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

Tuesday, December 01, 2009

A common question answered (and a life tip)

Life tip: Do not wake up to take meds at 4 AM then partially sit up with a drink in your hand and fall back asleep. It is a cold, wet, rude awakening and you'll have to sleep the rest of your psychotropic off on the couch.

Question Answered: Why isn't anyone covering for your psychiatrist?
That's tricky. She does have people covering, and most people have been able to see these doctors if needed. Originally the hospital people said I'd see one of them, they were waiting to see who (I think they were saying she wanted me to see but that is hazy). Then they apparently talked to her and she wanted to just have me wait and see me herself.

There are good reasons for that. My situation is so complicated that anyone messing with my meds can get hairy. People do things like the hospital doctor, who I really liked a lot, who told me that I might do well trialing Lamictal again. I've had 2 bad reactions to Lamictal, including the dreaded rash (and in a pattern that makes it more likely that I could have a very severe reaction if reapproached), and although protocol says I could try again in certain conditions she feels strongly that it would be bad. So the hospital doctor immediately tried to say she was wrong and over-cautious. I emailed her to say help!!! and she told them no Lamictal. That was the thing about the hospital; she was still involved in decisions if needed. With no connection to her someone might insist on doing something not good for me, where she knows me so well that she's much less likely to upset the apple cart.

She also knows me. She knew I would get my family doctor, who she trusts, to step in and help. They've been in contact and have worked together for4 years or so, and she knows he'd help me but be careful and listen to me, which is key because I've got a pretty good idea of what is a bad idea for me, but you have to know me well enough to realize I'm pretty aware of what is going on with myself before that matters when you treat me, and to someone new, on paper, I don't look like someone who could necessarily have a good grasp on this. She knew I'd aggressively get help if needed, and that Dr. Mind would aggressively monitor me and extremely aggressively get help if he was the least bit concerned.

So I know why she didn't have me see anyone else. She probably thought that was what I'd greatly prefer, and she was right. I think probably she thought after the Lamictal incident I'd be afraid of the hospital doctor, which is reasonable but I would have been ok following up with him in actuality.

What I don't know a reason for, and which I suspect was a failiing of the hospital social worker rather than anything else, was why I wasn't given someone to call in an emergency. There is always a resident on call, but there is exactly zero chance I will trust something like this to a doctor who may have only months of experience, has never met me, has not read my records carefully, and has no clue about how allergic I can be. Plus the only time I tried the resident on call I had a bad experience (bad enough the resident was disciplined; they just ignored my call) and so I have a big trust issue there. Which means that my only choice would be to call the unit I was on and try to get them to let me talk to the doctor I saw there. Which I would do in an emergency worse than this, but it is not ideal since that doctor wouldn't exactly expect it and so wouldn't probably even remember me. Any doctor who was aware I might call in an emergency would retain some memory of me.

So there are reasons things are this way, but there also was an error in there. This being me it was not unreasonable to expect that something like this might happen. Not being negative, just realistic. Which is why I suspect that this part was the social worker assuming I'd be fine and possibly Dr. Brain not feeling well enough to precisely direct her.

We'll see Saturday I guess.

1 comment:

Michal Ann said...

Thanks for the thorough explanation. It's just a darn shame that it's so complicated with many allergies, sensitivities, nutritional issues, recent illnesses, etc.

I wonder if in the future your wonderful Dr. Brain might be able to be more thorough in charting your history, "The Plan" and the problems. Like I said, it's such a shame that you've had to have so many fingers in the "pie." I'm very glad you're proactive, aware, capable, practiced: your own best advocate. I've always found that this HAD to be the case in any of my personal or family medical crises.

That awareness was very much reinforced when my first born was 2months old and I started to go partially blind in my right eye. The doctor was very straightforward to tell me that my optic neuritis and prior neurological symptoms indicated a 50/50 chance I had MS. (I do.) My mother was appalled that he would tell me such a thing but his position was "I have hundreds of patients. You have one disease. It's your responsibility to learn everything you can about your condition."

This reinforced opinions I'd already formed in prior experiences and that outlook has always proved necessary. I always keep a journal when a family member is hospitalized, etc.

So again, thanks for the explanation. You did a great job and you're thinking very clearly, it seems...a middle of the night cold "bed bath" not withstanding!

"Stay weak" as in

2 Corinthians 12:9-11 (NKJV

"And He said to me, “My grace is sufficient for you, for My strength is made perfect in weakness.” Therefore most gladly I will rather boast in my infirmities, that the power of Christ may rest upon me. Therefore I take pleasure in infirmities, in reproaches, in needs, in persecutions, in distresses, for Christ’s sake. For when I am weak, then I am strong."

In Him, Michal