When I told him about the depression I'd been having with the Copaxone, his first comment was, "Are you sure? Because depression is very rare with Copaxone." I explained that nothing else had changed in my life and that when I stopped taking the stuff I felt better fairly quickly.

"Well," he said. "I've only ever had one other patient have that experience and I see hundreds of MS patients."

Like I care, at all, whether or not he's seen other people with this? The point is, *I* am experiencing it and it needs to be addressed and, furthermore, he needs to know about it. And, thank you very much, I don't need him to scoff when I explain the depths to which I'd sunk the previous month.

Thankfully, the depression seems fairly stable (for the moment) and despite The Good Doctor's suggestion that I could try Tysabri, I opted to stick with the Copaxone for the time being and see how I felt now that my psychiatrist is tracking things a bit more closely. (And for the record, I've always thought my shrink to be a bit stand-offish, but he is downright cuddly compared with my neuro!! :-P )

Anyhoo, by way of engaging conversation, when I mentioned to The Good Doctor that I'd read that depression was an "infrequent" side effect of Tysabri, he poo-pooed that as well. Well, it may be unusual in his experience, but I don't think it's necessarily fair to dismiss the possibility because he hasn't seen it. I mean, it's already pretty obvious that my system is prone to excessive depression. If I'm experiencing it in a drug in which that side effect is rare, wouldn't it follow that I have a good chance of developing it in other medications - particularly in those where the side effect is described as "common," as Tysabri is?

From the prescribing information (emphasis mine):

The most common adverse reactions (incidence ≥ 10%) in MS were headache, fatigue, arthralgia, urinary tract infection, lower respiratory tract infection, gastroenteritis, vaginitis, depression, pain in extremity, abdominal discomfort, diarrhea NOS, and rash.

So I'm in a bit of a quandry at this point. As I said, I'm planning to stick with the Copaxone for the time being (assuming I can get the damned prescription filled) because I'm not sure that the Tysabri will be any better from a depression standpoint. If I just can't tolerate the Copaxone, even with the help of my shrink, I'll give it a shot. My concern is, I'm not 100% sure that I can receive Tysabri from a doctor at another clinic in the city.

Honestly, when it comes to my healthcare, I don't care whether or not the doctor think my points are valid. As my doctor, he is duty-bound to listen to me and take my concerns seriously. I want to feel comfortable sharing my most recent experience(s) with my medications and disease, and to get his unbiased opinion about them. And I don't care if he has to pretend that he cares about my point of view; sign the guy up for some acting lessons if necessary. What I need is honesty, frankness and the ability to listen - and that's what (my insurance company) is paying him for. What I don't need is skepticism and contempt, or nastiness from either him or the Hateful Shrew.

So, my plan is to begin doing some research into new neurologists in the city who are on my new insurance plan. Once I narrow it down to a few I'll make appointments, interview them and then decide whether to switch or stick with The Good Doctor.