Today was better. Dr. Mind clarified what he said last week, we left it at that although I later realized that I was doing precisely what he said I am doing but for a reason he can't know because I've never told him. We also had a lighter session, no big focus on the depression or the potential sadness of the holiday. It was what I needed and I'll be glad to get there next week and talk about what he doesn't know and how that factors in.
And then I just got what I needed, a kind note from Dr. Body. Because synthroid is typically a morning medication I have tried to take it that way. (It has to be taken on an empty stomach, something that I somehow wasn't told until I'd been on it for years and so I don't worry tremendously about that since I do fine with the current dose). It also needs to be taken consistently. The problem with this is that when I have a bad spell I don't always manage to take it and time will pass and suddenly I'll know that I've not had it for far too long. So I'll try to get back into taking it and if I'm still symptomatic with the bipolar I'll fail and eventually will have missed far too much, requiring new labs to be sure that I haven't caused a need for a dose change. In the past I changed to taking it at night and did that for a long time but this summer I was doing great with taking it in the morning and I was taking another med in the morning as well. That med just has gotten pushed down to one dose which isn't ideal but I can't help it right now.
Anyway, I had written to him that I would probably need labs, messed things up, etc. and sorry. And instead of telling me how important it is to keep taking the medication or pointing out that having my thyroid out of whack will make my bipolar worse or any of a dozen other tactics he just said not to worry, that I hadn't done anything bad but that we'd check labs in case and that taking it at night was not a problem. He didn't have to be nice; those other things are all true. But as he always is he was understanding and patient with me and I need that little bit of kindness. It took forever to find a family doctor who was well, willing ot be my doctor at all, and who would also work with me to make sure that physical problems were addressed but without messing up my psychiatric issues or causing drug interactions. Back when I started seeing him and he agreed to that I was "only" on lithium and depakote so I had interactions but not as many or as dangerous as I have now. He's seen me through numerous times I've messed up my thyroid (giving him further right to get frustrated, and he might but he never shows it) and has handled drug allergies, medication interactions and restrictions (plus meds that I can't take because the side effects are too extreme for my bipolar) and he has always been patient and kind.
That's not something you find every day or easily. I had a year that I just couldn't find a primary care doctor who was in my area and would take me as a patient and in that time my crappy but at least he'll see me doctor refused to treat severe cold sores that I had on both sides of my mouth that were so deep they bled and were there for 7 months before my psychiatrist finally said it was ridiculous and treated them and I wound up reporting him to the medical board who investigated him (but found him free of wrongdoing a year later) after he said "you can't take this antibiotic with depakote so here's this one". It didn't work so I called back and he didn't want to see me, called in a script for the med he said I couldn't have. I called the office again and another dr called in a safe script. That didn't work so I called in again and once again he prescribed the med he had said was contraindicated. Again I called back and was given a different antibiotic, this one make me extremely sick and I called again. I'm sure you can guess what happened. So after that I complained to the medical board who took it seriously and then I had to find another dr and found Dr Body, newly done with residency and very willing to take a challenging case. It took a few months for him to get used to the idea that I had the conditions I did and was still functioning in the work role I was in but once he stopped forgetting I wasn't on medicaid we did great.
He has no idea how much his little kindnesses help. I could never explain it to him. I hope he knows at least a little.