My Support Forums - View Single Post - Bipolar check-in #71

Aurelius710 · Nov 25, 2022, 10:32 AM

Quote:

Originally Posted by *Beth*

I hope anyone who is not asleep is having a peaceful night. I hope we ALL have a peaceful Wednesday.

I had my appointment with med dude. I'll be candid, because I don't know how else to be in life.

He began prescribing less than a year ago and it shows. He is empathetic and he does care. He's friendly, he has a sincerity about his manner that touches me, and that I'll carry with me when I remember him 10 years from now. His thinking lacks creativity because he lacks confidence, which causes him to be somewhat falsely arrogant and easily threatened. Logically, it follows that he gets defensive easily.

So, after about 6 months I do finally understand how to negotiate with him; I don't feel lost. What follows is how I've arrived at my conclusions.

I explained to Dude how hard this month has been (what you all know), that the Topomax has blurred the sharp edges of the depression but that the dose is still very low, that I am having terrible anxiety with waves of panic.

And I told Dude that a friend who has bipolar disorder uses Emsam to treat her depression. I told him that my therapist also said she has had clients with BD who have had success with Emsam. Med dude asked me how to spell it. He scrolled through his phone. OH, nah. That's an MAOI. Those aren't really used anymore. Too many side effects. I pushed a bit. (read: DUDE: Deep depression has side effects, too, hello) Disappointment - major. But I gave up.

I gave Dude the information that my GP referred me to an MD at the clinic where I receive my health care & that the MD is a doctor who specializes in addiction. I am seeing him, I explained, because I hope to be able to get off Klonopin (about 30 years on it).

I explained that Dr. D. uses the Ashton Method for benzo withdrawal. Med dude wanted to know which benzo Dr. D. would use to short-term replace the Klonopin. When I told him "Either Xanax or Valium" he came back with, "Xanax! That's a highly addictive benzo! That wouldn't be a good one to use, and I don't know why he'd even use it!"

Dr. D. is in his late 60's and has several decades of experience with treating addiction. It's his specialty, he's highly rated, etc. So... Maybe he knows what he's doing?

Then I told med dude that Dr. D. said we will most likely raise my Gabapentin dose much higher than it is. Dude became threatened. Kinda shrill Wanted to know "Can the guy prescribe, or what? I mean, is he a psychiatrist, or what? Because 1800mg of Gabapentin is the HIGHEST for Gabapentin unless it's being used for seizure disorder, so what is this guy doing, anyway?"

I had to be the calm one. I felt like med dude's mom. Except my own son never loses cool like that, because he wouldn't have his super-high-stress job if he did.

I backed up. *Empower Dude* I suggested that we start with me giving Dude Dr. D's name. Med dude liked that. Then he scrolled on his phone and discovered that Xanax can be successfully used as part of the Ashton Method. He scrolled some more and admitted that Gabapentin can be raised much, much higher to treat not only anxiety, but a number of medical conditions and that yes, we could raise it at some point (BS, if Dr. D. would raise it tomorrow, great, I'm at that pharmacy with my hand out).

Let's face it: I am one of med dude's guinea pigs. He did agree (praise the Lord in all His mercy) to raise the Topomax to 100mg/day and "check back in 2 weeks."

And that, dear ones, is the story of today's chapter of Med Dude.

Quote:

Originally Posted by *Beth*

I deeply appreciate your words, Boots. I have had a few good ones in the past, and not that long ago. So much of it has to do with insurance and apparently mine is sh-it. I thought Medicare would be good (SSDI lawyer claimed that), but it's awful. Med dude is sweet and empathetic, just sooo inexperienced. But at least he is nice.

I empathize with your Med Dude situation. There have been so many times I've had to proverbially hold my provider's hand as I led them to the answer I already knew. I've had enough physical and mental health issues in my life that I could do a differential in my sleep, but if I open with what I think the issue might be, they take it as a challenge and spend an inordinate amount of time trying to prove me wrong. Not saying I haven't been wrong, but I've been right more than once too. I have to play to those doctor's egos, so they can "solve" the problem that I already know about.

To their credit, my current set of doctors will engage with me in a productive way. Obviously, I'm not going to get in the way of them doing their job, but they'll take my thoughts and experiences into account when coming up with a diagnosis.