Next you you see him, apologise to him, but explain to him calmly the reasons you reacted the way do did. I am guessing the ''mood' effects of the hypertension medication have a huge impact on you (in light of your background and the other meds you take) and that makes it harder to handle them. If that's the case, explain that to him.
I think you'll find if you are a little conciliatory with him and open up a touch, he will become much more receptive to you. Having him onside will be much better than battling with him.
You said the side effects of the hypertension medication are horrendous - it sounds like some of those effects could be down to the meds interacting with and reducing the effects of the Suboxone (mood and energy wise). But that can be managed.
And you also said that after 3 days the effects are so dire you quit them completely. You may find that slowly increasing the dose, or just gritting it out, means your body gets used to it and the side-effects lessen.
I worked in the nursing/psychiatric field many years ago and administering drugs was a minefield of contraindications and interactions - I used to get a new copy of the BNF (British National Formulary) every year as it was constantly being updated.
All drugs have contraindications, but they also interact with hundreds of other drugs. Suboxone for example, interacts with over 500 and in a couple of minutes I found two interactions with heart or blood pressure medications (nicardipine or quinidine) - there are certainly going to be others.
But the only way to figure it out properly is for you and your doctor to work together on it.
And as far as your doctor being overweight - that in no way makes him any less of a doctor. But you know that anyway. You never know, if you work things out with him you may even be able to give him a few pointers on how to get himself in better shape (because that's an area you clearly have expertise in).
Good luck with it, but I'm sure you'll get it sorted out.
Thanks a lot man. I had no idea suboxone interacts with that many medicines so it's something I
definitely gotta check out.
I have no idea about medicine, so whether what the doc said was the right treatment or not, I couldn't tell.
That said, the doc handled it right and you wrong. You are paying HIM for treatment, not the other way around. His treatment says "A, B and C". If you don't follow his treatment (which you have every right not to, of course), he has the responsibility to fire you as a client.
Edit: When you go to a restaurant, you ask the owner why he's not fat and claim that ergo his food must suck?
Not sure how you came to that conclusion. I'm *paying him* for treatment just like you said. And when a doctor tells me "I'm not gonna collaborate with you" that begs the question "why are you even a doctor"? Aren't doctors suppose to ask questions, get feedback, run tests, etc rather than play psychic and say shit like "you're gonna die in your early 50's"? or worse, "I know this is a genetic problem and changing your lifestyle won't fix it"? All this guy ever does is test my blood pressure and weigh me when I go in. It genuinely scares me that in the last 18 months...
not one time has this guy drug tested me. Not even on our first visit! A sub doctor is
always suppose to drug test new patients. It's called the "initial assessment". If someone comes into your office on benzos, and you skip that test than give them sub they can kill themselves.
Not once has he done a blood test, hormones, gene panel test... he keeps wrapping that stupid balloon around my arm then spins a wheel in his head like this is wheel a fortune, it lands on some new random med and he just writes a new script.
Also, the weight thing is
most definitely an issue. Anyone who says it's not then answer 1 simple question. If a doctor can't take care of or manage his own health... then
how the hell is he suppose to manage a case load of 50-100 patients?
Sorry if this is off topic but I didn't read the OP as it's too long for the time I have available. Since we're talking of Doctors here I just wanted to throw in my 2 cents.
I do not believe in Doctors, I am sure there are those that are genuine but most so called Doctors are nothing more than a live encyclopaedia of information and sometimes not even that, especially here in the UK where when you visit your local GP they will start searching the web. Sometimes you might even get print outs as a bonus.
Unfortunately most Doctors, at least here, do not diagnose you properly they do not look at things from a perspective that requires the whole picture. Your body isn't a bunch of separate systems, it is a bunch of interdependent systems that work together as a whole. In my opinion in order to successfully cure/treat most of our problems Doctors need to do much more than just symptom questioning. Unfortunately the health system is such a mess that it will probably be a long time before our health is actually treated the way it should be treated. Not to forget all of the crap that we get in our food.
I'm not trying to say that Doctors are bad or that they're not trying to help you, they are, it's just that most of them do not think much for themselves or they're limited in terms of what they're allowed to do. They take information in for granted. Not enough people question why what how things work.
100% agree with this. If I had to guess... I've probably seen over 30 different doctors in my life. I can only think of 2 doctors who I'd consider "real doctors".
1) The doctor my dad sees. He's quite literally saved his life on 2 occasions. The first time he found a 98% blockage in my fathers heart, he had triple by pass surgery and if it weren't for that surgery he would have had a massive heart attack and died at least 10 years ago. 2nd time this doctor found a blood clot in my dads neck with >>HIS HANDS. He had to confirm it was a clot and of course it was. Then my dad had surgery and sure enough the surgeon said "if this clot wasn't removed in the next 6-12 months your father would have had a stroke".
One thing that's interesting about this doctor, he's around 72. A very old, skinny & energetic man. But he's very oldschool. He will use a BP test, EKG's, all the latest technology, etc but every single visit he
still taps your knees to check reflexes. That's something I see very few dr's doing these days. And he'll spend at least 30 minutes checking blood vessels / arteries with his hands. He also approaches problems from a holistic standpoint. Like with my dad, although he had to put him on medicines he went above and beyond to get my dads weight down more than 80lbs. He got his blood sugar down. Fact is, my dad would not be alive right now if it wasn't for this man. It just sucks that I can't see him cause he's not licensed to prescribe suboxone.
2) The dr I saw in Brooklyn. I already talked about him in the OP so I won't say anything else.
Aside from those 2, the rest of the dr's I've seen have been you're run of the mill > take weight > take blood pressure > make some small talk > get the pill pad out > next patient.
@OP
To your post you are on the right way.Dont take to much medecine since it will get your body toxic and you will have more issues.Eat healthy (most important) organic food ......make some sport and a detox and you will see it will go upwords.The body is a complex which is being created to heal itself if you provide the right prerequisites
Thanks. That's 1 thing I've always worried about is I don't eat organic veggies and certain foods feel disgusting. Like the cucumbers I buy from Shoprite, they come with this greasy, wax coating that is IMPOSSIBLE to remove. Last week I got a batch that was so greasy, I used AJAX dish washing soap to get the coating off, I rinsed off the soap, felt the outside of the cucumber and they still felt like tape. I don't know wtf that shit is they put on some of these foods but if soap can't remove it, I can't imagine what it's doing to your insides.
BB, don't you have any methadone clinics where you are? They have suboxone too for certain people. They give it once a week and it's free.
Thanks for the response and YES we do!
The way it works in our state is they give you methadone 1 year for free. But after that point you have to pay for it or get off, and there are MANY downsides to being on methadone.
1) The visits / pickups/ rules are way more stringent. I think for the first few months you have to drive to the clinic TWICE A DAY just to get your morning and afternoon dose. Then after a certain point 3 months or something they allow you take home a 1 week supply. So that's 4 visits a month. The closest methadone clinic to me is about a 40 minute drive and there's just no way I could do that much driving.
2) Methadone itself.... it's a horrible drug to give to opiate addicts. Why? Cause it's a *full agonist* opiate that gets you high same way heroin, oxycodone, morphine or poppy seed tea would. I've seen people on methadone. They knod out from their doses same way you would on heroin. It's massively sedating. Psychologically it's very addictive, and since it doesn't block opiates like suboxone does, like half of all methadone patients are taking heroin or some other opiate WITH their methadone.
I like suboxone cause it doesn't get you high (it doesn't get opiate addicts high but it will get a normal person high if you have no tolerance to opiates). You can't take opiates while you're on suboxone cause it blocks their effects. It has a slightly stimulating effect so I don't feel doped up all day. I just feel a bit energetic, happy, and motivated to do things. Suboxone for me has been a live saver. It keeps me the hell away from opiates. At the same time, withdrawals from the drug are worse than heroin and last for months. So as much as I'd love to get off, it's extremely difficult. I've tried before and usually within a week I'm suicidal, no sleep for months, RLS, depression, anxiety, vomiting, hot flashes, cold flashes, panic attacks, pain all over your body etc. I may be on this shit the rest of my life. I don't want to be. And I am going to try getting off sub again... but to be successful, I would need to take a 3-6 month vacation from life. And right now that's just not possible.
get well! driving 4 hours doesn't seems to be that bad in this situation
Haha. Thanks. I should have said "4 hours on a good day". A lot of times driving to NY I'll hit traffic, and sometimes it's taken me 6-7 hours just to take the trip. Plus I am NOT a good driver at all. Even though I saw that dr for about 3 years I would still get lost WITH a GPS coming home from the city. One day my GPS broke, I spent 2 hours driving around the city frantically / losing my mind. Then I had to call my brother who stayed with me on the phone for an hour using Google Earth to tell me how to get back home lol.
I know there are people who commute every day from NJ to NY but once I get into the city, I feel like I'm on an acid trip. There are so many roads and so many cars going in so many different directions I have no idea how people do it. Although... getting a 2nd, backup GPS might be a smart idea. My TomTom is fairly old.
OP: Doc is allowed to do whatever he wants to do. You're his client and if he doesn't want to treat you that's his choice. And you're a bitter asshole as much or more than he is. It was not him who walked into your office but the other way around. He wants to make money off your back? And what?! Everybody does. Unless you speak to at least 2 other doctors and they tell you this doc's professional advice was wrong, misleading or malicious, you're simply wrong about this. And whether he is fat or ugly or an asshole is irrelevant.
.
I said he was "severely obese" as in morbidly obese as in huffs and puffs when he walks into the room. I know I used the word "fat" in the title but lets stop mixing up fat with what he really is, which is morbidly obese.
And if you're telling me that doesn't matter, you're telling me you'd have no issue / reservations about seeing a dentist with brown, rotting farmers teeth... which we all know is bs so lets some pretending that weight doesn't matter.
Secondly. As I've said, I've seen enough doctors in my life to establish a frame of reference of what's right and wrong. You don't even need that frame of reference or a PHD to know this guy is talking out of his ass. All you need is common sense. He's never asked to do blood work, never asked to do a gene panel screening, never asked to test my hormones and NEVER asked me to lower my salt intake or caffeine consumption. The most he's said in regard to smoking is "I can prescribe you wellbutrin which will make the cigs taste like metal" but he never directly said "you need or should stop smoking". This is a >>>DOCTOR.
I'm not saying I'm perfect and that I know it all. I'm not even saying this is a "right or wrong" issue. What I'm saying is he IS a bad doctor. He's lazy as hell. Never want's to think outside the box. It's always about the pen and the pad. "I write this, you take it, end of story". That's not medicine, that's business. You can say "medicine is business" but I know by the way he runs his practice, by the way he treats his patients, the only thing he cares about is $$$. Get your patients back. Write them as many scripts as possible. Fail to do proper evaluations. Fail to experiment with different approaches. He's rude as shit. I've never met a doctor who will leave the room every single time someone calls. His secretary never says "can you wait? he's with a patient right now." He leaves the room in the middle of any visit, will sit his fat ass down in his office talking carelessly about random shit for 20 minutes then comes back like it was no big deal.
He does this shit all the time and it's rude as hell. Tell your f#cking patients to hold or call back CAUSE YOU'RE
SEEING A PATIENT. If you can't do that, at least RUSH THE CALL. He can't even do that. He goes on talking about shit that's completely irrelevant to the phone call. Like "how's your son doing? oh he's playing hockey now! that's nice... how about the wife"? Meanwhile I'm sitting in the room thinking "I wanna punch this fat fucker in the face".
Sounds like you've had a hard time of it BB. From my point of view i.e. a BMS and a Clinical Pharmacologist, taking BP meds that are causing these side effects in you is a complete no go. For him to suggest it's a genetic trait that's causing the elevated BP without actually taking the time to do a gene panel on you is a bloody farce as well. A similar situation was with my mum taking meds for her thyroid that made her vomit (sorry if anyone is eating when they read this) so much that she was left severely dehyrdated. It ended up that the doctor bollocked at both of us to get out of the room when he knew he was in the wrong. A week later she seen another doctor who incidentally I ended up working alongside for over a year and he prescribed her a tweaked formulation. It's very much about who you see, especially in the NHS.
Out of interest, did he try you on any beta blockers like propranolol and bisporolol? There's some evidence to suggest that they may cause a slight increase in the risk of Type 2 Diabetes but they are generally more well tolerated than the ARB's that you've been put on, plus they're pretty cheap as well.
Nifedipine would also be an option, but it can cause some pretty horrendous headaches in people as well.
Thanks for the advice! I'm about to write a list of all the meds he's prescribed me and atenlenol was one of them... which I believe is a beta-blocker. That drug specifically gave me migraine like headaches and horrible insomnia. I was popping ibuprofens that weren't doing anything and didn't sleep or workout for 3 days straight. So eventually I just said "screw this" and flushed them down the toilet.
I've also taking inderal / propranolol and get very little to no side effects (which is weird cause it's also a beta-blocker) ... only problem is it doesn't actually lower my BP. It does make me feel very calm and relaxed, my breathing slows down, but my actually numbers never drop.
Here is the list of meds I've been prescribed -
1) Losartan / Cozaar - This actually DID drop my numbers but it made me extremely lethargic, tired, muscle weakness, couldn't lift, couldn't run, couldn't get stuff done so I couldn't take it.
2) Atenolol - Gave me excruciating headaches like I said. Felt like someone was blowing up a balloon in the back of my head and I'd pound my head all day like a monkey.
3) Dyazide - Made me very dizzy, got vertigo, when I'd bend over it felt like the world was spinning. Made me loopy and disorganized. Plus I'd wake up 2-3 times during the night just to pee (from what I understand this med acts like a diuretic).
4) Toprol - Never did anything. No side effects but it also didn't drop my BP. We tried raising the dose and it was the same story.
5) Bystolic - This crap felt like poison. I'd get aches in my joints and muscles. But the worst part was the chest pain. I got this pain in my chest anytime I took a deep breath. And I'd pound on my chest to try and make it go away. If I went for a run, forget it, I felt like I was having a heart attack. I got very scared from the chest pain so I immediately stopped taking it.
6) Clonidine - Was given 100mcg / day during a hypertensive crisis for about 4 weeks straight then tapered off. This stuff worked like a charm. Down side is it felt a bit like valium. It made me very tired in a calm, relaxed, doped up sort of way. It also made me feel a bit groggy in the morning but it was honestly no big deal. The only reason I didn't take it long term is he said "you're not suppose to take clonidine long term". Which I'm still not sure if that's true or not.
7) Inderal - One of the better meds I took. And I still keep a supply in my home for giving speeches. It makes me feel extremely calm. Slows my breathing. I get no physical signs of anxiety in public (racing heart, sweaty hands, shaking, trembling, etc). And I get very few side effects at all. I honestly wish this med worked but unfortunately, it will not bring down my numbers. Even if I go up to 80mg my #'s maintain in stage 2 hypertension.
8 & 9.... I can't remember. But I do have them written down somewhere in my medical journal.
10 will be the Volsartan... which as far as I know is a sister of Losartan aka Cozaar. So I'm expecting unbearable side effects with that as well. I'm yet to actually fill the script but we'll see how it goes.
In the meantime I've set up an order for suboxone and clonidine online. I'm going to keep the sub as a back up for emergency and the clonidine I may use to manipulate my numbers for our next visit. I may honestly just tell the doctor "the volsartans working great!" meanwhile I'll just pop 1 clonidine every month before I go in. And I'll also keep them encase of another hypertensive crisis.
If he wants to get manipulative and controlling with me, we'll see who can control who. This will buy me a few more months to find a PROPER doctor then hopefully by then I can sort things out the right way... whichever way that is.
-BB
