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If We Could Be 'deputized' To Rx Our Own Tx, What Would Happen?

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#1 doinmdarndest

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Posted 02 June 2013 - 06:55 AM

in the course of stimulant prescribing there are and will ever be patients suffering from eds who believe they would benefit from higher doses of stimulants, if only their rx'er would provide them.

 

for the rx'er, any possibility of a negative response to a high dose regimen that exsists, no matter how small, potentially threatens their career.  this is especially so if the patient becomes psychotic and causes harm as the result of such an rx.

 

here's the kicker: THE MD IS ALWAYS RESPONSIBLE, not the patient.

 

what if a patient could be 'deputized', perhaps after first learning about medicine as it applies to this and passing an exam?  maybe a '3 strikes' criterion could comprise how pwn writing their own stimulant rx would lose the right to do so if/when they can't avoid harming themselves.

 

anybody here think my idea is other than absurd?  might be a good thing if self-rx'ing was possible for some pwn.  it would absolutely be for me.

 

talk about the impossible dream



#2 Hank

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Posted 02 June 2013 - 11:14 AM

I am not big on hypotheticals. My ideal treatment is the least medication possible. After 7 months of Xyrem (discontinued in January) my EDS is very manageable. I take no stimulant medication and manage EDS with lifestyle adjustments. I am just on Effexor for Cataplexy and trazadone for sleep. I am very happy with this for as long as it works.

I agree with the saying- A physician who treats himself has a fool for his patient.

Just out of curiosity, what lifestyle adjustments have you made to help with your EDS?

#3 doinmdarndest

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Posted 02 June 2013 - 06:44 PM

"a man that represents himself has a fool for a lawyer" is the actual saying. but there's nothing wrong w making your point this way. heck, I made a joke for my wife as i cut my own hair (fade) so i told her the old saying has me w/fool for a barber.

pro per inmates I've done time w/and the decent haircut (visible on my sleepconnect wall photo)given me by myself soundly disprove (well, in the case of the pro per inmates at least) the validity either use of the saying may have.

i am not aware what a 'lifestyle adjustment' is as far as eds sufferers' tx options are concerned. what do they amount to, hank? may i continue full time work in construction as superintendant's laborer on a public work's builder's jobsites? the work is as physically demanding as just about anything imaginable now and then. it's all I've ever known as a working man. by the 7th grade my yet to be dx'ed until my late 40s eds was quite severe causing me to drop out of school. from there i went from job to job, sometimes several in a single month. bosses simply would not keep me on site as my eds/fatigue disallowed movi9ng fast like costruction demands. like the ugly duckling becoming a beautiful swan, the amphetamines made of me a 'top hand' on site. the bosses treat me like gold and ive been w/present firm 8+ yrs.

might i ask, what do you do? i totally respect your preference for foregoing stimulants;i'm certain i require substantially higher amts. of same to hack physical labor, and that something i could do for a living in a relaxed state would = a lessened need for stimulants in terms of the mg/d amt.

again, what are 'lifestyle changes?'

#4 Hank

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Posted 02 June 2013 - 08:20 PM

The lifestyle adjustments that help my EDS are pretty straight forward:
- go to bed and get up at the same time every day, incuding weekends. I don't use an alarm on the weekends, so I wake up about an hour later than during the week.
- I don"t generally stay out late or I am toast the next day. When we do have late plans, I plan an easy next day and a nap before.
- regular exercise helps me a lot.
- when I travel for work (especially across time zones) I travel the day before so I can adjust to the time and take the stress of travel snags. "Hurrying" is also a trigger for my cataplexy.
- I have never taken naps- I have started within the past year. I can't generally do it during the week, but I do on the weekends. I learned from my MSLT that when I hit REM during a nap, it does not feel like I slept. So, I never took naps because I did not think I slept (that feels like a bad joke)
- If I have too much caffeine in the morning, I have a big crash mid morning. If I spread my caffeine across the day, it works a lot better for me.
- A sleep medicine a bed time ( Trazadone right now) helps me maintain sleep. I have HUGE interrupted sleep in my natural state. A medicated night means a good next day,
- Strong emotion, stress, etc wipes me out and also triggers Cataplexy.
- Alcohol is to me as Kriptonite is to Superman. So is a heavy meal.

I could not feel as well as I do right now without the help of Xyrem. Even though I discontinued it because of side-effects, I am still benefiting from significantly reduced EDS. I never recall feeling so consistently well throughout the day.

I did the above things when I was on Adderall and they still helped. I discontinued Adderall after several months on Xyrem because of racing thoughts and anxiety.

I have a fast paced job with a lot of problem solving and travel. Anything slower paced would be a huge struggle for me. As long as I am active, EDS is more manageable. Passive, slow paced stuff is the kiss of death for me.

#5 Hank

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Posted 03 June 2013 - 09:38 AM

[quote name="doinmdarndest" post="24416" timestamp="1370216671"]"a man that represents himself has a fool for a lawyer" is the actual saying.

http://www.iwise.com/B2kRr

Sir William Osler- "a physician who treats himself has a fool for a patient".

#6 doinmdirndest

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Posted 11 May 2014 - 02:46 AM

here's something I brought up long ago here,  under username banned w/senator McCarthy's methods.  long story;tmi. 



#7 purpley

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Posted 11 May 2014 - 10:37 PM

Even doctors can't prescribe controlled substances for themselves -- someone who did that would either lose his license or at minimum have his license suspended. That kind of power would just be abused far too readily.

#8 doinmdirndest

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Posted 11 May 2014 - 11:30 PM

in other words if we were free to choose our tx (=treatment.  medical notation we'd do well to familiarize w/, like pwn) we'd destroy ourselves, right? if so, are you sure?

 

has you or anyone w/eds you know of ever been in that position?



#9 purpley

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Posted 13 May 2014 - 10:15 AM

in other words if we were free to choose our tx (=treatment.  medical notation we'd do well to familiarize w/, like pwn) we'd destroy ourselves, right? if so, are you sure?

 

has you or anyone w/eds you know of ever been in that position?

 

Of course not everyone would destroy herself; only some people would.  But I do think it's just as bad an idea for a doctor to treat herself as it is for a lawyer to have herself for a client, and I'd certainly question the judgment of anyone doing it.  I wouldn't go see a doctor who was prescribing controlled substances for herself, not just because it's forbidden by medical boards, but because if she couldn't even find a single colleague willing to prescribe it for her, that would be an indication to me that something was very wrong.



#10 rayraybaybay

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Posted 13 May 2014 - 10:36 AM

* "Poof-ed" original post for privacy's sake =) PM me for details if interested *



#11 doinmdirndest

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Posted 14 May 2014 - 06:09 AM

very enlightening.  everybody knows from micheal Jackson/elvis that the extremely wealthy can have any treatment they desire, even if 'treatment' is just access to a drug.

 

spent a lot of time digging up cases of md's facing penalties/loss of 'shingle'  and do you know how many turned out to involve stimulants such as Adderall.

 

I only found one.  the huge majority w/rx'ing a med in ?  were painkillers/ sedatives.   I think a lot of us might just be ok were we given authority over our wakefulness promoting regimens..

 

maybe I'm useless on the pc.  I don't know.  prolly plenty cases of questionable rx'ing practices  on record of stimulants treating eds.

 

I believe adult humans are best off if free to choose their own path.  in medical/all matters.

 

 

did you know u.s. total alchohlol cons. went  up after repeal opf prohibition, but hard core alcoholism went down..



#12 Lorax64

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Posted 15 May 2014 - 02:20 AM

rayraybaybay - that was a hugely informative post! I can believe it totally with pain meds - when I have had them for a short while, it was very easy to see how they could be abused.



#13 purpley

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Posted 16 May 2014 - 10:44 PM

Rayray -- Amen.  Now take down the post before one of your docs or concierge patients finds it!  It's good to stay employed these days. ;)