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, October 11, 2010

Yesterday's Psych Appointment

I realized that I have a lot of new readers and that I probably should explain some of how my psychiatry care works, because it is a huge part of why I do well and it is very different than most people.  For one thing, something that amazed Dr. Mind back when I first started seeing him because it's apparently quite unusual, I see Dr. Brain every month and I have for the entire 7 1/2 years she's seen me.  There have been 2 appointments that either I was sick or it was too snowy for me to drive so far that we've done on the phone, and she missed one appointment last year when she had surgery (and will miss one this year for reconstructive surgery as well I think although she's not mentioned that again for a long time) and that's it.  Otherwise every single month.  The 6 months prior to that, (the first few I was diagnosed) I saw a psychiatrist every other week because I was in the clinical trial.  They strongly recommended ongoing monthly appointments, and my therapist at that time talked to Dr. Brain about this because she felt we'd be a good match.  At that time Dr. Brain came to the counseling center where I have gone for about forever several times per month, and after reassurance I wasn't dangerous she agreed to see me after her regular appointments (we were alone in the building, that's why the safety thing) every 4 weeks.  Later she moved to where she is now and has one Saturday per month that is mostly a clinic type thing for something not related to me, and me.  She knows it's the only way I can see her, work, and not have to admit to work about having serious psych needs, which isn't ideal.  It also allows for long appointments, which is important for me at times.  Dr. Brain believes that everyone should get the time they need and so she tends to run behind a lot, and you're just warned that this is part of being her patient.  I think she's tried to do this less significantly in the last few years, but my appointments tend to be long because of my unique situation.  So I still spend 45 minutes to 2 hours with her, depending on whether I'm losing it or not.  Two hour appointments generally mean I've hit another wall with med options.  Since I drive 2 hours each way and usually wait 30-90 minutes, it's an all day adventure. These last months we've been talking more as well about some of the hard things I've been dealing with, so there's been a counseling component involved too, which has been on and off over the years.

Anyway, yesterday was a good visit.  We discussed my crazy hormones and she couldn't find any sign that my meds are at fault, which I assumed as there hasn't been any correlation to med changes and what's been happening.  She was concerned and agreed that something isn't right.  Everything is now documented too,right down to gaining weight and incredible carb cravings.  She agrees with seeing the gynecologist and with my plan to ask Dr. Body to do a FSH level, which will give some information about whether this is peri-menopause, although it isn't definitive.  However I have met my deductible for the year and would rather have hormonal testing that the gynecologist is likely to want done now than to pay for it when I see her in February.  I think he'll agree that this makes sense, especially as something is clearly going on whether it is menopause starting, a hormonal imbalance of some kind, endometriosis, or something else, and having some information when I can see the gynecologist (I had to schedule it far out because I wanted to have time to log things, but I also won't have paid days off for a few months after I start my new job.  I actually am scheduled for the 2nd day I'm eligible for PTO, which is actually not something I planned since I didn't plan at the time that was scheduled to take a week off between.
We briefly talked about my need for ankle surgery and she verified my fear that they'll want to do this with a spinal/epidural, which I'm terrified of.  She said when we get closer she'll see what else is an option.  Anesthesia and MAOIs don't mix.  But with notice like this she'll find a way around my terror.  Just like the hospital.

We talked a bit about last year leading up to the hospital.  She kind of missed that month of my life because ti was when she was diagnosed with cancer. But we were talking about how I've changed so much in the last year and how much the MAOI has helped me and what some of last year was like pre-hospital, how frightening I found what I felt, and how glad I am that I don't seem to go there anymore, even as tough as parts of this year has been.  (She also said I am the best I've been in a long time, and since this episode is still not entirely over that is saying a lot.)  But talking about it made me remember sitting in a therapy room with this patient who tended to try my patience on the best of days and in response to every sentence she would say I would think "I'd rather die than do this."  "I just want to die."  "I hate this.  I want to die." because I felt so horrible that listening to whining about something relatively minor compared to 99% of my patients and to what I was dealing with was way, way too much for me.  I have had patients who annoyed me before.  I have never felt that desperate to get away.  In fact, the session I realized that this was my line of thought was the session I realized I needed to be in the hospital.

I really have come a huge distance.  Not just as discussed yesterday, but in how well my meds work and how much more control we have now.  As bad as I've felt lately we've had a lot of control over what I've felt.

I just realized I forgot to eat dinner.  So maybe that starvation thing is changing too?  Who knows.

(And then I forgot to post.  And made dinner but forgot to eat it for 40 minutes.Distactible anyone?

1 comment:

Michal Ann said...

Yes, you've some such a long way this year. I'm so glad you have such excellent care! And the team really DOES care.

I found this verse encouraging today.

The LORD your God
wins victory after victory
and is always with you.
He celebrates and sings
because of you,
and He will refresh your life
with His love.

Zephaniah 3:17 (Contemporary English Version)