Friday, November 14, 2008


Lately this has become my griping about doctors sounding board. I assure you that I am generally not a cranky or unsatisfied person but whatever.

So, traditionally many Masto patients take Doxepin for fatigue/depression because aside from being a tried and true (or one could argue "old") antidepressant, it also has a ton of antihistamines in it. The whole killing two birds with one stone thing (or I guess alleviating two symptoms with one pill thing)

My psychiatrist (Who for the record is -not- the one I posted about yesterday, as he himself felt he was underqualified to write an evaluation of me, and of who I am no fan mostly because he seems sort of cold and removed...something evidenced by the fact I've been seeing him for a year and he feels incapable of writing a review on me) is not keen on Doxepin because it is old, because there are side effects that are unpleasant, because higher doses are required, etc etc. He instead has been pushing Remaron instead, as it is newer, has antihistamine properties, less side effects, lower doses are required, all that stuff. However, from my totally unscientific polling of the main masto list, it seemed like I couldn't find a single person using Remaron to treat both their masto and the resultant psychological side effects...It seems like Doxepin is generally the gold standard.

So yesterday I went to talk to him about getting a script for Doxepin and he got all pissy that I didn't want to go on Remaron instead, since he was incredibly attached to his idea. I explained to him that I was cautious because I didn't know anyone who had used Remaron while it seemed quite a few people had used Doxepin to great advantage. He was being very difficult about it, so I asked him to call my masto doctor (who practices in the same building as him) to discuss the pharmacological pros and cons between the two medications since we were looking to use it to both improve my energy/mindset as well as to lessen my histamine burden. He got all reticent about it, saying that if I was deadset on Doxepin then he'd write the script and be done with it.

Now, I mean, I'm not a physician, I only have anecdotal evidence that one drug is preferable to the other, and I would prefer if my two doctors spoke about the medical, pharmacological benefits of the two drugs and which would be better. Why it is that doctor A thinks and commonly prescribes drug A to her patients and doctor B finds drug A to be an outdated and risky drug that could be successfully substituted with drug B. The two of them, as peers would have a far more intelligent conversation than I could have ferrying information between the two of them. Eventually it had to come to me acting like a spoiled child, saying I would refuse to take any medication my psychiatrist prescribed for me until he talked to my masto doctor.

This is not one of my proudest moments. While I am a persistent and headstrong person (often to a fault) I am not one to be so brattish. While my refusal to take any new meds prescribed by my psychiatrist would put me in absolutely no harm, it was a regrettable but necessary stance. I cannot believe that it took that measure to get him to agree to call a physician who is literally -2 floors- above his office. He is so caught up in the concept that is perspective is clearly the only logical one while putting my more pressing diagnosis (being the Masto) ahead of anything else is very disconcerting to me. That coupled with the fact that after having been under his care for a year he felt incapable of filling out my lawyers paperwork makes me feel that it is time to find a new psychiatrist. The main reason I had picked this doctor is because he works for the same hospital as my masto doctors, and his reticence to communicate with them regarding the best course of action for my treatment plan without my making ridiculous grandstanding statements is very unsettling.

In other news, I drank -coffee- today. Typically I get a decaf iced coffee from Dunkin Donuts (one of the only non organic, home prepared things I will ingest) however today the barista apparently decided I needed an extra kick...which in and of itself wouldn't be a big thing but I have only ingested trace amounts of caffeine over the past 2-3 years (I stopped drinking alcohol and coffee well before my diagnosis) and HOLY COW I WAS SO BUZZED AS A RESULT. It was amazing. I felt like I could take over the world. While my unexpected coffee high was ridiculous pleasant feeling, the resultant crash...not so much. Nothing at all to do with masto, but I thought it was amusing that I was buzzing around on caffeine the way I imagine one would be on a more illicit substance. I am sort of wondering if I should add coffee (in lesser amounts) to my diet since I had markedly higher energy levels today and it felt super good. However, I need to see if caffeine is ok for the bones (i know soda is bad for the bones, but I don't know if it is the sugar, corn syrup or myriad of other ingredients)

Finally, in the "Bridget never watches television" file, I am just getting around to watching the HBO docudrama on John Adams and it is incredibly good. I still need to read the book that provided the source material as both it at 1776 are sitting on my good. All television should be this gripping instead of inane like Grey's Anatomy and its insulting depictions of, well, everyone. HBO and the BBC also teamed up and made this really riveting docudrama about Saddam Hussein called, "House of Saddam" which a friend downloaded for me...also really amazing. Though I'm a sucker for generally historically accurate dramas.

1 comment:

Peter said...

It seems that after the initial studies that found that "Soda is bad for bone health", further studies found the issue is rather more complex.

Further studies were able to determine that the issue is actually that people are drinking soda instead of drinks that contains calcium and other vitamins and minerals and generally high soda consumption went hand in hand with a poor diet. This obviously is problematic. The studies were less able to definitively prove there was a definitive link between soda consumption and weakening bones, especially with people who otherwise had healthy diets.

Others strongly believe that there is something inherent in soda that causes bone problems, but have since focused there worry on two issues: phosphorous content and the carbonation.

Some Doctors claim that it is the high phosphorous content generally found in darker sodas (colas, dr. pepper, etc), causes your stomach acid to be less able to absorb calcium. Still others believe it is the carbonation itself, but there is less and less evidence to support this.

So I think you're fine having a little more caffeine in your diet with regards to your bone health. Of course caffeine has its own problems (