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kaiser docs & wellbutrin


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Dear thisthat,

My primary care doctor is the one who has given me all of my anti-depressants.  Can you explain to your doctor that you're depressed and Wellbutrin helped you to function day-to-day?  It isn't like you're asking for some nasty habit-forming drug, for heaven's sake!

Depression is the most common form of mental illness in this country.  Unless he's living in a vacuum, he must have a lot of patients telling him that they're depressed.

I wouldn't emphasize the smoking thing, because they would only want you to have it for a limited time to quit smoking.  Even as stable as I am, my doctor gives me a 3-month prescription for my AD, not a year's worth.

See what he says and let us know what happens.

olga

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I'm not sure I can add anything valuable, but I'll give you what I've got. I'm not on Kaiser; however, my mother is. She's been on Kaiser for at least a couple of decades now. Anyway, the thing I've noticed with Kaiser is that she's been able to get pretty decent care -- at times, I'd say even excellent -- but it IS a hassle. You kind of need to know how to work the system and to be an aggressive advocate for yourself. Unfortunately, my mom is about the shyest, most soft-spoken woman you'd ever meet, so it's taken a lot for her to do this for herself -- but she has.

Two things I can think of to keep in mind:

1) Very Important - FIND A PRIMARY PHYSICIAN YOU LIKE.

Took my mom a bit of doing, but she kept insisting. If I remember correctly, she'd asked around among her friends/co-workers on the same plan for input on what they thought of the different docs. Bottom line, having a primary doc who listens to her has made all the difference in the world -- both in terms of her primary care, and in getting the referrals to specialists when she needs it.

2) If you are referred to a psychiatrist to deal with meds, BE VERY INSISTENT ABOUT YOUR NEEDS & WHAT YOU WANT.

I'll give you an example: my mother's and my depression are very similar, and we have almost identical reactions to meds. I was on Effexor for about 15 years, the 1st antidepressant that really worked for me. (It eventually pooped-out on me, but that's beside the point here.) My mother kept asking her pdoc at Kaiser "What about Effexor? It's worked real well for my daughter." For some unknown reason, he kept trying her on everything else -- over a period of I think maybe 2-3 years, or more. Finally last year, he put her on Effexor, and -- bingo -- my mother's lifelong depression lifted! (I could cry ever time I talk to her...it's so amazing, I have never heard her this happy before.)

Again, please keep in mind that my mother is not a very assertive person, so hopefully you won't have this problem. My mom is also 76 yrs old and has severe hearing loss, so communication is not always the best either. I live in another state, so I'm not there when she is going through this. A few years back I was there when she had a couple of carpal tunnel operations, and I went with her to her appts. Doing this, I realized how much communication was being missed, mainly because she can't hear well, and she'd just assume the surgeon had understood what she'd said in her extremely soft voice. So, I ended up being her advocate and making sure everyone understood one another. (An aside: I've had wrist surgery myself, and I was very impressed by her Kaiser surgeon.) Anyway, I go into this detail about my mom because again this may not apply to you.

One bummer about Kaiser in my mom's case is that at 1st they covered the Effexor. Then they changed their formulary of accepted meds, and Effexor isn't one of them -- they no longer pay for it. However, the pdoc does fill out the forms she needs to get the meds from Canada, so at least she is able to save money that way.

I hope this is of some help. Good luck! And keep asking Qs here -- people are always willing to do what they can.

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