Go back in thread:
Posted by Pandora on February 10, 2001, at 0:17:57
In reply to Good. Now focus on your work, and stop and smell » Tracy, posted by Rzip on February 9, 2001, at 23:42:25
Tracy,
I don't know if this will help, but it's worth a try. You say a major stumbling block is not being able to get your school to recognize your situation without a diagnosis. I have worked in the mental health arena in Texas for several years, most recently with a state and county funded agency. Almost EVERY person who was assessed by us was given a diagnosis. Granted, there were some who really didn't have a psychiatric disorder (I worked with kids and sometimes the school refered them or their parents brought them in for minimal difficulties or learning disorders, etc. - in the mental health part of the agency we only dealt with axis I disorders and no v-codes). Anyway, my suggestion is to find a similar agency and go for an assessment there. Chances are you will have to pay out-of-pocket for the service (ours is ~$120) since they probably are geared toward those who have no insurance or are below poverty level. However, if they are run at all like our agency, you would be given a Dx and could have a therapist or psychiatrist fill out the proper forms to allow you help at school. I would never presume to diagnose anyone over the internet, but from what you've already written, I can almost guarentee if we sat down and I conducted an assessment, you would have SOMETHING to take away with you.A second though -which I'm sure you've already explored - is to use the school's counseling center for an assessment.
I realize that effective treatment is what you need most and that my suggestions don't really address that, but I hope this has been of some help. Good luck, and hang in there! (Oops, that was almost a c-hug... sorry!) : )
Posted by willow on February 10, 2001, at 0:19:53
In reply to RE: letter to the clinic that treated me like crap, posted by Tracy on February 9, 2001, at 22:50:07
Tracey
BRAVO! I wrote a similar but shorter letter to my previous family doctor, though I didn't send it! I applaud you for having the balls to send yours!!
"your theory of "stress", my symptoms include: extreme fatigue, as well as
excessive daytime sleepiness; feeling too cold or too hot, sometimes coming
in waves; lack of concentration; my mind feeling foggy and slow; inability
to speak coherently (stumbling over my words) or remember what I am saying
(forgetting or becoming confused mid sentence); becoming easily distracted;"Your symptoms are all similar to mine (I have muscle pain.) I'm starting to have some success with Effexor, but unfortunately this is at at "non-stress" level. I'm not able to work or function normally at home.
In my opinion you should change to a doctor who does believe in involving the patient. I found a new doctor (first practice) who doesn't have a problem with this. My anxiety level has decreased significantly. I agree with RZip in that you should find one good care-provider. For myself this involved seeing a psychologist, I'm from a one shrink town and he's the "crazy" one, and my family doctor.
PS I didn't see a great improvement on the effexor until about four months, though I immediately had some response. I know this doesn't help when you want an immediate cure, but honestly I don't think you'll find one. Get your family doctor to write you a health dismissal for the time you had your exams, he doesn't need to clarify why! This will probably help with some of the anxiety. Talk to a school official concerning your future concerns. You probably have laws that will protect you and someone at the school schould be able to direct you.
If you do a quick search on the internet you may be able to find these yourself.BEST WISHES
Posted by allisonm on February 10, 2001, at 8:47:04
In reply to solutions not cyberhugs » Tracy, posted by allisonm on February 8, 2001, at 20:16:44
Tracy,
I will reiterate what I said in my first post:
> > Maybe it would help to get out of that psych clinic, if you can afford it, and find an experienced pdoc with 10 or more years under his belt, who knows his stuff and isn't practicing on you. < <
Sounds like you need someone with more experience in clinical psychiatry. Sorry, but a resident doesn't have that. Also, psychiatrists who have practices in town are much less likely to move away, as your other resident pdoc did.
Since you do have insurance, it might be worth your while to look outside. Syracuse is a big enough city and should have a large enough pool of psychiatrists. You might have to interview a few before you find the right one for you, but with patience and perseverance you will. And if it does cost more, isn't your physical and mental health worth it? I think your school work will be much more of an uphill battle, if not impossible, without it.
I also wonder whether there are some grains of truth in what your recent doctors recommended. Sometimes it isn't possible to keep on the path you are on no matter how much you want to or think that the doctors should help you in this goal. I have learned this lesson several times. Whether you want to accept this or not is your decision of course, but if they're right, the current situation may well bring you to your knees at some point in the future, if it hasn't already. Will it be worth it?
If the stress of school is a major cause of your distress, and if stopping school isn't an option even for a short time, perhaps there is a middle ground. Can you take a lighter course load for awhile? Can you take a semester off? If not, if this work is doing this to you and this scholarship is putting the pressure on you to do this work at this pace, is there an alternative to this scholarship that will allow you to continue your schoolwork at a pace that works better for you? Many people get their degrees with student loans.
Also, perhaps there are alternative ways to obtain health insurance. At the university where I work, I believe it's possible for students to get health insurance policies through the university if they can't be covered on their parents' policies.
I wish luck in your struggle and peace on your journey.
Allison
Posted by PhoenixGirl on February 10, 2001, at 10:33:31
In reply to RE: letter ** BRAVO Tracey, posted by willow on February 10, 2001, at 0:19:53
I dispise doctors also. I'd be interested in learning how the director responds to your letter.
Posted by Noa on February 10, 2001, at 14:10:00
In reply to I am fucking angry;give me solutions not cyberhugs, posted by Tracy on February 8, 2001, at 17:00:41
Tracy,
I am not sure what tests you took to determine if you are anxious or depressed, but I would trust what you say you feel over a test.
Also, have you ever tried a mood stabilizer either alone or together with an antidepressant?
Posted by shar on February 10, 2001, at 16:38:25
In reply to OK, here » Tracy, posted by MarkinBoston on February 9, 2001, at 16:31:14
My post disappeared, and it was a pretty good one, too, if I do say so myself.....8-)
What's the deal? It was number 53607.
Censorship (gasp) ?!
Shar
Posted by shar on February 10, 2001, at 16:46:07
In reply to Good. Now focus on your work, and stop and smell » Tracy, posted by Rzip on February 9, 2001, at 23:42:25
I would like to echo Rzip's suggestions to you, and also encourage you to not give up on ADs or docs altogether. It can be a long row to hoe, but you are in good company here!
S
> Tracy,
>
> My therapist used to remind me to stop and smell the roses. You will always have your undergraduate degree. You are in Law School, and furthermore you have a full scholarship and stipend to go with it. Stop a minute and appreciate the roses.
>
> Now, go back to your work. You have written the letter. I hope it makes you feel stronger, more in control. Now, pick a therapist (perhaps not one from the clinic) for the next couple of weeks till the end of the semester. Right now, forget the people who are no use to you and focus on your agenda. Therapists are only as good as long as they are useful and helpful to you. Otherwise, forget them. Only you can turn around your work situation. You have to reach within yourself to redefine the inner strength to pull through till the end of this week, this month, and finally this semester. Only you are going to be graded on your exams.
>
> My suggestion is to pick a therapist and stick to him/her till the end of the semester in a stable manner (i.e. weekly session). You only have to commit to this till the end of the semester (one step at a time). What you need most of all, in my biased opinion, is stability. With stability, comes the ability on your part to concentrate and turn around the choas and confusion that is surrounding your personal and professional situations.
>
> - Rzip
Posted by Rzip on February 10, 2001, at 17:33:10
In reply to Hey!! What happened to my post????, posted by shar on February 10, 2001, at 16:38:25
Shar,
Are you sure you posted it? Maybe some computer glitch.
I think the only time Dr. Bob pulls a post without comment is when the content is revoltingly inappropriate. Since you do not do that, I suspect perhaps you forgot to push the submit button. Perhaps you can write another post?
Thanks for your support on P-Social-B and PB-Admin.
I think Tracy has been blocked, but I hope she finds comfort and guidance in our continuing suggestions.
- Rzip
Posted by MarkinBoston on February 10, 2001, at 20:09:53
In reply to Re: give me solutions not cyberhugs, posted by Tracy on February 9, 2001, at 20:14:03
Some of your symptoms sound viral like Chronic Fatigue Syndrome, Epstein-Barr, Hepatitis, ???, mono. The others sound stress related. The stress of being sick and not diagnosed and having to deal with the medical system.
My first stress reduction measure would be to stop seeing that therapist who just wastes your time and pisses you off. No amount of talking will kill off a virus.
I had an appointment with a new doctor and she cancelled it because the type of hormone therapy I want (Arimidex, that she used in research) is not shandard practice (yet, but someday I hope) and the AMA says testosterone should not be used for weight loss after telling her I was quite pleased losing 30 lbs in two months on testosterone. It used to be that the AMA claimed anabolic steroids (testosterone is only one) didn't improve lean/fat ratios. As if Arnold Schwartzineger got that big from a balanced diet and regular exercise. Now the AMA has conceeded that they work, but have few uses. This doc is going to be a good girl, follow the party line and persue a lucrative practice of helping monied career women get pregnant in their late 30's and 40's. I won't die tomorrow without Arimidex and these women can adopt. My want is less Politically Correct than their want, so I lose.
I think its kind of ironic, this being a mental health board and the AMA, US government and so many institutions are out of touch with reality.
I asked about the cold medicine because histamine blockers like Benedryl and especially Remeron knock me out.
Posted by willow on February 10, 2001, at 21:03:31
In reply to Virus? Some doctors Really suck, posted by MarkinBoston on February 10, 2001, at 20:09:53
CFS is what I've been diagnosed with, but honestly I think it's a "I don't know" diagnosis. Tracey symptoms sound so similar to myself. I do feel for her emotional pain. She's still so young.
Markin are you not in Ontario?
The reason I was wondering is because I'm looking for something safe to help me fall asleep since the effexor has kicked in. And I don't know if the remeron is available up north?
Posted by Dr. Bob on February 10, 2001, at 23:43:16
In reply to Hey!! What happened to my post????, posted by shar on February 10, 2001, at 16:38:25
> My post disappeared, and it was a pretty good one, too, if I do say so myself.....8-)
>
> What's the deal? It was number 53607.
>
> Censorship (gasp) ?!Sorry, but you let that naughty word slip through...
Bob
Posted by Dr. Bob on February 10, 2001, at 23:59:28
In reply to Re: Virus? Some doctors Really suck, posted by TAB on February 10, 2001, at 22:51:15
> Yeah I was blocked -- I don't understand why, either.
I ended up sending my post to the admin board:
http://www.dr-bob.org/babble/admin/20001124/msgs/616.html
Which is where I asked discussion of this to take place, which is why I've deleted this post that I'm replying to. Besides, you're supposed to be blocked! Please feel free to email me, though, if you want to discuss this further.
Bob
Posted by MarkinBoston on February 11, 2001, at 13:03:37
In reply to Re: Virus? Some doctors Really suck, posted by willow on February 10, 2001, at 21:03:31
> Markin are you not in Ontario?
No, but we're sending our govenor to Ottawa! I've been to Toronto and Missasauga numerous times on business and like every Canadian place I've visited.
> The reason I was wondering is because I'm looking for something safe to help me fall asleep since the effexor has kicked in. And I don't know if the remeron is available up north?
My solution was going from Effexor XL - > Effexor instead of taking another drug. The only withdrawl symptom I get is a little headache reminding me to take my afternoon 75mg. My one experience of taking 15mg of Remeron on a friday night and being sleepy all weekend really put me off. I wasn't safe to drive and spent most of the weekend in bed. Taking a drug on a friday night, becoming unsafe to drive, and spending the weekend in bed is supposed to be done with a new friend and little sleep!
Posted by willow on February 11, 2001, at 14:27:29
In reply to Ontario? No. Take our Govenor, please! » willow, posted by MarkinBoston on February 11, 2001, at 13:03:37
"My solution was going from Effexor XL - > Effexor instead of taking another drug. The only withdrawl symptom I get is a little headache reminding me to take my afternoon 75mg."
You had mentioned this before, at the time I had hesitated because I had had to split my XR dose into two to avoid the headache. Finally that is starting to go away, and now sometimes I forget the afternoon dose. So your suggestion is probably the best option for me now, I'll suggest it the doc on Tuesday when I get my refill.
"My one experience of taking 15mg of Remeron on a friday night and being sleepy all weekend really put me off."
Thanks for the warning! I'm a sleep addict and if I spent the weekend in bed it would probably turn into a week long marathon.
PS I'll nab your govenor if he's not racist, if you take our premier! - Mike Harris - I think he would really enjoy the states.
Posted by allisonm on February 11, 2001, at 17:57:24
In reply to Ontario? No. Take our Govenor, please! » willow, posted by MarkinBoston on February 11, 2001, at 13:03:37
The thing about Remeron, though, is that it will knock you out for a couple of days, so it is wise to start taking it on a weekend. However, that side effect goes away quickly, I found.
Posted by Andre Allard on February 11, 2001, at 23:15:23
In reply to I am fucking angry;give me solutions not cyberhugs, posted by Tracy on February 8, 2001, at 17:00:41
If you think that the testosterone therapy caused you to drop 30 pounds you are mistaken.
You can take all the steriods you want and your bodyfat mass would not significantly decrease. The only reason why you might drop a couple pounds of body fat is because the more muscle you carry the more calories you burn (1 pound of muscle burns 35 calories/day).
I have stacks of internet info and books on anabolic steriods and from what the steriod gurus state there are no significant metabolic enhancing effects from the sauce.
I just thought that I would clear that up.
Posted by Bill L on February 12, 2001, at 7:50:23
In reply to Re: solutions not cyberhugs, posted by Tracy on February 9, 2001, at 5:55:35
Tracy - If I were you , I would try to get back on the Ritalin or a similar drug. Job 1 for you right now is getting good grades to get into law school. That's an immediate concern. If you get good grades, you will feel better.
You said that the Ritalin worked, but you needed a large dose and it increased your blood pressure. Adderal is longer acting and there is also now an even longer acting extended release Ritalin. Maybe they would work better without the blood pressure effect. If the raise in blood pressure is not too severe, I would accept a low to moderate increase as the price to pay for being able to concentrate. If it is a severe increase, maybe try a lower dose of Ritalin or Adderal.
Also, I would seriously consider trying cytomel (thyroid supplement) even though your thyroid blood tests are normal. Docs frequently give thyroid supplements to people with normal tests because the blood tests are not that great. They show blood levels, but not the levels of thyroid hormone that enter the cells. Your symptoms are classic of those that could be helped with cytomel. It's worth a try.
But right now I would see if the doc would put you back on Ritalin or a similar stimulant, atleast until the school year ends.
Also, some people are helped by vitamin B12 injections when they are always tired. Have the doc order blood tests to check for this if he has not already. Also take a multi vitamin/mineral each day. Also a B complex might help.
It's always funny when docs tell you that you suffer from "stress". That has always been their code word for saying "I don't know what's wrong with you".
Posted by willow on February 12, 2001, at 12:16:41
In reply to Re: solutions not cyberhugs, posted by Bill L on February 12, 2001, at 7:50:23
"Also, some people are helped by vitamin B12 injections when they are always tired. Have the doc order blood tests to check for this if he has not already."
Gosh I forgot to mention this! It has helped me and there's no harm in trying it. The effect doesn't last."
"Also take a multi vitamin/mineral each day. Also a B complex might help."
When I began with the hypersomnia I tried all sorts of vitamins. In my opinion a healthy diet and lifestyle habits are probably better.
"It's always funny when docs tell you that you suffer from "stress". That has always been their code word for saying "I don't know what's wrong with you"."
We are all individuals and I don't think we can dismiss this issue. Especially when there is distress caused by symptoms sometimes we have to weigh what we are willing to sacrifice to be able to do what we enjoy. Sometimes this can be a painful exercise emotionally when a persons well-being has changed, and they have to give up previously enjoyed activities.
Posted by Noa on February 13, 2001, at 8:05:20
In reply to Re: solutions - B12, posted by willow on February 12, 2001, at 12:16:41
Isn't B-12 deficiency very very rare? If you eat any animal products, supposedly you get ample B12.
Also, the liver is supposed to store lots of it, so if you have a deficiency, the deficiency in the diet can be traced back over a few years. For example, my sister, a long time vegetarian, became a vegan a couple of years ago. Now she has B-12 anemia, and has had to get B12 shots and take supplements. Apparently, the shots also take a while to feel the effect.
Posted by Lisa Simpson on February 13, 2001, at 8:42:02
In reply to Re: solutions - B12, posted by Noa on February 13, 2001, at 8:05:20
Hi Noa - PMFBI (is that right? Or should it be PMFI? I'm never sure with these things), but B12 deficiency can also be caused by digestive problems like I have. I have ulcerative colitis, and cannot absorb B12 properly, so I have to have B12 injections. I found that if I was really exhausted, they worked quite quickly.
Lisa
Posted by willow on February 13, 2001, at 10:39:35
In reply to Re: solutions - B12, posted by Lisa Simpson on February 13, 2001, at 8:42:02
Noa
I'm not lacking in this vitamin, and the effect may be a placebo affect and I've tried to cut them out, but it has been the most effective thing so far in helping wake me up. I think they're also used to improve mood for geriatrics too.
LisaA year before I became ill I had an intestinal parasite (giaridias sp? "beaver fever".) I don't have anything else wrong except an inflammed duodeum (sp? lower part of stomach) for which I take Losec and Zantac. Suprisingly when I started the zantac I initially had my first significant improvement of symptoms, but it only lasted several months.
BEST WISHES
Posted by Noa on February 13, 2001, at 13:24:58
In reply to Re: solutions - B12, posted by willow on February 13, 2001, at 10:39:35
Lisa,
That's right. I forgot about that--thanks for saying something. Apparently there are several digestive problems that cause an inability to absorb B-12, right?
Posted by Noa on February 13, 2001, at 13:35:16
In reply to Re: solutions - B12, posted by Lisa Simpson on February 13, 2001, at 8:42:02
I should be the one saying PMFBI!
Posted by Lisa Simpson on February 20, 2001, at 5:55:39
In reply to Re: solutions - B12 » Lisa Simpson, posted by Noa on February 13, 2001, at 13:35:16
The only problem with B12 injections, is that they have to be given directly into the muscle ... so my doctor stands at the other side of the room and throws it hard at me as if I were a dart board... (at least, that's what it feels like!)
:)
Lisa
Posted by Noa on February 20, 2001, at 11:26:04
In reply to Re: solutions - B12, posted by Lisa Simpson on February 20, 2001, at 5:55:39
> The only problem with B12 injections, is that they have to be given directly into the muscle ... so my doctor stands at the other side of the room and throws it hard at me as if I were a dart board... (at least, that's what it feels like!)
>
> :)
>
> Lisa
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