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  #16  
Old 06-07-10, 11:26 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

This is definitely disturbing and I hope you will prevail. A couple of people have suggested enlisting the help of your doctor. I said this in another thread but it bears repeating. I asked my primary care physcian if he would be willing to manage my meds. He asked me to have my psych send over my records and he has handled my meds ever since.

As far as havng your parents fill out forms for you at your age, I would ask Kaiser if they are honestly denying you the mdication you have been using for numerous years under the care of a psychiatrist for several years until you jump through their hoops? I would also say that my parents are dead so you can't have them fill put a form. They were executed for murdering an insurance company administrator!
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Old 06-08-10, 12:41 AM
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Re: Kaiser and Adult ADD/ADHD. Help :(

I'd be checking out if they are legally able to do this thru the HIPPA laws. Your health insurance from the last company should be portable.

They cannot ask you to have someone from your work fill out a form about your medical condition, that would violate your right to privacy..

I think I'd simply tell them you want to look into this further with HIPPA and other disabity associations.

It may change their tune.
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  #18  
Old 04-06-19, 12:32 AM
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Angry Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by Tchadensis View Post
Kaiser does good research on healthcare but last I heard it was not the best company. But things may have changed. What does this "special testing process" entail?

I switched to Kaiser last August through Medicare and find the 2 psychiatrists I have talked to not only rude but set in their ways... I can only imagine that Kaiser is telling every psych to limit prescription dosages to limit their risk.



I was diagnosed 4 yrs ago and was on Adderall for 2 yrs and Vyvanse for this past yr. When I joined Kaiser I saw one psych who had no interest in working with me. She refused to tell me if she had worked with post menopausal women. This was critical for me because I was not diagnosed til 10 yrs after menopause and did not get estrogen replacement therapy and, because estrogen binds dopamine to neurotransmitters, I was afraid my levels were too low and that my dosage needed to increase. I showed her the list of over 20 resources I have read about this and she LAUGHED and said, "so you've read a lot of books!" My GP ordered all the tests of estrogen, thyroid and many other factors that play into how adhd meds work. When I told her i had had these tests she said "but you are not menstruating so why does it matter?" When I told her I wanted to switch from 50 mg Vyvanse back to 60 mg Adderall she told me point blank that those doses were TOO HIGH, that she would never switch me to 60 mg Adderall, 30 mg was her limit, because she believed that stimulants can damage your heart (disproved - BY KP - in 2011 for adhd people).

I asked for a 2nd opinion and my GP had to ask her to appoint one...


Well, this second one started right off by telling me that he would never prescribe more than 30 mg either because there was a CRISIS in ADHD stimulant prescriptions that could be compared to the opioid crisis!! He had no interest in hearing about how i have faired on different medications or dosages, he would prescribe 25mg XR and required a urine sample and me to keep a record of what I had been able to focus on and accomplish in the next 30 days that was different than when I was on Vyvanse. And if there was no change then my problem was not the stimulants... Huh? Hey dr, maybe I've been on the wrong stimulants!! Unbelievable. Does not trust me to report on my own, it has to be in a CHART. frankly I am appalled at the attitudes of these 2 doctors. They acted as if my offering what I had learned was a challenge to them, not the start of a conversation, and they each cut off discussion.


Has any one had success in being trusted by a psych, one who welcomes your input?
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Old 04-06-19, 06:45 AM
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Re: Kaiser and Adult ADD/ADHD. Help :(

I am very very fortunate. I have been with my psyche now for almost 20 years. She has always trusted me and welcomed my input. In the beginning though I let her guide me. I have absorption issues now and she was very willing to rework all my meds 10 years ago post gastric bypass. I am on a high dose of adderall and she and her staff worked with me through an 8 month appeal with my insurance company to get my adderall approved when they decided that they knew better than my doctor about what dosage I should be taking. I blame the opioid crisis for this crack down. Now all controlled substances are being monitored. I am sorry this is going this way for you because its not right.

Quote:
Originally Posted by melissab52 View Post
I switched to Kaiser last August through Medicare and find the 2 psychiatrists I have talked to not only rude but set in their ways... I can only imagine that Kaiser is telling every psych to limit prescription dosages to limit their risk.



I was diagnosed 4 yrs ago and was on Adderall for 2 yrs and Vyvanse for this past yr. When I joined Kaiser I saw one psych who had no interest in working with me. She refused to tell me if she had worked with post menopausal women. This was critical for me because I was not diagnosed til 10 yrs after menopause and did not get estrogen replacement therapy and, because estrogen binds dopamine to neurotransmitters, I was afraid my levels were too low and that my dosage needed to increase. I showed her the list of over 20 resources I have read about this and she LAUGHED and said, "so you've read a lot of books!" My GP ordered all the tests of estrogen, thyroid and many other factors that play into how adhd meds work. When I told her i had had these tests she said "but you are not menstruating so why does it matter?" When I told her I wanted to switch from 50 mg Vyvanse back to 60 mg Adderall she told me point blank that those doses were TOO HIGH, that she would never switch me to 60 mg Adderall, 30 mg was her limit, because she believed that stimulants can damage your heart (disproved - BY KP - in 2011 for adhd people).

I asked for a 2nd opinion and my GP had to ask her to appoint one...


Well, this second one started right off by telling me that he would never prescribe more than 30 mg either because there was a CRISIS in ADHD stimulant prescriptions that could be compared to the opioid crisis!! He had no interest in hearing about how i have faired on different medications or dosages, he would prescribe 25mg XR and required a urine sample and me to keep a record of what I had been able to focus on and accomplish in the next 30 days that was different than when I was on Vyvanse. And if there was no change then my problem was not the stimulants... Huh? Hey dr, maybe I've been on the wrong stimulants!! Unbelievable. Does not trust me to report on my own, it has to be in a CHART. frankly I am appalled at the attitudes of these 2 doctors. They acted as if my offering what I had learned was a challenge to them, not the start of a conversation, and they each cut off discussion.


Has any one had success in being trusted by a psych, one who welcomes your input?
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  #20  
Old 04-06-19, 06:50 AM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by melissab52 View Post
Has any one had success in being trusted by a psych, one who welcomes your input?
My GP, who has a specialty in ADHD, trusts me and welcomes my input, and has prescribed 60mg Dexedrine for me for years. He stays informed with current research and understands that different people respond differently to medications.

Cheers,
Ian
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  #21  
Old 04-06-19, 12:53 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by aeon View Post
My GP, who has a specialty in ADHD, trusts me and welcomes my input, and has prescribed 60mg Dexedrine for me for years. He stays informed with current research and understands that different people respond differently to medications
Is your GP at Kaiser?
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  #22  
Old 04-06-19, 02:05 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by namazu View Post
Is your GP at Kaiser?
No, but I wanted to demonstrate the possibility of an engaged, magnanimous doctor.

I think Sarah was doing much the same.

Cheers,
Ian
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  #23  
Old 04-09-19, 05:14 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

How backward that a previous proper psychiatric diagnosis would be set aside and a long process before a new diagnosis would be required! Do they do the same thing with diagnosed Diabetes? Congestive Heart Failure? Ulcers? Insomnia?
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  #24  
Old 05-18-19, 08:52 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by melissab52 View Post

When I told her I wanted to switch from 50 mg Vyvanse back to 60 mg Adderall she told me point blank that those doses were TOO HIGH, that she would never switch me to 60 mg Adderall, 30 mg was her limit, because she believed that stimulants can damage your heart (disproved - BY KP - in 2011 for adhd people).

I saw a psychiatric nurse practitioner a few years ago and commenting on my age (I'm 58), he said that I shouldn't take stimulants "because of my heart." He wanted me to use Strattera instead. But he said this even though he had no knowledge at all about my health history or if I have ever had any heart problems (I haven't).

Fortunately, my primary care doctor is quite knowledgeable about ADHD and ignored his recommendation. He recommended instead that I take Adderall or Vyvanse and let me choose. So I decided to try the Vyvanse and have been on 50 mg for a while now. I had an EKG done before I started and my doctor ordered another one about a year later, but didn't find any problems. And my doctor doesn't think 50 mg of Vyvanse is too high. In fact, he regularly inquires if I might want to raise the dose or add an afternoon booster. I'm the cautious one. I'm lucky to have a good doctor that I trust and can talk to and dread the thought of ever having to find another doctor.
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Old 05-19-19, 01:30 AM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by PoppnNSailinMan View Post
And my doctor doesn't think 50 mg of Vyvanse is too high.
Given how weak Vyvanse is compared to Adderall or Dexedrine, he's quite right to think so.

Cheers,
Ian
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  #26  
Old 05-19-19, 01:26 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

Quote:
Originally Posted by aeon View Post
Given how weak Vyvanse is compared to Adderall or Dexedrine, he's quite right to think so.

Cheers,
Ian
The OP mentioned wanting to switch from 50 mg Vyvanse to 60 mg Adderall, but those two don't seem like they are anywhere near being comparable doses now that I look at it.

I don't know how accurate it is, but according to a stimulant conversion chart online, 50 mg Vyvanse would be equivalent to about 20 mg Adderall XR or 10 mg immediate release Adderall twice a day. The largest doses of Adderall available are 30 mg for both the Adderall XR and the immediate release. 50g Vyvanse and 10 mg Adderall twice per day are supposedly equivalent to about 7.5 mg Dexedrine, twice per day.

If all that is correct, I can see the doctors thinking that 60 mg Adderall is a little high, but can't imagine how they would think that 50 mg Vyvanse is high, especially since it's only two doses above the 30 mg starting dose recommended by Shire for Vyvanse.

My doctor has suggested a few times that I try Adderall just to see if it works better for me than the Vyvanse. But one of the reasons I like the Vyvanse is that because of the way it enters your system, it's not affected very much by what you eat whereas with other stimulants, you have to be more careful to avoid some foods. I also take a proton pump inhibitor for acid reflux which can also affect how Adderall works but doesn't have any effect on Vyvanse. I also like the Vyvanse because at least for me, it really does seem on most days to last for a long time, usually at least 12 hours or more.
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  #27  
Old 05-19-19, 07:58 PM
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Re: Kaiser and Adult ADD/ADHD. Help :(

I think I misread you.

I posted a dosage equivalency chart in the Medications resources section.

I would need to take 180mg of Vyvanse for it to be efficacious for me.

That's why I take 60mg of dextroamphetamine sulfate.

Cheers,
Ian
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