![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by blueberry on March 20, 2006, at 18:43:24
So my new doc noticed I have some parkinson-like symptoms...mild twitching of thumbs, little spasms in foot muscles, feelings of butterflies in the stomach, and he prescribes an MRI scan and gives me sinemet.
I have depression and anxiety. And my cortisol levels are far below normal levels. All I wanted from him were some referalls to a pdoc and an endocrinologist. Does that sound right to prescribe sinemet? I'm too afraid to try it, afraid of worsened anxiety and worsened depression, and afraid of the horrible dopamine crash that would come if stopped it. And I also have bad insomnia. Sinemet for insomnia? Doesn't sound right to me. I'm on no other meds.
Comments?
Posted by SLS on March 20, 2006, at 19:04:52
In reply to Sinemet for me?, posted by blueberry on March 20, 2006, at 18:43:24
> So my new doc noticed I have some parkinson-like symptoms...mild twitching of thumbs, little spasms in foot muscles, feelings of butterflies in the stomach, and he prescribes an MRI scan and gives me sinemet.
>
> I have depression and anxiety. And my cortisol levels are far below normal levels. All I wanted from him were some referalls to a pdoc and an endocrinologist. Does that sound right to prescribe sinemet? I'm too afraid to try it, afraid of worsened anxiety and worsened depression, and afraid of the horrible dopamine crash that would come if stopped it. And I also have bad insomnia. Sinemet for insomnia? Doesn't sound right to me. I'm on no other meds.
>
> Comments?
The guy is either brilliant or both ignorant and arrogant.Go see an endocrinologist. You need to rule out Addison's Disease. I don't know enough to suggest what else would cause adrenal exhaustion.
- Scott
Posted by Phillipa on March 20, 2006, at 21:56:15
In reply to Re: Sinemet for me?, posted by SLS on March 20, 2006, at 19:04:52
My Mother had addison's disease. She was in and out of the hospital for years. They used to give ACTH but that was in the 60's don't know what they use now. Love Phillipa
Posted by Emily Elizabeth on March 20, 2006, at 22:34:25
In reply to Sinemet for me?, posted by blueberry on March 20, 2006, at 18:43:24
Does he actually think you have Parkinson's? My understanding is that if that is what he thinks you have, the current standard of tx is to start w/ one of the dopamine agonists (like requip) before moving to sinemet. With PD, sinemet stops working after a while, so it is ideal to delay starting it until you need to. I have no idea how that works for someone who doesn't have PD.
It sounds like you should visit a pdoc and a neurologist to get some info from specialists in this area. You also mentioned an endocrinologist--it sure wouldn't hurt. Do you need regular doc's referral to get to see these folks? Will he give it to you?
Best,
EE
Posted by yxibow on March 21, 2006, at 2:41:15
In reply to Re: Sinemet for me?, posted by SLS on March 20, 2006, at 19:04:52
> > So my new doc noticed I have some parkinson-like symptoms...mild twitching of thumbs, little spasms in foot muscles, feelings of butterflies in the stomach, and he prescribes an MRI scan and gives me sinemet.
> >
> > I have depression and anxiety. And my cortisol levels are far below normal levels. All I wanted from him were some referalls to a pdoc and an endocrinologist. Does that sound right to prescribe sinemet? I'm too afraid to try it, afraid of worsened anxiety and worsened depression, and afraid of the horrible dopamine crash that would come if stopped it. And I also have bad insomnia. Sinemet for insomnia? Doesn't sound right to me. I'm on no other meds.
> >
> > Comments?
>
>
> The guy is either brilliant or both ignorant and arrogant.
>
> Go see an endocrinologist. You need to rule out Addison's Disease. I don't know enough to suggest what else would cause adrenal exhaustion.
>
>
> - Scott
The above suggestions are important and should be followed up upon, but there are a few things that do distinguish Addison -- first, its extreme rarity, while our distinguished 34th president did have it, it occurs in about 1 in 100,000 at most. Second certain features can be shown on an MRI, and third, very often (90%+) but not always characteristic hyperpigmentation of the skin precedes symptoms and nausea and vomiting are present.
Also Requip does have a bold face warning of sudden somnolence, especially in Parkinson's. Which doesn't mean one might get it, but is of concern in treatment.
Sinemet CR is also available now.
Wishing the best-- Jay
Posted by blueberry on March 21, 2006, at 19:56:05
In reply to Sinemet for me?, posted by blueberry on March 20, 2006, at 18:43:24
Thanks for responses, all! Appreciate it. This doc really bumbed me out. I mean, I have depression and anxiety and insomnia...so he prescribes a parkinson drug with common side effects of depression, anxiety, and insomnia? Sure I have some very mild tremors from long term zyprexa use, but I wasn't complaining about that. I don't care about it.
He flat out said no to referring me to an endo. He said one thing at a time. I asked why couldn't I see an endo while waiting for the MRI? Why can't we do more than one thing at a time? He said come back and see him in 30 days.
Oh, and my tinnitus, he wants to do a hearing test. Give me a break. My tinnitus is in my brain, not my ears. I can prove that by making it go away with xanax, zypexa, prozac, dlpa, or tyrosine.
So I'm kind of out in the cold now. Bad shape and no doctor. I only have so many insurance paid visits during a year, and I'm not wasting one more at that office.
Posted by yxibow on March 23, 2006, at 2:53:29
In reply to Re: Sinemet for me? Follow Up to Responses..., posted by blueberry on March 21, 2006, at 19:56:05
> He flat out said no to referring me to an endo. He said one thing at a time. I asked why couldn't I see an endo while waiting for the MRI? Why can't we do more than one thing at a time? He said come back and see him in 30 days.
One thing at a time is usually a practice for medication, but I don't see how it matters for parallel doctors, none of whom are himself.
> Oh, and my tinnitus, he wants to do a hearing test. Give me a break. My tinnitus is in my brain, not my ears. I can prove that by making it go away with xanax, zypexa, prozac, dlpa, or tyrosine.
A hearing test might determine at what dB your tinnitus is at, but its relatively useless information I would agree, I think. I assume you insisted on what you knew about it and took for it. Xanax is fairly common. One can also "make it go away" by a modified version of behaviour therapy -- essentially ignoring it over time and adjusting to it; one then usually notices it only if it is mentioned. Of course as they say, your miles may vary. I
> So I'm kind of out in the cold now. Bad shape and no doctor. I only have so many insurance paid visits during a year, and I'm not wasting one more at that office.
I'm sorry to hear that -- can you get PA -- prior authorization from your insurance company for a visit to a second opinion doctor or referral?
Posted by TylerJ on March 23, 2006, at 9:45:58
In reply to Re: Sinemet for me? Follow Up to Responses..., posted by blueberry on March 21, 2006, at 19:56:05
> Thanks for responses, all! Appreciate it. This doc really bumbed me out. I mean, I have depression and anxiety and insomnia...so he prescribes a parkinson drug with common side effects of depression, anxiety, and insomnia? Sure I have some very mild tremors from long term zyprexa use, but I wasn't complaining about that. I don't care about it.
>
> He flat out said no to referring me to an endo. He said one thing at a time. I asked why couldn't I see an endo while waiting for the MRI? Why can't we do more than one thing at a time? He said come back and see him in 30 days.
>
> Oh, and my tinnitus, he wants to do a hearing test. Give me a break. My tinnitus is in my brain, not my ears. I can prove that by making it go away with xanax, zypexa, prozac, dlpa, or tyrosine.
>
> So I'm kind of out in the cold now. Bad shape and no doctor. I only have so many insurance paid visits during a year, and I'm not wasting one more at that office.
Doctors can be such *ssholes sometimes! It's like they think they're *mini-gods* or something...they can be so heartless! Sorry Blue, you'll figure something out though..you always do. :)Tyler
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.