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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 Phillipa on March 7, 2007, at 21:20:13
Here's an e-mail from a friend. Seriously does anyone have any ideas? Thanks Phillipa
I went to an orthopedic doc because I have severe pain in my shoulder and down the arm even into my fingers. I have had chronic bursitis in both shoulders but this time it is excruciating. I was afraid I tore my rotator cuff. Thank God it isn't torn. This guy, I don't know about him, told me my pain is due to depression. That I should get on strong anti-depression meds and I will not feel back pain or any for that matter. Said there r 10,000 people with depression related pain in the USA and that 4,000 are on opiates like me for this pain. Also told me the pain meds r not working on me anymore. I could have told him that myself. So now I am looking for a shrink that could help me to get off these stupid pain meds. I hate taking them. I take enough to fell a 300 lb. man and it has no effect on me. There has to be a better way. I can't take the pain any more, both physical and emotional.
Posted by Declan on March 8, 2007, at 0:35:51
In reply to Can You Help My Friend?, posted by Phillipa on March 7, 2007, at 21:20:13
And the solution to this is to go onto ADs?
That's not medicine, IMO.
Posted by Phillipa on March 8, 2007, at 12:31:06
In reply to Re: Can You Help My Friend?, posted by Declan on March 8, 2007, at 0:35:51
Declan she even has to walk with a cane. Doesn't anyone have any answers for her? Please people? Love Phillipa ps she's in her 70's too.
Posted by Racer on March 8, 2007, at 13:38:42
In reply to Can You Help My Friend?, posted by Phillipa on March 7, 2007, at 21:20:13
Phillipa, depression does exacerbate physical pain -- which then exacerbates depression. The two interact with one another, and anti-depressants are used as an adjunct to other treatments for chronic pain. Cymbalta is one that's actually labelled for pain, but the TCAs were used often for pain, and sometimes still are. They're often *very* effective. Sinequan and nortriptyline come to mind as the ones I've heard most often used for pain.
My advice, if this were my friend, would be to try to find a doctor who would explain that more respectfully, and then actually prescribe something. The problem I see from your friend's note isn't that the doctor suggested the pain might be related to depression, but that he apparently did it disrespectfully. Your friend deserves better than that.
Still, it doesn't mean that the doctor is wrong about the issue. Only that he flunked "Bedside Manner" in med school.
I hope that helps.
Posted by Phillipa on March 8, 2007, at 18:39:29
In reply to Re: Can You Help My Friend? » Phillipa, posted by Racer on March 8, 2007, at 13:38:42
Good to see you back missed you. I did suggest cymbalta and sent her a link from here related to cymabalta and pain. She has had one hip replacement and needs another too. She's on fentanyl patches with vicodin and percocet for breakthrough pain. And her Father and one Son committed suicide so this should carry a trigger will add one. And she said today that she's been of l00mg of zoloft since her Son's death. Oh this doc sure flunked bedside manner. Love Phillipa
Posted by Quintal on March 8, 2007, at 21:08:24
In reply to Re: Can You Help My Friend?Add *Trrigger * » Racer, posted by Phillipa on March 8, 2007, at 18:39:29
Phillipa, I'm confused. The doctor thinks that pain refractory to Fentanyl, Vicodin and Percocet is actually due to depression, and will respond successfully to an antidepressant alone - despite the fact that she's already taking a high dose of the antidepressant Zoloft and would have to contend with a further huge depression caused by the opiate withdrawal?!?!
I don't understand what's going on there but it sounds like a recipe for disaster.
Q
Posted by Quintal on March 8, 2007, at 21:11:15
In reply to Re: Can You Help My Friend?Add *Trrigger * » Phillipa, posted by Quintal on March 8, 2007, at 21:08:24
P.S. Isn't this doctor aware that opiates are powerful antidepressants and are being used successfully in treatment resistant depression? Anticonvulsants like valproate, Neurontin and Lyrica can also be used to treat pain.
Q
Posted by Phillipa on March 8, 2007, at 22:14:50
In reply to Re: Can You Help My Friend?Add *Trrigger *, posted by Quintal on March 8, 2007, at 21:11:15
Can you believe it? This doc is a you know what. She wants to see my doc but I know one who will switch her to cymbalta as she said this afternoon she's been on zoloft since the suicide of her Son at l00mg no longer works either. This doc with the cymbalta also runs a bupe detox center. I think he can help her as she wants off the opiods and fentanyl too. Love Phillipa
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