help - am I reading too much into this?

I think I might have accidentally caused an argument between my psychiatrist and GP.

I was diagnosed bipolar, and was started on Depakote, for which I had a blood test at the beginning. I was told it was for liver function. So afterwards my blood results went back to the hospital and I had a letter saying to see my GP and I assumed this was for the beginning prescription of Depakote. I didn’t hear anything else until I turned up at my GP’s office and he said out of the blue not to worry about my cholesterol and that the hospital was overreacting.

Well, I didn’t worry, because I trust my GP absolutely, but the next time I saw my psychiatrist I thought I may as well ask him about it as well, because I was curious as to how the hospital had “overreacted.”

He pulled up the results on his computer and went through them and said my cholesterol levels were really dangerously bad. Well, I couldn’t say my doctor had mentioned it and done nothing, so I said he’d advised me not to worry. The psychiatrist seemed a bit put about by this and said that I really should do something about it.

He gave me paperwork for a further blood test which I took away, but I haven’t had it yet. I should have had it a few weeks ago. It’s really difficult for me to get out of the house, and not just because I’m depressed. But even when I remember, and I have the opportunity to go get the blood test done, I don’t, because I’ve usually had toast for breakfast instead of a banana or something, and I’m not wanting to make the psychiatrist worry. I told my CPN this last week.

I think they’ve talked together, because when I saw my CPN this week, he told me that my GP should be putting me on medication for high cholesterol, and that I need to ask him to prescribe it for me, and that it had been an oversight.

I feel really bad for my GP, because he’s just the most wonderful doctor in the world. He’s saved my life many times over the years, and I just feel terrible because clearly there’s some kind of argument going on behind the scenes and I feel like I have caused it.

I need to apologise when I see him, because there isn’t a person in the world whose opinion I respect and trust like his.

But…

…then I’ve got to try and be assertive with regard to my pulsatile tinnitus and explain that I want him to listen to the bone behind my ear with a stethoscope to test for objective vs subjective, and I need to have him check the blood pressure in each arm to see if there is a difference that would indicate an occlusion of the subclavian artery. And then I have to ask him to check for a pulsatile movement of the tympanic membrane, which would indicate a couple of other things that might be causing the pulse in my ear.

Actually, I’m feeling pretty miserable now about the entire thing. He really is a great doctor. Maybe I’ll take a nice bottle of port into the appointment with me…

What would you guys do?

I would accept that even the best of GP's get things wrong, and that the whole thing could have been miscommunication between hospital and doctor. These things happen, and it's not as though your GP is going to be struck off over this... it's as likely to have been caused by a clerical error as anything else, so don't get too stressed about it.

I don't know what your relationship with your GP is, but personally I wouldn't bring him a bottle of port! You don't need to bribe or placate him, he's a good man from what you say, a good doctor, despite this error, so he'll do his job anyway. If you want to get him a Christmas present that's something else, but you don't need to present it in such a way that he thinks you're trying to coddle him or make up for something. You've done nothing wrong, and there's no way your GP would hold it against you. If it makes you feel better get him a Christmas present.

I'm in the UK too, and in the past I've had times when I've been unable to get to the doctor's. Is there a patient's advocacy group in your neighbourhood? I have a lady working for a local support agency who helps me attend things when it gets too much for me. She's assisted me with debt, housing, court cases, getting to doctor's appointments, dentist, interviews with DSS, even supported my son by getting me to meetings at his school etc. It's worth finding out if there's any comparable group in Sheffield (where I see you're from.)

http://www.sheffieldmentalhealth.org.uk/

Hopefully something on that list might be of use to you... there was one time when I was unable to leave my house even to put the bin out. This lady drove up to help me walk to the end of the pavement to put out my bin. Then she came in and had a cup of tea with me, and helped me feel like a normal human being again. I'm sure that you can find someone locally to help you get to your appointment.

In the mean time, really don't panic. Treat your doctor as you would have done before. He's still a good doctor, even if he did make a mistake. Ask him whatever questions you were going to anyway, and just remember that anything going on behind the scenes isn't to do with you anyway... it's just NHS politics. It happens regardless, he's probably used to it. And I do think it sounds more like a clerical misunderstanding, they may have sent him records that weren't completely clear. It happens... don't worry.

I apologise for going off topic, but I was wondering what your tinnitus is like. I have this problem where I hear a constant background static, especially in a quiet environment, but most bothersome is the pulsing/rushing in my ears. Sometimes it happens at random, but usually when I turn my head or eyeballs. It even happens when I am driving and I go into a turn. When I get the pulsing, I feel like I am the beginning of the process of blacking out. I think if the pulsing went on for longer than it does that I might black out. Any thoughts? I am afraid this could be dangerous.

Thank you so much for the reply mgran. I know it sounds like a silly thing, but I think I'm getting it all out of proportion in my head. Probably just a clerical error, like you said.

My relationship with my GP is great, I've been seeing him for years. I think he'll definitely say along the same lines as yourself when I do see him.

Thank you for the link! My CPN helps me with stuff so far, or he will do; we're just getting to know each other at the moment. I have issues leaving the house that have to do with my neighbour and the council. We've got a case with the ombudsman right now. Maybe one day when it's over I'll be able to tell the story.

I feel much better about my GP now. Just needed a few words of common sense.

Mine is a loud, low frequency constant heartbeat in my right ear that's synchronous with my pulse. It's present at all times, even when I sleep, and I've had it for around six years. Before I started my last cycle of mania and depression I was having hearing tests that were starting to show hearing loss in that side.

It can be caused by a load of things, but what you said about eyeballs might mean Superior Canal Dehiscence Syndrome. Check out this links page, the second one down.

Also, this is a useful link.

I'll be starting a pulsatile tinnitus thread in Health Support soon to share what happens.

When your MDs disagree, they own their disagreement; it's their responsibility. If one of them makes a mistake and it gets pointed out, this is a good thing for your health and for the health of their other patients.

I'd have your labs done over before you start on anything. My cholesterol was through the roof last year 256, and i'm only 25. I quit smoking, started exercising, ate oatmeal and my cholesterol is now 169. I also was 2 1/2 yrs sober so my liver was feeling better.
and make sure it your blood is taken on an empty stomach with no alcohol the day before for a more accurate read.

There's also new research to suggest that the numbers used today aren't a good indicator anyways.

I agree with everyone. If there is something they disagree on, it's between them and you don't need to say sorry for anything. I do the same thing where I try to take on what goes on between other people and it's just not our place no matter how much it feels like it is. Try not to worry about it ok?