Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Monday, March 17, 2008

Your questions answered: Psychiatric visits

I had a blog search for what a psychiatrist visit should entail. I think a lot of people are so used to crummy care that they don't know, so here's the run-through.

Each of my visits follows the same format although there are variations. My allergy alert always pops up when she signs into my chart, so that always takes a minute. Now that I'm on several meds for my thyroid and kidneys and constipation and reflux (some of those should help resolve others) and I have a few meds I can adjust we make sure her list is what I'm taking. I have flexibility with several things and I generally email her from time to time so she knows what I've done. We also communicate about labs and things like my kidney issues via email as needed, so usually she pulls the most recent email and we make sure it's accurate.

Some things don't happen every single visit, but close enough. We always talk about work, since that is both my biggest stressor and my greatest area of success. We talk about how therapy is going and I sometimes pass info back and forth between the doctors. We discuss any questions or concerns I have. Often we try to figure out how to reduce some side effects while keeping me at high doses. We check what labs are due (although in theory labs can be every 6 months I get them more frequently. I'm getting one set done every 2 weeks to be sure my kidney med is ok and I get Depakote levels as often as every 2 weeks. I also have to repeat a liver level from my last 6 month set because it was elevated). We talk about where my mood is and how stable/unstable it has been. Usually I have to rate my mood, which I hate doing. Most times, unless I'm in a truly incredibly great place she runs through the suicide questions. I think when I'm doing well she sort of alternates the suicide/psychotic symptom questions.

Throughout the visit my thoughts and questions are welcome. It will take an hour to 75 minutes. There is no pressure; if I'm crying and needing more she'll give it to me. Once she was with me 2 1/2 hours.

That's an ideal situation, but it's something everyone should search out until they find. My life would not be nearly as good as it is without her.

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