Lack of prescription heightens anxiety of Las Vegas woman

Crazy. Insane. Ludicrous. Scary.

Words 42-year-old Brenda Bertsch used as part of a monotonic description of her medical situation.

Perhaps because of her robotic delivery, what she said seemed even more frightening than if she had been hysterical.

Her physician lost his license and now she couldn't find another doctor to write her the same prescription for an anxiety medication.

"Other doctors tell me he was giving me way too much," she said as we sat inside a coffee shop at a Barnes & Noble. "They don't want to take on the responsibility of what could happen to me."

If she stopped taking her medication cold turkey, she was likely to have seizures, which are sometimes fatal, she said.

"I've only got a few days of medication left," she said.

The Nevada State Medical Board of Medical Examiners should have a formal referral plan in place for patients when it suspends a doctor, she said.

Doug Cooper, executive director of the board, said his agency isn't set up to give referrals.

"There are many, many agencies out there to do that, including The Salvation Army," he said.

"Why would I go to The Salvation Army for a referral to a doctor?" Bertsch said.

It turns out that Bertsch's former physician was Dr. Larry Yee, a family practitioner with an office in West Las Vegas.

On Sept. 2 he was suspended indefinitely by the medical board after he failed to appear before the board's investigative committee on matters related to "questionable prescribing practices and the obtaining and attempting to obtain prescription medications, including controlled substances, for himself through staff and patients."

Cooper declined to go beyond that statement regarding Yee's relationship with drugs.

Attempts to reach Yee were unsuccessful. A message on his office door says he is on an extended vacation.

The medical board's order of summary suspension also said there were "confirmed instances" of Yee's "increasingly erratic and inappropriate behavior as witnessed by patients, current and former staff members of Dr. Yee, as well as board staff."

Just what "erratic" and "inappropriate" means isn't specified in the board's order, but a Vimeo.com video about Yee may help define those terms.

On the video, which shows his medical diploma from the University of Arizona, Yee says he's so talented that he can come up with the correct diagnosis for patients just by looking at them.

He also invites people to come by so they can get shots that he says will make them live longer.

He soon will be able to do nipple enlargements, he tells viewers.

He also dances by himself in the office, and with what looks like a staff member, and with the male narrator of the video.

Bertsch said Yee didn't dance with her, but he did start prescribing her far more alprazolam, also known as Xanax, for anxiety.

When she first saw him as a patient in 2008, she was taking just 2 milligrams. Soon she was up to 8 milligrams and was on that dosage for most of the past three years.

"Whoever prescribed that was not being responsible," said Dr. Ole Thienhaus, chair of psychiatry at the University of Nevada School of Medicine. "It's not standard of care. You usually don't want over 2 milligrams. Other drugs can be used."

Alprazolam is not normally recommended for long-term use because of the increased likelihood of developing a tolerance and subsequent addiction to the drug, Thienhaus said. Evidence suggests that more than one third of adults who have been taking the drug for a long period of time develop depression. Other consequences for long-term addiction include the higher probability of a fatal overdose as the patient tries to overcome his or her tolerance.

Thienhaus said that if Bertsch were his patient, he would wean her off alprazolam as soon as possible. Under no circumstances, he said, should someone with her history with the drug abruptly stop it because of the possibility of dangerous seizures.

With pills to spare, Bertsch finally found a doctor to carefully undo what Yee had done.

"If they don't get a formal referral plan in place, somebody's going to die," she said.

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.