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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Optimist on February 4, 2005, at 10:50:52
I've wondered if many people here have contemplated taking their medication regimands in to their own hands. I've seen a few people here that have ordered meds over the net without prescriptions. They're ordering meds either because their pdocs can't or won't prescribe them. It seems there is a lot of needless suffering that occurs which is sadly unfortunate.
I have to offer a disclaimer here first. I am not advocating or suggesting people bypass their pdocs. I think it can be very dangerous... a little bit of knowledge... There are probably just a select few that should really consider this option. I imagine I would possibly think of self medicating if my pdoc wasn't so liberal and understanding.
So... any comments, or personal stories to tell regarding your own self medicating?
Brian
Posted by banga on February 4, 2005, at 11:47:02
In reply to Getting off the pdoc merry-go-round, posted by Optimist on February 4, 2005, at 10:50:52
Difficult question.
Pdocs out there are so different!
--My initial pdoc was quite OK, but was leery of polymedicine. We'd set sth up and it would work somewhat and his first comment was a hopful "then maybe in two weeks we can get rid of drug x and only take drug y."
--I then changed from yet another pdoc, who was wise, sympathetic and skilled, but openly admitted another pdoc may be better for me--who is willing to take more risks. (It is good to know she is there as back-up if I need someone to take full conservative control in the future.)
--And so I now went to the other extreme--a good pdoc who is well known to be...well, liberal is a light description. I have a LOT of say in what we decide, he is game to try it out, no qualms.
I would NOT be going to this pdoc if it weren't for my ability (and preference) to research things on my own, AND if it weren't for this board where I can get some hints an advice.
Seriously, there is no way I would have ended up on the meds I am on now had I not read this board, and had I left control to my pdoc.If a person has the luxury to "Shop around" to get a good fit, or at least get a second opinion, I encourage it immensely.
In cases where it is not feasible it is tough. If you hear of someone through others who truly sounds like a good fit, it might even be worth shelling out the money for a couple of spread-out appointments with a poc not under your insurance--if you agree on a regimen (and esp. if you find one that works) you can go back to the stingy pdoc that insurance does cover...they will be much more willing to continue a regimen that is already set up and working.
Some suggest seeing a psychopharmacologist--who typically looks at things bit deeper, from a different angle. That's how I found my current pdoc, though he wasn't exactly what I had in mind at the time!
Going completely alone is very dangerous I think. You need that resource that looks at you--in person--and evaluates what is going on. I am probabl ADHD, and this NEVER would have occurred to me (and I am in psychology!!) because I am sosed to the disease I thought it was "normal" to feel this way.
Butit is easy for meto tlk. EVen though my insurance costs an arm and a leg, the list of covered pdocs is vast so I can shop.
My two or tree cents.
Posted by Ritch on February 4, 2005, at 12:14:16
In reply to Getting off the pdoc merry-go-round, posted by Optimist on February 4, 2005, at 10:50:52
> I've wondered if many people here have contemplated taking their medication regimands in to their own hands. I've seen a few people here that have ordered meds over the net without prescriptions. They're ordering meds either because their pdocs can't or won't prescribe them. It seems there is a lot of needless suffering that occurs which is sadly unfortunate.
>
> I have to offer a disclaimer here first. I am not advocating or suggesting people bypass their pdocs. I think it can be very dangerous... a little bit of knowledge... There are probably just a select few that should really consider this option. I imagine I would possibly think of self medicating if my pdoc wasn't so liberal and understanding.
>
> So... any comments, or personal stories to tell regarding your own self medicating?
>
> BrianMy pdoc is generally willing to experiment as well, so I count myself somewhat lucky. I really need to see a bipolar specialist and there is no such person anywhere near where I live. So, I'm stuck making med propositions and rolling the dice. Ideally, I should just seek out a specialist, give them 2 hrs. of detailed information to start, drive a few hundred miles every few weeks, spend the cash, let them drive 100%. But that's not feasible for most people and I think there are a lot of treatment resistant, treatment intolerant, mixed/confused dx patients out there dealing with less than adequate pdocs that would probably be just as well off doing it themselves, so I can't condemn the practice even though I am not doing that.
Posted by Bill LL on February 4, 2005, at 12:51:23
In reply to Getting off the pdoc merry-go-round, posted by Optimist on February 4, 2005, at 10:50:52
I personally have drug coverage included in my health insurance and would therefore have to pay a whole lot more if I did not use the prescription plan. So cost is one factor.
Safety is of couse another important factor.
Try another doc. Many general practitioners and pdcos are very willing to prescribe all kinds of drugs.
Posted by banga on February 4, 2005, at 13:30:03
In reply to Re: Getting off the pdoc merry-go-round, posted by Bill LL on February 4, 2005, at 12:51:23
Just to clarify--I was talking IDEALLY what steps one could take...for most of us mortals it is not possilble or is at incredible cost. I know with the costs of docs ad meds it is usually out of the question to pay off-insurance. Even WITH insurance we have to each month decide wht we will cut down on so I can buy the meds. As I said, I am lucky in that my insurance is good and I have a husband to keep us from sinking (though we have been close). I would literally be dead if that were not the case.
Posted by Optimist on February 5, 2005, at 10:37:34
In reply to Re: Getting off the pdoc merry-go-round, posted by banga on February 4, 2005, at 11:47:02
I agree it's a good idea to have a skilled professional there to more objectively assess how we are. Logic and thoughts can become distorted when one is mentally ill, and what makes sense to us may be considered off the wall by others.
I wouldn't go around my pdoc personally but I think I would if my pdoc would only prescribe SSRI's per say and I couldn't find anyone else that was better.
I was thinking of people who shop online for drugs like Selegiline, Amineptine, etc... or people who can't find a doctor that will prescribe them MAOIs due to ignorance or extreme conservatism. MAOI_Chairman comes to mind in that respect. He had to order Parnate over the net without a prescription when no other doctor would give it to him. According to him he's made tremendous improvement.
I imagine though if my current pdoc wasn't so liberal then I'm sure I could find someone in the general area that is. Toronto seems to have a number of informed/aggressive pdocs that I'm sure I could get a hold of if need be.
Brian
Posted by rvanson on February 5, 2005, at 12:41:17
In reply to Getting off the pdoc merry-go-round, posted by Optimist on February 4, 2005, at 10:50:52
Funny you should ask this but here goes:
I am currently dropping my insurance down to a more affordable plan without a drug benefit.
After my last Pdoc played around with my request to use a Nardil regimen that helped me in the past, and watching as drug company salesman were sitting in his waiting room 80 percent of the time when I had an appointment, and he let them ahead of me, I have had it with Pdocs for the last time.
They are have become little more then drug pushers who care more about drug company kickbacks, then helping their patients get well.
Life is too short to keep begging these people to use medications that work, not the latest psych med that costs 3 dollars a pill and is loaded with side-effect that render it useless.
Overseas meds are cheaper and they dont have an additude that these college trained "professionals" have towards a lay person who knows something about thier little racket.
-Rant mode off-
> I've wondered if many people here have contemplated taking their medication regimands in to their own hands. I've seen a few people here that have ordered meds over the net without prescriptions. They're ordering meds either because their pdocs can't or won't prescribe them. It seems there is a lot of needless suffering that occurs which is sadly unfortunate.
>
> I have to offer a disclaimer here first. I am not advocating or suggesting people bypass their pdocs. I think it can be very dangerous... a little bit of knowledge... There are probably just a select few that should really consider this option. I imagine I would possibly think of self medicating if my pdoc wasn't so liberal and understanding.
>
> So... any comments, or personal stories to tell regarding your own self medicating?
>
> Brian
Posted by rvanson on February 5, 2005, at 14:05:51
In reply to Re: Getting off the pdoc merry-go-round » banga, posted by Optimist on February 5, 2005, at 10:37:34
> I was thinking of people who shop online for >drugs like Selegiline, Amineptine, etc... or >people who can't find a doctor that will >prescribe them MAOIs due to ignorance or >extreme conservatism. MAOI_Chairman comes to >mind in that respect. He had to order Parnate >over the net without a prescription when no >other doctor would give it to him. According >to him he's made tremendous improvement.Bingo!!
These sad-sack Pdocs will try anything in the book to avoid Dx'ing meds that are deemed more difficult to use or involve more paperwork.
In my experiences, these include, but are not limited to:
1. Benzodiapines (Xanax)
2. Stimulants (Addderal)
3. MAO inhibitors (Nardil)No, its much easier and more profitable to keep prescribing SSRI's, or other "safer" meds, even when the patient has already had failed past trials on these very same drugs, then listen to the patient and precribe something that may indeed help a person to lead a somewhat normal life.
IMO, by law, Pdocs ought to have a notice plastered on the wall in thier waiting rooms as to which meds they wont DX, no matter how lousy the patient is doing in their mental state.
I wont hold my breath waiting.
Posted by Optimist on February 5, 2005, at 15:12:14
In reply to Re: Getting off the pdoc merry-go-round, posted by rvanson on February 5, 2005, at 14:05:51
> Bingo!!
>
> These sad-sack Pdocs will try anything in the book to avoid Dx'ing meds that are deemed more difficult to use or involve more paperwork.
>
> In my experiences, these include, but are not limited to:
>
> 1. Benzodiapines (Xanax)
> 2. Stimulants (Addderal)
> 3. MAO inhibitors (Nardil)
>
It's too bad that modern medicine hasn't improved much upon the 40/50 year old psych meds. There exceptions of course, but some of the most useful drugs are also the least prescribed. They've made many psych meds safer but in the process they've also made them less effective unfortunately. And since they are off patent they are no longer promoted sadly enough.Brian
Posted by rvanson on February 5, 2005, at 21:40:24
In reply to Re: Getting off the pdoc merry-go-round, posted by Bill LL on February 4, 2005, at 12:51:23
> I personally have drug coverage included in my health insurance and would therefore have to pay a whole lot more if I did not use the prescription plan. So cost is one factor.
>
> Safety is of couse another important factor.
>
> Try another doc. Many general practitioners and pdcos are very willing to prescribe all kinds of drugs.
I wish I could say the same about my experiences with doctors but, sadly, I cannot do so.Too many of them do not want to prescribe something like Nardil that they do not really understand or are afraid of because of the slim possibility of a stroke (how about all the stroke causing Vioxx you Dx'ed over the last few years, doc? ), or they are unwilling to Dx medications for conditions that they are not specifically mentioned in the PDR as used in that condition, particularly FDA schedule I and II medications.
I am glad that your experiences were more favorable.
Posted by Maxime on February 6, 2005, at 19:33:42
In reply to Re: Getting off the pdoc merry-go-round, posted by banga on February 4, 2005, at 11:47:02
Banga, can you tell me how your session with a
psychopharmacologist went? What type of questions were asked? Did he explain things to you?I'm starting to think that I will not try another med until I get a referral to see one.
Maxime
Posted by banga on February 7, 2005, at 7:53:52
In reply to Re: TO BANGA, posted by Maxime on February 6, 2005, at 19:33:42
Hi!
RE: the psychopharmacologist...well my experience is a little odd.
My friend's husband has an anxiety disorder and in Boston consulted a psychopharmacologist who gave very specific advice taking into account his unique case. Since then a stream of her friends have gone and were extremely pleased. Unfortunately I never could coordinate an appointment in my Boston visits.
So I tried finding one here. My insurance co. had on idea what I was talking about. I finally found one clinic in the phone book. A PhD-MD combined degree is usually what you look for. The guy is very nice and knowledgeable....but sort of an absent-minded professor type, so I didn't get the experience I hoped. He turns out to be infamous here among psychiatrists as a person who is perhaps a bit lineral with his meds. He is good but just quite unique.
So in my case I did not find the psychopharmacology advice I expected! but in him I found someone who is very willing to try just about anything I suggest. So he's my pdoc now.So i actually can't guarantee they are all like my friend's person. If I were able to find one, I would still go. I don't know how. I might contact my friend, see if her doc could tell her if there is some sort of countrywide network or something. See, in insurance lists they are prpbably listed among the psychiatrists--there is no separate way to search for one that has a PhD in addition.
I will definitely keep in mind--if I do find out more info on how to locate them, I will post it here.
I am not sure I'd hold off meds altogether...as you can see it may not be a simple matter to find one. But my sense is if you can--it would defninitely be worth it.
If I ever get to Boston, I will go see this guy.
Good luck!
This is the end of the thread.
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