Posted by John O. on 3/17/2008, 3:35 pm, in reply to "doctors"
69.129.197.8

Linda, Tell your Dr. Jekyll and Mr. Hyde PCP to take a hike and sign on with the pulmonology team. No matter who you get it'll be better than this jerk. If any doctor told me I was an addict just because I had a perfectly legitimate reason to use a perfectly legitimate medication his next trip would be to an oral surgeon to re-attach his teeth. First of all, and apart from the obvious fact that a pulmonologist is nearly always a better choice than an internist; as illnesses go, COPD is pretty predictable, and one of them will give you as informed a treatment plan as another, particularly if, as you say, they work together as a team. I work with a consortium of eight pulmos, all of whom know me, and though one of them is my "main" pulmo, the times he hasn't been available, for whatever reason, I get one of the others, and so I am definitely not "a chart without a face". I realize not everyone has this choice, but you do. If you go in enough times you'll get to know all three of these docs. What's not to like? They'll probably sit down together once in a while and discuss your progress. I know mine do. Second: "Addiction" is a word everyoe throws around without really knowing what they're talking about. True addiction is when you keep craving a drug (or anything else) without regard for your own health or welfare, and using it far more than intended. Included are not only widely used substances like alcohol and tobacco but also illegal street drugs. When we talk about needing Ambien to get a decent night's sleep -- a not unreasonable demand for chronically ill people stressed out by not being able to breathe -- we are referring not strictly speaking to addiction, but to what some people call dependence. After all, you don't start taking one Ambien, then 2 the next night, 4 the night after that, and so on--you just use enough to have it work for you. Now, if you do that every night for a while, and then stop, you may have a night with little or no sleep, because you're used to the drug. But this is a far cry from Addiction, with its suggestion of a life out of control because of unrestricted drug use. While seeing a pulmonologist you might inquire about Xanax. Technically it is an anti-anxiety drug, not a sleep medication. But it can be used, quite effectively and at a relatively low dose, as a sleepng pill. Anxiety is certainly something that goes along with not being able to breathe--if you get my drift. I've been using Xanax for sleep in a dose of .25mg for several years, and my doctor doesnt have a problem with it. I tell him it relaxes me and helps my breathing, which is true. And it doesnt have the problems that have been in the media about Ambien. I am again fortunate that I've had the same pulmonoligsts for nearly 30 years now.

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