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Thank you, each of you, for your replies. It is a blessing when we have a skilled psychiatrist, isn't it?
I posted this because I have been angry at my pdoc, Dr. W. And I'm wondering what I might be doing wrong (if anything).
I am on Medicaid and receive my care from a clinic. I feel very fortunate to have the care I do - especially because psychiatrists, even paid out of pocket, are scarce around here.
I am always honest with my Dr. W. 2 weeks ago I (very honestly) explained to her that I had made some changes in my Abilify. I was having severe side effects that truly prevented me from functioning "normally." For example, I was falling asleep all day. Wherever I was, falling asleep. I was washing dishes and awoke when my knees bent as I was dropping to the floor, sound asleep. Of course, no way would I drive in that state.
Dr. W. reamed me for changing my med without her approval. She didn't seem to hear my explanation of how I felt; she seemed only to hear that I had changed my Abilify dose on my own.
Now, here's the tricky part. Dr. W. is in the clinic 4 days per week. On Saturdays, Sundays, and Mondays, there is zero back-up for psychiatry. (In fact, there is no back-up for standard medical care, either.) This week, she's out tomorrow (Tuesday), too.
When she lectured me, 2 weeks ago, about changing my Abilify I reminded her that I'm not clear on the protocol for the days when she is out of the clinic. Her answer was that I should go to the ER.
A ridiculous suggestion, because the ER will not touch (change) psych meds unless there's a life-threatening reaction or unless the patient is IP. In addition, to get to the ER I need to drive. My husband is not always available to drive me places and no way do I have the $ to take a taxi or some other hired driver.
I told Dr. W. that I believe I deserve credit for keeping notes and for being honest with her about the changes I made. She seemed unwilling to budge.
I will say that when my pdoc is there in the clinic she is usually concerned, helpful, and does go the extra mile to assist me (for example, she'll call my pharmacy during our appointment to be sure they have a certain medication in stock to save me a trip over there). She seems to be aware of the various med options and has experience with them.
Anyway, this week-end I dropped the Abilify altogether. The stuff is not working for me, despite my 5 weeks of trying hard to make it work. I hadn't slept for more than a 3 hour stretch during that entire five weeks. Last night I stopped the Abilify and took 12.5 mg. of Seroquel and slept! I feel alive today. Anxious, agitated - but alive. I can function.
I have an appt. with Dr. W. on Thursday. I'm nervous about it; I don't want another lecture. A different psychiatrist is not an option, as I live in a town that has 2 psychiatry options for those on medicaid - the county and my pdoc. The county would take a couple of months to get hooked into, plus there are problems with seeing a pdoc outside of the clinic where my therapist is.
So that's where I'm at today.
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