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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Cam W. on March 3, 2001, at 1:20:39
>Dr. Bob is to be thanked that the general quality of the postings on this board, especially those by Cam W. are of a far higher caliber than those found anywhere else on the internet, and in Cam's case, dare I say
reflect a knowledge of pharmacology superior to that of many doctors
steve - You've made me blush. Actually, I just love my job (most of it, anyway). I have learned much from this site and feel that I owe it to Bob (and those who want to be educated about their treatment) to share what I have learned through extensive reading and personal clinical experience. I may not always be right, but I try to give as accurate information as the literature, my past observations, my memory, and the current laws allow.
I also believe that self-diagnosis (of which I have learned from my own experiences) and self-medication cannot be done unobjectively. One needs an objective viewpoint and therapy needs to be monitored. In my view, doctors are needed; but those with a disorder need to do research as well (blind faith in a doctor's orders - ie compliance to therapy without any additional work on the part of the patient - seldom results in full remission of the symptoms of a disorder). To resolve a disorder, or at least resolve it's symptoms as much as possible, requires hard work on the part of the patient. The patient who passively accepts treatment, WITHOUT working towards remission through changes in lifestyle (ie diet, exercise), taking medication properly, and doing the homework from psychotherapy sessions, will have a far worse outcome than those who actively engage in the above treatment factors.
A person with an affliction should try to find a doctor who has the clinical experience and open-mindedness to be able to assess and correctly monitor therapy on a case by case basis. This is not an easy process either (but is not impossible) and is made harder by the institution of HMOs in the U.S. In Canada, we have a little more freedom in which doctor we can see.
In other words, for treatment to be successful, both the doctor and the patient MUST have input into the treatment plan. The doctor's point-of-view is from clinical experience and evidence based knowledge of the
disorder and it's treatment. The patient's own belief system needs to be then entered into the equation. Both
the doctor's beliefs and the patient's beliefs have equal weight in this equation. A happy medium between
the two must be arrived at through education of the patient by the doctor and through the patient's own
research. The development of a treatment plan is arrived at through a concordance between both parties; with each party being an equal partner in the final decision. Honesty and openness in this partnership is a must.To find a resolution may necessitate much trial and error and both parties need to try not to get frustrated. The initial attempts at symptom resolution may not work. Patience and perseverence are key factors. The correct combination of treatments (eg pharmacotherapy &/or psychotherapy, along with appropriate lifestyle changes) for any disorder must be developed on an individualized basis. Finding the right
combination may take considerable time and effort on the part of both the doctor and the patient. In a majority of cases, by using the above methods, the time to resolution may be greatly decreased.I try to facilitate this process with what I have learned in my past 17 years of clinical pharmacy experience and passing along what I have learned about medications. I try to help posters cut through the jargon (ie interpret and define the scientific terminology) and state theories using plain english and metaphors, whenever possible. Sometimes it is hard to convert emotions or feelings into words; the same can be said physiologic mechanisms. There are times that I succeed, but there are other times that I fail miserably; but each time I try, I learn something. So, my giving of my knowledge on this site is not purely altruistic as it may seem; I am here to learn as much as the next guy.
I try not to let my emotions and passions get in the way (sometimes unsucessfully; as evinced by the number of 'please be civil' warnings I have accrued) and try to stay within the boundaries of my expertise. I will help where I can with my knowledge of medications, which is, in some instance deficient. I try to only answer posts to which I feel comfortable answering. I will not diagnose, nor will I try to hinder a doctor's treatment plan. I am only getting one side of the story and never a full medical history in any post. Therefore, I try to limit my answers to what the medications do, what,if any, drug interactions may occur, and what and why side effects occur. I may mention options, but try always to say to discuss these option with the poster's doctor and to get a second opinion.
Sorry for being so long-winded, but I thought that I should relate why I come to this site. I don't do it for
the praise (although steve's comments did catch me off guard and has made my night - compliments do make one feel great, even if they are a tad exaggerated, as I believe steve's was). There are many competent, knowledgeable drug people on this site, let alone on the internet, but I would like to thank you again for your kind comments, steve.Sincerely - Cam
P.S. Is there anyone out there looking for a community pharmacist who specialize in community mental
health. I am looking for a position where I can play Aristotle to someone's Alexander the Great. ;^)P.P.S. God, now I think I need a big jar of petroleum jelly so I can grease the sides my head so i can get it
through the door. =^P
Posted by dj on March 3, 2001, at 8:21:26
In reply to Thany You For Your Complements Steve and errata, posted by Cam W. on March 3, 2001, at 1:20:39
>I try to help posters cut through the jargon (ie interpret and define the scientific terminology) and state theories using plain english and >metaphors, whenever possible
And that backed with your professional understanding and generally thoughtful commentary is the gift you offer those who use this board.
Sante!
dj
Posted by Sulpicia on March 3, 2001, at 21:06:33
In reply to Thany You For Your Complements Steve and errata, posted by Cam W. on March 3, 2001, at 1:20:39
> Cam, I too thank you for your dedication and insightful accurate posts.
And like you, I've had the equivalent of Dr. Bob's "please be civil" on
other boards when I periodically loose it with certain religious zealots.
[I have ADD, and choose to treat it rather than waste my life] I was blown
away by your looking for an Alexander to play Aristotle to -- classical
training in a scientist??? What next, another Enlightenment? If you seek
employment in the US, perhaps the most noticable imitatio Alexandri is
Bill Clinton, not that his behavior results from psychopathology or anything.
Perhaps Donald Trump? Possibly the best use of your offer might
be made currently in Israel. Its current leader definitely would benefit
from some learned political philosophy on behavior appropriate to a
good king. But then again, Alexander didn't listen to Aristotle too closely.
Did create all those interesting Hellenistic kingdoms tho, and probably
all the plots for American soap operas as well.Thanks again for the wisdom and compassion you bring to this forum.
S.
Posted by steve on March 5, 2001, at 1:44:06
In reply to Thany You For Your Complements Steve and errata, posted by Cam W. on March 3, 2001, at 1:20:39
Cam,
I'd be even * more * impressed by you if you'd look up www.moshersoteria.com read it thoroughly, and come up with some comments. I do not know that the man is on the right track, but with schizophrenia being as devastating a disease as it is, I think his approach should at the very least be looked into some more. A 70% rate of healing is incredible, as is the fact that he was fired from his job as division chief at the NIMH for reporting that he got his patients well. There's no doubt in my mind that if someone reported the same results for, say, breast cancer, they would immediately have been followed up. But then schizophrenics can't really stand up for themselves.
> >Dr. Bob is to be thanked that the general quality of the postings on this board, especially those by Cam W. are of a far higher caliber than those found anywhere else on the internet, and in Cam's case, dare I say
> reflect a knowledge of pharmacology superior to that of many doctors
>
>
> steve - You've made me blush. Actually, I just love my job (most of it, anyway). I have learned much from this site and feel that I owe it to Bob (and those who want to be educated about their treatment) to share what I have learned through extensive reading and personal clinical experience. I may not always be right, but I try to give as accurate information as the literature, my past observations, my memory, and the current laws allow.
>
> I also believe that self-diagnosis (of which I have learned from my own experiences) and self-medication cannot be done unobjectively. One needs an objective viewpoint and therapy needs to be monitored. In my view, doctors are needed; but those with a disorder need to do research as well (blind faith in a doctor's orders - ie compliance to therapy without any additional work on the part of the patient - seldom results in full remission of the symptoms of a disorder). To resolve a disorder, or at least resolve it's symptoms as much as possible, requires hard work on the part of the patient. The patient who passively accepts treatment, WITHOUT working towards remission through changes in lifestyle (ie diet, exercise), taking medication properly, and doing the homework from psychotherapy sessions, will have a far worse outcome than those who actively engage in the above treatment factors.
>
> A person with an affliction should try to find a doctor who has the clinical experience and open-mindedness to be able to assess and correctly monitor therapy on a case by case basis. This is not an easy process either (but is not impossible) and is made harder by the institution of HMOs in the U.S. In Canada, we have a little more freedom in which doctor we can see.
>
> In other words, for treatment to be successful, both the doctor and the patient MUST have input into the treatment plan. The doctor's point-of-view is from clinical experience and evidence based knowledge of the
> disorder and it's treatment. The patient's own belief system needs to be then entered into the equation. Both
> the doctor's beliefs and the patient's beliefs have equal weight in this equation. A happy medium between
> the two must be arrived at through education of the patient by the doctor and through the patient's own
> research. The development of a treatment plan is arrived at through a concordance between both parties; with each party being an equal partner in the final decision. Honesty and openness in this partnership is a must.
>
> To find a resolution may necessitate much trial and error and both parties need to try not to get frustrated. The initial attempts at symptom resolution may not work. Patience and perseverence are key factors. The correct combination of treatments (eg pharmacotherapy &/or psychotherapy, along with appropriate lifestyle changes) for any disorder must be developed on an individualized basis. Finding the right
> combination may take considerable time and effort on the part of both the doctor and the patient. In a majority of cases, by using the above methods, the time to resolution may be greatly decreased.
>
> I try to facilitate this process with what I have learned in my past 17 years of clinical pharmacy experience and passing along what I have learned about medications. I try to help posters cut through the jargon (ie interpret and define the scientific terminology) and state theories using plain english and metaphors, whenever possible. Sometimes it is hard to convert emotions or feelings into words; the same can be said physiologic mechanisms. There are times that I succeed, but there are other times that I fail miserably; but each time I try, I learn something. So, my giving of my knowledge on this site is not purely altruistic as it may seem; I am here to learn as much as the next guy.
>
> I try not to let my emotions and passions get in the way (sometimes unsucessfully; as evinced by the number of 'please be civil' warnings I have accrued) and try to stay within the boundaries of my expertise. I will help where I can with my knowledge of medications, which is, in some instance deficient. I try to only answer posts to which I feel comfortable answering. I will not diagnose, nor will I try to hinder a doctor's treatment plan. I am only getting one side of the story and never a full medical history in any post. Therefore, I try to limit my answers to what the medications do, what,if any, drug interactions may occur, and what and why side effects occur. I may mention options, but try always to say to discuss these option with the poster's doctor and to get a second opinion.
>
> Sorry for being so long-winded, but I thought that I should relate why I come to this site. I don't do it for
> the praise (although steve's comments did catch me off guard and has made my night - compliments do make one feel great, even if they are a tad exaggerated, as I believe steve's was). There are many competent, knowledgeable drug people on this site, let alone on the internet, but I would like to thank you again for your kind comments, steve.
>
> Sincerely - Cam
>
> P.S. Is there anyone out there looking for a community pharmacist who specialize in community mental
> health. I am looking for a position where I can play Aristotle to someone's Alexander the Great. ;^)
>
> P.P.S. God, now I think I need a big jar of petroleum jelly so I can grease the sides my head so i can get it
> through the door. =^P
Posted by Cam W. on March 5, 2001, at 7:20:02
In reply to Re: Thany You For Your Complements Steve and errata » Cam W., posted by steve on March 5, 2001, at 1:44:06
Steve - I have read the entire website. Not once does Mosher say anything that isn't being done or would like to be done. In the late 1960s and even sometimes today, ridiculously high doses of neuroleptics were being used to trat patients with mild psychotic disorders.
This Soteria House he talks about is just a good group home for those in remission from mild psychotic episodes or for those with nild mental deficiencies. Someone who is floridly psychotic could not be treated by this method. First, they wouldn't understand what you were talking about and would be very much a danger to themselves, and second, it is far from cost effective (ie who would pay for this treament).
I do note that no specific treatment modalities were mentioned in regad to Soteria House. If his psychosocial modalities were that effective, don't you think that every psychologist would be using these treatment. It sounds like Mosher is hiding something, possibly for a reason. The only way I could see to possibly control a psychotic patient in the middle of an episode, without medications, is with physical restraint (be it straight jackets or beatings).
Mosher's treatments sound a lot like Community Assertive Treatment programs, which do work, but still necessitate the use a psychotropic medication. Mosher himself states that people at his treatment facilities could not do without medications, completely.
Most psychiatrists today try to reduce the amount of medication given, but this does not address the many people who are treatment resistant. Sometimes ery high doses of multiple medications are need to keep people in the community. Why, I don't know; everything else doesn't seem to work (including multiple types of psychotherapies).
Mosher's ideas are nothing new and most have been integrated into most public mental health facilities. This may have been an issue 25 years ago, when patients were drugged into catatonias or 50 years ago, when insulin-shock therapy was themode of the day.
Until we can "reknit" nerve cells from the thalamus to the prefrontal cortex (etc). we will need psychotropic medication to help people lead as "normal" productive lives as possible.
Yes, psychotherapy is underused, but that is because people are not willing to go through a lot of pain for some gain. It is easier to dampen thoughts with a pill (but thses are people with emotional or affective problems, that I am talking about here, not true schizophrenia or bipolar disoreders). Psychotherapy can also help those with chronic mental illness live more prodcutive lives, but only if they are able to understand the therapy (which those with florid psychoses cannot).
- Cam
This is the end of the thread.
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