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The_little_didgee
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Member Since: Apr 2013
Location: Ontario Land
Posts: 3,549
10 yr Member PC PoohBah!
Default Jan 15, 2023 at 07:26 PM
 
I read more records last night. The reading made me realize there was profound misunderstanding on both sides (misdiagnosis and suspicion) and lack of communication. There was no way an alliance could form under those conditions.

Psychiatric Emergency Service at the Ottawa General (This service is to be avoided):

"Patient is guarded with her history."

Later entry:

"Patient left hospital; refused follow-up."

I wonder why? If they took the time to investigate further and actually listen I would have been more compliant.

The consultation was done with a PGY-4 psych resident. Notes from this consultation:

Past psych history - see chart. No contact since around 2 years.

Impression: 23 year old female with difficulties coping and complains of ??? consistent with major depressive episode with panic attacks.

......

Unfortunately patient does not appear ready to accept help. When help was offered (e.g. acute day hospital) she rejects it. Appears to be an ongoing problem. ..... patient states we don't understand her problem. When challenged with our offers of help she decides not to talk further about the issue.

Patient would likely benefit from SSRIs for major depressive episode and panic attacks, but compliance with meds has been a problem in the past and starting it from the emergency without having agreed to followup would risk ??? and misuse of meds. Also SSRIs may initially worsen panic attacks. Therefore meds need to be started by someone who can followup.

.....

Forcing treatment would not work and may reinforce non-cooperative stance with treatment. Unless patient agrees to help offered, prognosis is poor.

Patient left unannounced.

-- This visit was in spring 2001. It was one of my last encounters with this service. The resident's note did not contain any personal attacks at all. It was written in a way that the patient might actually read it someday.

No one was listening to me. All they were doing was judging my character, assigning motives I did not have, and telling me conflicting things. No one was consistent with me. Nothing was ever explained. I really had no say in anything.

Doctors shouldn't tell their patients they can't do anything for them then offer referrals in the specialty and medication. It's so confusing.

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Dx: Didgee Disorder

Last edited by The_little_didgee; Jan 15, 2023 at 07:43 PM..
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