Ask your doctor about drug X!

Let me tell you how my morning went.

Six months ago…

JT:  Hi doc.  I have problem A and problem B.  You’re a doctor.  I pay you money to fix those problems and to make me feel normal.

Doctor:  Try drug X for problem B.  It exacerbates problem A, but it can fix problem B.

JT:  Ok.

Almost six months later…

JT:  Hi doc.  Drug X does wonders for problem B.  But, as predicted, it exacerbates problem A.  I have a friend who takes drug X and has experienced the same.  Her doctor gives her drug Y as well to combat problem A.  Can I try that?

Doctor:  No.  Drug Y is a stimulant.

JT:  Does it fix problem A?

Doctor:  Yes.

JT:  So, why does it matter if it’s a stimulant?

Doctor:  Let’s try a non-stimulant.  Here’s a prescription for drug Z.

JT:  So drug Z fixes problem A?

Doctor:  Sometimes.  But it’s not a stimulant.

JT:  Ok.

One week later (today)…

(JT sits down in the exam room and sees this)

JT:  Doc, I’m allergic to drug Z.

Doctor:  That’s too bad.  Stop taking it.

JT:  Yeah, two steps ahead of you there.  Can I just try drug Y?  Y’know, the one that fixes problem A all the time?

Doctor:  No.  Drug Y fixes problem A, but it exacerbates problem B.

JT:  But, didn’t you prescribe me drug X to fix problem B even though it exacerbates problem A?

Doctor:  Yes.  That’s different though.

JT:  Why?

Doctor:  Because drug X isn’t a stimulant.

JT:  Do stimulants have some horrible side effect or something?

Doctor:  They can be addictive.

JT:  But you still prescribe them?

Doctor:  Yes.

JT:  So it can’t bug you that much.  Besides, being addicted to a drug that fixes my health problem doesn’t sound so bad.  Any other horrible issues with stimulants?  I mean, if stimulants are so problematic, why are they on the market?

Doctor:  No, no crazy side effects aside from exacerbating problem B.  They’re on the market because they fix problem A.

JT:  So because I have problem B I’m stuck with problem A?

Doctor:  No, drug Y could fix problem A.

JT:  But I can’t get drug Y.

Doctor:  You’d have to see a specialist.

JT:  …ok.  What do I have to do to see this specialist?

Doctor:  Well, none of those specialists in the area are taking patients at the moment.  You could talk to a person who can’t help you for three months, then pay for an evaluation that’s not covered by insurance, which would get you in to see the specialist.  They may not prescribe you drug Y though.

JT:  So I can’t get the drug that fixes problem A?

Doctor:  Not without spending a lot of money on a roll of the dice.  See you again in six months?

JT:  No.  You’re my doctor.  I pay you to fix my health problems.  If you can’t fix my health problems, why should I keep paying you?

Doctor:  Well, we tried drug Z.  That’s the non-stimulant that sometimes fixes problem A.

JT:  I was allergic to that.

Doctor:  *give the “that sucks” face*

JT:  I’m going to leave now.

Three cheers for the system.

About JT Eberhard

When not defending the planet from inevitable apocalypse at the rotting hands of the undead, JT is a writer and public speaker about atheism, gay rights, and more. He spent two and a half years with the Secular Student Alliance as their first high school organizer. During that time he built the SSA’s high school program and oversaw the development of groups nationwide. JT is also the co-founder of the popular Skepticon conference and served as the events lead organizer during its first three years.

  • John Eberhard

    That sucks.

  • http://peopleofpublictransport.wordpress.com Zinc Avenger (Sarcasm Tags 3.0 Compliant)

    Truly the American Healthcare Prevention System is the finest in the world.

  • http://faehnri.ch/ faehnrich

    Go to your friend’s doctor.

    • http://freethoughtblogs.com/wwjtd JT Eberhard

      Friend’s doctor is in Missouri.

      • http://faehnri.ch/ faehnrich

        Then tell your doctor to give you the stimulant Y and explain that if it does cause an addiction then point to his acupuncture ad where it says on the bottom-left that it cures addiction.

        • http://freethoughtblogs.com/wwjtd JT Eberhard

          You win at life.

  • https://twitter.com/nicoleintrovert Nicole

    You could ignore the statement that “those docs aren’t taking new patients” and call them yourself to find out. At least you would know for sure.

    • http://freethoughtblogs.com/wwjtd JT Eberhard

      This dialogue was created just to convey the gist. I was the one who called around everywhere and this is how I know they’re not taking patients.

  • Randomfactor

    And the reason you can’t get the stimulant is not that it’s addictive, but that each prescription for it comes on a triplicate form. One copy of which goes to a bureaucrat who reads them assiduously for signs of bad behavior on the part of the doctor. Late at night. Sustained by stimulants.

  • Rebecca Hensler

    Unholy mother of f*ck.

    You are at this point the third person I know who is struggling with this type of situation.

    Only thing I can think of is to broaden your search for a specialist and see one outside of your area. It sounds like the benefits would outweigh the hassles and once the doctor has seen you once in person, he or she might be willing to do phone appointments from then on.

  • Carol Eberhard

    Unfortunately, a lot of what happens in a doctor’s office is to protect the doctor, not to help the patient…:o(

    • Epinephrine

      If doctors are protecting themselves, it strikes me as a problem stemming from the overly litigious nature of the USA, which is in part due to the lack of socialised medicine (my probably hopelessly naive impression is that there is a need to sue to get the medical care you can’t afford to pay for out of pocket).

      Your situation still sucks, and I agree that maybe a solution (for this issue) is to try another doctor. Addiction is a real concern, so you can’t fault a doctor for worrying about it and trying to find other approaches.

      For the socialised medicine problem, take another term of Obama, and come back in 4 years. Hopefully things will be looking better.

      • iknklast

        The overly litigious system also comes from a failure to understand science. People demand antibiotics for viruses; if they don’t get them, and something happens, they sue. If the doctor prescribes them, and something goes wrong, they don’t sue. If the doctor poopoos the homeopathic remedy, and the patient likes it and thinks it works, then the patient might find a reason to sue. So on.

  • http://eepineapple.wordpress.com Jessica

    I can sympathize. I’ve seen two separate doctors who tried to write me a prescription for an antibiotic for my allergy problems. It seems like doctors just do what’s easiest instead of what will actually help their patients.
    Best of luck finding the help you need.

  • Otrame

    You need a new doctor. A few years ago, my doctor said, “hey, I was reading about the effectiveness of drug P–which, among other things, is a mild stimulant– in reducing the problems with xyz disorder. Let’s give it a try.”

    I’ve been taking it ever since. It helps a lot. You need a new doctor. Refusing to prescribe an effective drug because of some fetish about stimulants is evidence of a lousy doctor.

  • Kevin K

    Any physician in the United States can write a prescription for any legally available drug, especially when used on-label.

    There is no legal restriction to prevent your physician from writing you a prescription. There is no requirement that you see a specialist in order to obtain a prescription for a stimulant.

    No kidding, get a different doctor. Your doctor sucks at medicine and at life.

    • PessimiStick

      100x this. He is not doing his job. Fire him and go to someone who actually does theirs.

  • Pierce R. Butler

    Eberhard, it’s time for you to stop messing around and just cold-turkey quit consuming alphabet soup.

    • AylaSophia

      JT’s “alphabet soup” is what he uses to manage what would otherwise be pretty debilitating symptoms. I won’t speak for him, but he’s been pretty open about his mental health problems in the past. Telling a mentally ill person to just stop taking their medication is extremely insensitive at best– potentially harmfull at worst. I believe I am on the same drug X as JT (for similar, thought not identical, reasons) and the last time I went off it for any length of time it was pretty disastrous. Managing mental health problems that can result in a horrible quality of life– preventing suicidal tendencies, etc.– is not “messing around.”

    • Amyc

      I had to quit my medication cold turkey (due to finances, I don’t have health insurance and I switched to a smaller school that doesn’t offer the same health services). I ended up in the emergency room (and handcuffed at one point, yep treated like a criminal for having a mental illness and no conceivable way to treat it) because suicidal tendencies came back quickly and strong. “Alphabet Soup” my ass. Even with counseling, some of us cannot function without the proper medication, and we don’t need judgmental assholes like yourself acting like you know what’s better for us.

    • Artor

      I don’t know what JT’s medical problems are, but sometimes, going cold-turkey is just not an option. I have a grass pollen allergy bad enough I get BLISTERS ON MY EYEBALLS!!! Quit cold turkey, even from meds with unpleasant side effects? Absolutely not, and also, fuck you.

  • http://www.ziztur.com Flimsyman

    Yup, I feel you. This is eerily similar to how my conversations about depression and asthma went with the doctor I was seeing.

  • Kevin K

    BTW: I’m somewhat of a snob when it comes to doctors. If I know more than they do about my condition/problem, then they’re not my doctor anymore.

    I’ve fired a lot of doctors in my lifetime.

  • http://www.atheist-faq.com Jasper of Maine (I feel safe and welcome at FTB)

    For those who say that Obama care would turn the healthcare system into a DMZ/government-stereotype situation – it’s managed to get that way all on its own.

    • ButchKitties

      “Single-payer systems are terrible because have wait lists,” said a person to me, just minutes after I’d told her that I have symptoms that could indicate a heart problem, but I won’t know for at least a month because that’s the earliest cardiology appointment I could get.

      • iknklast

        When I moved to a new town, the doctor I had an appointment with told me it would be six weeks before she could see me. No, she couldn’t call in the medicine I was already on until she saw me. I had only three months before nearly died of an asthma attack (so severe they called my husband to the doctor’s office) but she couldn’t see me a single second before six weeks. By that time, I would be dead. Fortunately, there was another doctor in town that recognized certain conditions as worthy of using one of his emergency appointments.

  • Loqi

    I happen to have written some doctor search software for internal use at a national health insurance network. Need some help finding a doc? :)

    • http://freethoughtblogs.com/wwjtd JT Eberhard

      Sure. :) My email’s on the sidebar.

  • didgen

    Try having a short but heartfelt discussion with the specialist’s office manager. It worked for me, I explained my problem and begged for mercy. It is demeaning and stupid that you have to beg for something that you need, but in my case I was beyond desperate. This from a person that retired from a career of working in the medical field as a critical care nurse. Good luck, and absolutely find another Dr. yours Sucks on several points.

  • Joe T

    Take a vacation to Mexico with your girlfriend and visit a pharmacy? I know that’s shitty but hey, vacation to Mexico!

  • LurkerMD

    Perhaps you don’t have a long enough relationship with your doctor. You look young and healthy enough in your picture. You probably don’t go in very often. Doctors tend to be jaded about people that pop in with diagnosis in hand requesting stimulant and/or narcotic drugs. Just an FYI.

    Let’s do some algebra and try to solve for A and B.
    Assume A is hmmm…. ADHD. Stimulants are often used in treatment for this. Unfortunately, it is a difficult diagnosis to make. There is no blood test. There is a set of tests that can be done (by the specialist) that can verify the diagnosis. There are also a lot of other conditions (B, C, D….) that can have similar symptoms. Unfortunately, many of those are not helped and may be harmed by stimulants.

    Lets assume drug Y is Adderall. It is a schedule II drug, deemed by your federal government to be a drug with high potential risk of abuse. Street price of 30 mg of Adderal is about $10-30 each. A potentially addictive drug for some people.

    Perhaps disease B is hypertension, cardiac arrhythmia, or anything in the DSMIV manual. Drug A may be absolutely or relatively contraindicated.

    Like life itself, it is complicated. Of course, these calculations may be all wrong. Your results may vary.

    • http://freethoughtblogs.com/wwjtd JT Eberhard

      Shoot me your email address and I’ll give you details.

  • No Light

    Ah, the war on drugs.

    You’re about the twentieth American I’ve known who’s hit this wall.

    A veteran denied pain meds for an injury received in the field, a few cancer patients, a narcoleptic, someone with grade IV endometriosis. All met with “No. It’s addictive”

    When I asked my doc about potential dependence on my fentanyl, he said “Of course it’s addictive, but it’s better than you committing suicide because of the pain”,

    I know way too many people in the US who are forced to treat legitimate conditions by visiting Doctor Krakhaus. He’s expensive, he works strange hours, but he doesn’t charge them and then leave them empty-handed.

    It’s a national disgrace.

  • http://Facebook.com/BareSyntax Joseph Gaspar

    I had this problem when I mentioned Welbutrin to my doctor. She said it would exacerbate my anxiety issues despite it fixing my wallet and depression issues. Instead she prescribed that I up my dosage of Zyprexa to 5mg despite the fact that I was having increased anxiety at the time because I didn’t have any Zyprexa due to running out of it and that it costs a shit ton of money.

    • Paul Neubauer

      It happens that Zyprexa has run out of its patent recently. I don’t recall the exact date, but generics suddenly became available within approximately the past year. The price of the generic is dramatically lower than the branded drug. You might consider looking into that again. YMMV.

      Best of Luck,
      Paul

      • Joe Gaspar

        Yeah, I was made aware of that im February, but the cost is still prohibitive. It went from $331 (with insurance) to around $80-ish. I can get it from my school’s health department, but I was just suspended for a year and given the glorious status of persona non grata, just because I yelled at the top of my lungs on the way out of the building when my professor refused to accept the fact that I was getting food stamps as an excuse for missing a test, essentially failing me from that class. She then lied and accused me of threatening her. I was taken to the local mental health center after five squad cars showed up. Now, my life lies in ruins and I have to find a job to pay for rent by the first of september or else I’m going to be evicted. The worst part is that my house mastes will be affected by having their rent go up and one in particular, a girl coming in from Peru, said she was unable to afford the 3 person rate, so my biggest concern now is them.

        But I’m rambling. Yeah, generics are great when they’re affordable. I’m scaling back on the dosage by cutting the pills in 1/8ths for the ones I have left so that when I do run out, it’s not as bad this time.

    • http:.//thisbitchwontshutup.blogspot.com EEB

      I have pretty bad PTSD but even worse depression. I was on a host of mood stabilizers that kept me from being totally suicidal, but I was never happy. They stabilized me somewhere below “OK” but above “I want to die.” After a lot of pleading, the doc put me on Wellbutrin, even though it would make the anxiety worse.

      Yes, the anxiety is a lot worse. I have 2-3 panic attacks a week, now, and some days I have difficulty leaving the house. However, she also gave me Ativan, which helps quite a bit (it is addictive, though, so some docs are hesitant to give it).

      But OMG. I am happy for the first time in, literally, years. I feel joy. I want to do things. I smile. Funny things make me laugh. Sweet things give me that fuzzy feeling in my chest. I’m writing again. Anxiety sucks, yeah, but I wouldn’t give up this feeling for the world. It’s like coming back to life. My father gave me a hug the other day, just held me tight and wouldn’t let go, and whispered, “I have my daughter back.” He was almost in tears, and he is not an emotional, open kind of guy. He’s the “look up stoic in the dictionary and find his picture” type. So, yeah, Wellbutrin kicks ass and I get very…protective, when people want to play around with my medications. I never want to go back to being a zombie (topomax, zyprexa), I never want to go back to never being happy (lamictal, some othetrs).

  • CC

    Oh, I feel for you. It sounds like you really need a new doc. FWIW, I’ve had some success with what didgen suggested. I called a specialist’s office and told the receptionist all about my problem, namely that all the specialists in the area were booked up and I needed a new prescription. She worked me in.

  • Azkyroth, Former Growing Toaster Oven

    Whereas, by contrast, the last pyschiatrist I saw basically refused to even DISCUSS any condition that couldn’t be treated with a pill. >.>

  • milieux

    I had a problem not with my doc, but my insurance. Two different docs suggested Cymbalta; an antidepressant that would also help with my back pain. Insurance said no, it’s too expensive, try generic antidepressant drug A. Took it, didn’t work. Ok, try drug B, took it, reacted badly with other prescribed meds. Long story short; they insurance made me try 4 different generic medications before they would pony up and ok the the drug that both docs wanted me to have in the first place; and it took a year to get it. Then they made me pay 2 name-brand prescription co-pays for the dosage I needed since the insurance company still felt that they knew better than my docs as to what I should and should not need. Frelling ridiculous.

    • Amyc

      I get so annoyed when people rail against a single payer system or Obamacare because they say they don’t want their health care decided by bureaucrats. My response: it already is you idiot. The question is, which bureaucrats do you want in charge? Ones working at a for profit insurance company with the company’s best interests in mind, or ones working the government with no eye toward profits?

  • http://www.improbablejoe.blogspot.com Improbable Joe

    … and this is why I self-medicate with lots and lots of beer. I’m not kidding, I’ve walked out of the doctor’s office screaming at the top of my lungs just too many times to ever bother again.

  • Micaycay

    I think we have the same problem lol, I even had an allergic reaction to the non stimulant…I had to wait forever for a specialist to get drug A and be tested for ADHD. But it was kind of worth it even though a regular doctor could have given it too me. I just wanted to be safe since I used to have problems with stimulants and anxiety.
    In my version of this…
    X=SSRI, Z=Strattera, Drug Y= first Adderall then Concerta aka finally feeling myself again! (+panic attack medicine as needed)
    I have really bad anxiety and ADHD: innatentive type. Stimulants aren’t as bad as the first doctor says they are. My doctor who prescribed me the anti-depressants and then non-stimulants warned me against stimulants like I’d die of panic attacks or something but I’ve been okay so far. I still need as needed anxiety meds some days but my mental cloudiness is gone and I feel like I can reach my full scientist potential now :D They are life savers and sometimes help both problems. This is just my experience though so what do I know.
    Best of Luck!

  • rcs

    It can really be tough to get medication when you have any kind of psychiatric history. Eating disorder? No stimulants. Past addiction problem? No painkillers. Major depression? No sleeping aids. This shit will follow you for years. And if you go to a new doctor with a request right away for a controlled medication, they consider it “Drug seeking behavior.” This is a systemic suspicion of non-neurotypical patients.

  • vcatalysis

    That’s really rough. In rapid succession, I was cajoled into taking 3 different anti-depressants, each of which progressively caused worse and worse nausea. I thought spending sobbing and retching the whole day in the bathroom at work was an “intolerable level of side effects.” I was ordered to keep taking them. A week of constant retching will make anyone more depressed… enough to want to die. Fail. After that, a doctor tried to persuade me to take narcotic painkillers to deal with the pain of my disability, even though being too high to get out of bed wasn’t going to make my life better. (I only feel debilitating pain when walking/standing, so being too high to walk around is stupid.) Then, he then told me about his patient who didn’t get high from the painkillers, but it also didn’t kill the pain, and a few weeks later she was in the hospital for detox and wished she was dead instead… So I shouldn’t worry about getting high. As I rolled out he was yelling at me to take narcotics. Haven’t been to a doctor since, even though if I find a way to stop the pain, I will be able to walk. I’d be better off if I got these feet amputated and used prosthetics, but I doubt the system will do that for me. Mexico?

  • emptyknight

    This kind of problem is all too common. Not just in GP’s offices either. I’m an RN in a Trauma ICU and there are doctors who are so afraid of the side effects/addictiveness (is that a word?) of painkillers/antianxiety drugs/what have you that they either prescribe a tiny ineffective dose or won’t prescribe them at all. So I end up with a patient with multiple fractures and internal injuries screaming in pain and I’m having to wake up everyone from the nursing supervisor to the medical director to force some self-important ass to properly medicate their patients. And then when the patient satisfaction surveys come in a few weeks later, do you think it’s the MDs who get in trouble?

    I won’t speculate on the sources of this kind of behavior among doctors, but if you shop around you can usually find a good one. For anyone who is wondering, depending on state law, you can shop around in the hospital too. If you get a doctor (or nurse, or whoever) who is looking out for their own best interests instead of yours, you generally have recourse to fire them and request someone else.

    In an outpatient setting, I have an easier time getting proper treatment and medications at Urgent Care Centers (Doc-in-a-Box type places.) But maybe that’s because I always make sure they know I’m a nurse so they don’t try to put one over on me.


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