[spacemonkey36]

Oh, yeah, I fired the jerks. They have one unfortunate thing in common with respect to accomplishments: They reduced me to tears on my last appointment.

Wednesday was the last straw. I saw my PCP for the preoperative history and physical, which was a joke: no bloodwork (not a tegretol level, no blood count, kidney or liver function tests to tell the anesthesiologist and surgeon my body can handle the anesthesia), no x-ray of my hip and pelvis that my orthopedic surgeon and I both requested due to sudden increase in pain. And no one "remembered" I'd had a fall the previous Monday--all I got was the "no narcotics" speech.

Pal, if it were narcotics I wanted-the hood I live in, the access is very easy. Plus, I am given a reasonable amount of my own every month. And I repeated what I've told PMR and what I clearly told ortho: I don't want an increase because doing so before surgery makes pain management after surgery a freaking nightmare!!! I am not niave, or stupid--I've had nine orthopedic procedures (and when I told him this-I had to prove it by showing the number of scars, and telling him which procedures caused them). The jerk didn't even get a complete surgical history from my abdominal surgeries, the fractures I had fixed, and bother to learn about the TBI I had in childhood that left me with seizures for two years. And the med changes that I've informed them about the last three times I've been in have yet to be changed on my med list. Dosages are wrong, formulations, and so on.

But the refusal-he simply said, "I'll let ortho 'worry' about that." Well, it cost me an emergency trip to Seattle, leaving me scrambling for a ride which didn't turn up unti last minute-literally. I have been basically told that I am to remain in bed; have my MRI on the 4th, preop visits on the 11th, and do as little activity until my surgery on the hip on the 15th.

But jerk-off in PMR wants to know what kind of exercise I am doing to lose some weight (hey buddy, spend a lifetime almost, on anticonvulsants; and 17 years on psychotropics and let me know what it does to your waistline); and why my PT has been stopped. I told him to take it up with ortho. But at any rate, I finally realized I was tired.

And the reason I have been irritable, angry, impatient, and not really very social in general, is because of these two jerk-off's. Why? Out of fear of losing one of the few things that does help my pain, in addition to the meditations, guided imagery, etc, and so forth I do; and yeah, I know the DEA doesn't want to hear this; and given most doctors have at least their noses if not their entire heads, up the butt of the DEA, these jokers were no different. I simply couldn't take it anymore.

My body was showing stress; I had high blood pressure, swelling in my legs, anxiety attacks, and you guys know this stuff; none of us are strangers to the stress on the body that all of us go through with unrelieved and intractable pain. And few of them do much to understand.

And it's been my psychiatrist that has cleaned up the messes that the stress of dealing with these two jokers has caused: the psychological stress, the damage that their lack of effort to do a dang thing to really even try to help me; throw the minimal amount of meds at me, and walk away; showing no compassion.

Neither of them shows any sign of trusting me. But I am supposed to walk in the door, meet them one time, and put my trust, and my physical, psychological, and mental well-being entirely in their hands. But what have they done to earn mine--except to make me cry? Forget it.

I pay them for a service: they are technically by definition, my employees. They are not doing their jobs, and treating the boss in a disrespectful and in an insubordinate manner at best. They do not perform medicine, they are practicing it. When I said that, my friend Dave put it rather succintly: "More like practicing dead farts out of a chicken." Not sure exactly what it means, but sounds about as good as the physical I got Wednesday; everything had to be repeated Friday by the surgeon; plus they added the hip x-rays and all, plus blood work, and an EKG, and so on. The surgeon was mad as heck because as he said, "I can't even use anything he did, except your pulmonary function tests...at least he went that far." But it went so south with my PCP, his own staff (the PFT lady and the x-ray tech) both said, "Maybe you should think about another doctor: we have a bunch of others on staff..." At first I was hesitant: If I changed; what would happen to who was supposed to take up prescribing my meds?

Then, I would happen to get a text message from the "reminder" service my psychiatrist uses (they text you reminders on your appointments), with a "my email is _____ @____.com-I thought it might help. I remembered how he's always had my back; that he's been around for me when no one else has: that when no one even believed I was even in pain; he did, and he took up my "cause" and got them to listen. And they still suck at it; for all his screaming and yelling (literally); and I just said, "You know, he was doing your prescribing before; why not again?" I asked him and he said no problem-especially if it would give me piece of mind.

Piece of mind? How about Peace. Security knowing I am not going to get screwed. Secure in the knowledge if it gets worse, someone is going to listen.

I promptly did a Donald Trump with the PCP and the PMR docs:

"You're fired!!!"

I was more diplomatic about it-didn't burn any bridges; just said I was "moving on" and that nothing had changed at PMR in over four months; so I didn't feel my time and resources were well spent any longer; I do just fine with my home PT; thanks for helping with the meditation, thanks for my month's supply, and have a nice life.

The PCP I simply said I was moving my care to one of their clinics that is closer to my home where my GYN is two days a week, and my orthopedist is once a week; and that I need my healthcare closer and all in one place.

Have a nice day. Click.

Got a great weekend's of rest, and feel much calmer, more relaxed, in a good mood-and not manic--just a really good mood.

This is better for my sobriety than the constant "I don't trust you-here, pee in a cup." My shrink uses the honor system; he figures people will trip themselves up just fine on their own; and he's pretty much right. They do.

So, in all, Friday was great; that's when the pink slips were sent out; and today it was finalized with a phone appointment with my psychiatrist, which he insisted on (at no charge--get that from a pain doc...or even a PCP!!!) so he could make sure I was "taken care of and had what I needed for prior to my surgery," and re-instructed me on the oxycodone, since he's in charge now, and said given the bruised hip, swollen SI joint, popped disc (yup-last one finally went), and the fact that now I have sciatica on the right and the left side; he wants it every 3-4 hours, not every six. ROL (Roaring Out Loud!!!). God love people like him who step in, take charge, and actually give a darn--and I don't say that because of the med change-I didn't ask for that--I say it because he insisted on a session at no charge to make sure I was okay and taken care of.

Special place in heaven for people like him; and pergutory for the other two; it's called 100 millenium in a waiting room with 200 year old magazines you'd never read, and no clock or calander.

[Leed]

Oh happy days !!! That's great !! Finally you're get the care that you DESERVE !! Those other 2 should be reported and punished -- afterall, not even doing pre-op testing??? There's got to be some kind of "rule" about that. The Board ought to take a "look" at him. His head is so far UP - that he could see China!!!

I hate the fact that you need surgery, but for Pete's sakes you need pre-op testing ! Something is wrong with that guy. He has just plain lost it and he's a danger to his patients.

Thanks for posting this. Maybe it will give some of us who are intimidated by our doc's the nerve to speak up and DEMAND better care!! God bless you -- and keep us posted. Hugs, Lee

[BrokenNBeautiful]

I am glad there are still some ppl out there who actually act like doctors; that psychiatrist of yours.

Billi

[spacemonkey36]

Originally Posted by billi_leli

I am glad there are still some ppl out there who actually act like doctors; that psychiatrist of yours.

Billi

Billi,

I think he's made of gold, but I might poke him next time to make sure he's real...lol

But it's more than just him providing the meds...he's not afraid to say, "Let's try this first; but I promise, if it doesn't work, we will have a Plan B." And when I was in his office; before anyone would even prescribe for me; I was crying--I honestly wanted to put a bullet in my head (I gave my gun to a friend for safekeeping--he still has it, as he's a cop, he has to make sure my reflexes are that I'd be safe in having it again), and told him; "I am not suicidal; don't take this the wrong way, Dr. L, but I swear to God, if I have even 30-40 years that the statistics say I do, which although doubtful with the new lupus diagnosis, if I have to live this way for the rest of my life, I wish someone would put a bullet in my brain; two for good measure-one in the brainstem, and one in the cortex--just to make sure that if I survived, there's little chance I'd feel anything." He asked me why they weren't treating my pain, and I go, "Well, as they don't trust me-even after three straight and perfectly clean random UAs; which why they gave them-as they don't prescribe so much as the stupid migraine meds for me (I take Fioricet--always have, it's my "Gold standard" and the kind with no codeine-just the sedative, tylenol and caffeine does it for me); why they even think they have the f***ing right to UA me-but I wanted also to prove I have nothing to hide, and nothing in my system."

He told me that the day before; when I'd had an appointment with my former PCP (before the one I just fired), he'd spoken with her in the morning, and she'd indicated to him she was going to re-start my pain medication since I was so miserable. But I'd walked into her office, she asked how I felt, and I burst into tears--the sciatic pain was so unbearable that day, walking across the street from the bus stop to her office, and across the parking lot-maybe 100 yards--put it to where I almost threw up in their waiting room, and the MA had to bring me back in the wheelchair, and said the sciatic pain was making me sick to my stomach. First words out of the b****'s mouth: "I'm not giving you narcotics" in a really snotty tone. I told her that I'd not asked for them; and had simply answered her question; so let's move on, and just get to the point of the visit which was to get the bloodwork for my thyroid, or whatever it was. She never addressed the pain beyond that. Her reason she finally gave for refusing to do my pain management? I take psychiatric medication, and she is "concerned" about interactions. BS! Then pick up the phone and call the shrink, stupid cow! Believe me a long letter went in my God Box when I finally fired her. And as much as the VM doc was a jerk, this is nothing compared to the 18 months of he** I went through with her. And visit after visit; "Oh, she's sick; made herself come in anyhow--or 'she's having an 'off' day," or "I was also in a bad mood," and "it's a two-way street, maybe I said something." Then, when she told me to treat an 8mm kidney stone; and actually, she made the MA, who obviously felt awful about it come in and tell me; "She said to take 200-400mg of ibuprofen every 6-8 hours but only if you need it." Then he lowered his voice, and said, "But I'm sure you have stuff way better than that;" as he knew, although she didn't, at that point, the shrink had me on a long-acting, and short-acting BTP medication. But when she found out; oh, was she ticked off. "When were you going to tell me about the pain meds, Jenna?" I looked her right in the eye and said I hadn't planned to. She started a lecture on doctor-patient relationships, and how important it is to have trust. I literally almost choked on (sarcastic) laughter, and said to her, "You have not shown one ounce or even any indication that you trust me; You gave me 3 UA's, which I passed, and still let me suffer to the point where I was so close to killing myself that I gave my gun to someone for safekeeping. And yeah, it's legal-I've never had a felony-a psych patient with no felony, what a concept, huh? And I've never had an involuntary commitment. Plus, you lied to Dr. L and told him you were going to restart my pain meds; and then said you weren't, and in a snotty tone of voice; going to prescribe any pain meds. So, have you given me absolutely any reason to trust you? And yet, because you have an MD after your name, which I respect, but I have letters after my name, but I don't demand respect because of it. In case no one ever told you, respect is earned, and you don't just get it because you're a doctor, and just because you work in a doctor's office; you get it through building that trust, not treating me like a common criminal or making me feel like I am the one at fault because our "doctor-patient" relationship has been seriously lacking the trust factor. So by lying to me, and lying to my psychiatrist, why should I trust you??? So, no, I wasn't going to tell you-I figured you'd eventually find out, and that this is exactly how you'd react-because you don't trust me, but you're demanding it from me. So obviously, we have nothing further to discuss; so you have a great day-I am leaving." She was totally stunned; clearly no one had spoken to her that way in a long time; perhaps she needed it, because as I was leaving, she asked me to stop and sit down so we could talk about this. So I gave her the benefit of the doubt. She did apologize for not hearing that I was hurting to the point of being suicidal, but then suggested maybe it was a depressive episode of my bipolar disorder, and had Dr. L considered that? I said absolutely he had. She asked if he'd checked the blood levels of my meds. I said yes. She asked if he'd seen my MRI and the records he sent. Choking back what I wanted to say, which was (unlike you, yes, he reads the notes and records he's sent), I replied he'd even called the orthopedist, the back doctor, and the radiologist who'd read my MRI. So she said that fine, she wasn't going to make anymore of an issue of it. But that if we had this many issues, maybe I should come in weekly so we can just start working on things. I thought, "Okay, she's trying. Give her a break; she could have 'fired' you." So, being who I am, and how I am; and in AA we try with everyone, to practice "patience, love, and tolerance." And considering by no means am I an "easy patient," I figured give it another shot.

But when it got to the point that she tells me-not even to discuss with Dr. L about maybe increasing my BTP meds (which is what I ended up doing, and ended up having to do--and he even told me to crush them in applesauce, but that since they're bitter, I might want to put a bunch of sugar on top of that--it's still gross, but that does help, and they work a whole lot faster too), she tells me with an 8mm kidney stone--which she did not refer me back to urology for; which medically speaking a stone of that size, he should have at least seen me to make sure it didn't need to be "blasted"-with 200-400mg of ibuprofen every 6-8 hours? I kinda then realized the trust factor, after 4 months of weekly appointments where she seemed to be "trying" and had been pleasant and tried to appear helpful; were total BS. And not because of the "narcotics factor." Heck, the package on the Motrin says you can take it every 4-6, but just not to exceed a certain amount in 24 hours!!! But here she had a scan that showed clearly I had a stone the size of Mt. Raineer, and I'm being treated like my suffering is irrelevant to her. I realized it was pretty much over.

Two weeks after the stone passed (and yeah, it felt like I was giving birth again); I called for a follow up because I felt like the stone had caused a UTI. She was unavailable for 3 1/2 weeks; when previously had been available within a few days. I saw the new ARNP-very nice lady, who, btw, gave me a small script for hydrocodone since it turned out to be a kidney infection, but she even said not to tell the PCP she'd done that. Jeez, so no mention. A month later, a sinus infection; and she's got no appointments for over a month. Again, I saw the ARNP. Clearly, she's instructed them to pass me to the ARNP because she doesn't want to "deal" with me.

That was my last visit at that clinic; and when the claims posted on the ARNP (my insurance is Regence Blue Cross/Blue Sheild of WA, OR, and ID. We have a website where members can do many things; amongst which is to post evaluations of specific doctors-and we get "points" but that's a long story; but they take those evaluations and post them publicly in a forum so that when another member does a provider search looking for a new doctor; specialist, etc, they can pull up the "member reviews" and see what the rating are, and what other members' comments were...ooooh, yeah, did I give this PCP a steaming review!!! With decorum, I roasted her...but I did give the ARNP a decent review, because she was good to me; but not available as a PCP--she was kind of there to "put out fires," if you know what I mean), she got a decent review; she was cool. But each visit with the PCP I could post a review on, I put roasting, steaming reviews. But I also checked; other members had also. She had a 1.5/5 star rating, and not one member said they'd recommend her and the whole practice as a whole had at best, a leukwarm rating; 2.5/5 stars. They'll be lucky to stay contracted.

Virginia Mason is good-I've just been unfortunate with the PCP I landed with. This time, I am going online, and carefully reviewing all the VM PCP's at the closer clinic in Lynnwood. I found the one who's area of interest is "palliative care, autoimmune disorders, and systemic arthritic conditions." Exactly what my main problems are. But I wish I could talk to her first. I don't trust enough right now to make an appointment; but I am due for a blood test before my thyroid meds can be renewed. My gynecologist could do it in a pinch, or the shrink could--since it was lithium that killed my thyroid-but we'll see.

After the PCP and the PMR sharing the commonality of reducing me to a steaming pile of tearing snot at my last appointment-totally unacceptable--I need to do some healing, in a sense. If that makes sense. But having lupus, amongst other things; and since my rheumy retired; I'm kind of in a sort of "medical no-man's land."

But God has truly blessed me with the psychiatrist; he cell is a blocked number for obvious reasons, but texting me his email, saying, "I thought this would be helpful; let me know if you need something. Good luck on your surgery and MRI." Never had that happen.

But I am grateful it did--because it was the "therapy" I needed!

[BrokenNBeautiful]

I am glad that things are good with that psychiatrist.

the bedside manner is invaluable and the feeling that he CARES!

I am so sorry about that pain doctor.

My shrink fired me today.

Suddenly she is unavailable, after I confirmed/made an appt this week.

Never happened before.

When I went to the clinic supervisor, she said, "Billi, she goes to meetings often."

i told her, "She was always available before." and I questioned them for possible retaliation because I had complained about their desk clerks being rude to me, plus their 2 counselors being mean to me.

Hope things turn out okay.

Billi

[spacemonkey36]

Originally Posted by billi_leli

I am glad that things are good with that psychiatrist.

the bedside manner is invaluable and the feeling that he CARES!

I am so sorry about that pain doctor.

My shrink fired me today.

Suddenly she is unavailable, after I confirmed/made an appt this week.

Never happened before.

When I went to the clinic supervisor, she said, "Billi, she goes to meetings often."

i told her, "She was always available before." and I questioned them for possible retaliation because I had complained about their desk clerks being rude to me, plus their 2 counselors being mean to me.

Hope things turn out okay.

Billi

Billi,

Did you get a specific statement that you were "fired?" Or just an appointment that's very far out? Anything directly from the doctor that your care "has been/is being discontinued?"

Most importantly, they are required by law to send you a letter by certified/return receipt requested mail stating that your care is being discontinued, why it's being discontinued; and also that they are going to be available to you for basic care for the next 30 days. This is legally (and ethically) required.

However, if this has been going on for a while, that the doctor is regularly unavailable all of a sudden; that the provider is just not mentally/emotionally "connected," if you will; yeah, they may be trying to send a "message" but then again, maybe not.

Sometimes, they have things going on in their lives; with their own health-maybe they're having health problems also? I had a doc that suddenly, after previously being very supportive, suddenly I had a hard time getting an appointment; and when I did, she seemed distant and not really "there" (this was many years ago), and I finally confronted her-asked her directly if there was a relational issue of some sort between her and I; and if there had been something I'd said or done within or outside the practice that had upset her-and honestly, was it time for me to "move on?"

It turned out she'd been diagnosed with breast cancer; now this is an extreme case; but contrary to what a doctor may seem to want us to think, they're as "human" as we are--maybe she does just have a lot of "meetings;" and they're just falling on the wrong date...it doesn't mean you're "fired," unless they specifically tell you that.

If it were me--and clearly, it's not--I would just take the appointment; let them know if you need any refills before then, and honestly have a discussion with the doctor-especially if you have previously had a good, close, and honest relationship with her. If may be a case of wrong day at the wrong time; and it may seem otherwise when we're hurting or otherwise vulnerable.

But be aware of her behavior at your next appointment:

• How "present" is she? Does she seem like she really wants to be there?
• Is she acting impatient, when has not previously done so?
• Is she seeming distant?
• Is she telling you that you are "fired" or your care is "discontinued?"

These are just some signs to watch for. But not every doctor/patient relationship lasts forever. I don't know (and though I pray otherwise) that mine with my psychiatrist will last forever, or at least for a long time.

But there's things we can do to try and preserve the relationship, when a good one is present:

• Don't make frequent after hours calls when it can be avoided. Be respectful that they've got families and plans after hours. But also remember you have needs; and in an emergency; it does get tricky.
• Ask the provider to make an "after hours plan" with you for any plans regarding your care if you run into a crisis, trouble with your medications; specifically, guidelines for you to need to have in order to call or have them contacted at home-particularly when calling at night.
• Find out if there's an email addy they give to patients (my doc very rarely gives his up; he and I have some "outside the box" issues, and not all have been discussed here).
• Ask them if they will please be "straight up" with you, and agree to do the same; if something you've said or done is bothering them. Note things that have happened that are causing you concern.

And I would, at the appointment honestly tell her of your difficulties finding her to be available, and that you're concerned. You have the right to be; and true and open honesty and communication is key to a good relationshipwith the psychiatrist.

But what I put above are my general criteria; otherwise, I simply leave a voicemail in the general mailbox, indicationg it'sa non-urgent call; but giving my reason for calling; and that if you can get a call back "at their earliest convenience," that would be "most helpful," and leave it at that. Or maybe just leave a message at the doctor's office and ask to speak with her directly after you've scheduled the appointment and just tell them you have "concerns you'd like to discuss with the doctor," and ask her if you've been "fired" when/if she calls before your appointment. And indicate it's important for you to speak with her as soon as she is available. Just try to be as open; but not overly "stressed" about it when leaving this message; and stay calm.

Often it's easy to see it, and see that "oh, wow, she usually is available in a week, I need to see her soon, and she's not available for three;" and kind of panic. And when it's a patient-psychiatrist relationship; it's easy to be troubled when they suddenly seem to be not as "available;" but open and honest communication is vital, and can actually further the relationship. You just never know until you've directly gone to "the source," in this case, the doctor.

But I also understand how you feel. I had a PCP who had usually been available in 2-3 days, and suddenly it was 3-4 weeks to get an appointment; she stopped returning my calls; as did her MA's, if I persisted, then I'd get an irritable call from the MA working with the practice's new ARNP asking did I want an ARNP appointment?

I found a new provider--that signal was pretty clear. But I'd hang in there; but I'm not you, and I don't know "the whole deal either," I'm just offering my opinion, and my experience, having been there before...JMO, I guess.

Good luck, and keep us posted...