[Martina]

I am currently seeing a psychiatric nurse practitioner for medicaitons, and a therapist for therapy. I just started with the therapist and I really like her.

I've been with the pnurse since April 2008 - almost 3 years. She literally saved my life when I first came to her. I was highly suicidal with manic episodes in-between. She got me stable.

But recently, I'm a bit frustrated with her. We were going nowhere in therapy (I used to see her for both meds & therapy) and she's the one who referred me to the new therapist. I guess she knew she wasn't working for me.

And with the meds, I feel like all she wants to do is throw another pill at the problem. I am sooooooo overmedicated. Here's my cocktail:

Lithium 1200mg (300mg 2 twice daily)
Lamictal 100mg, soon to increase
Invega 9mg, switching to Saphris soon
Wellbutrin 150mg - she meant to put me up to 300mg but didn't want to titrate too many meds at the same time
Along with a multivitamin, extra Vitamin D, and fish oil

Thats TEN pills every day. TEN!

I'm constantly living my life around the side effects, especially the sleep and zombie-ness I get after taking them. If I take them at bedtime like it says, then I don't wake up in the morning. So I take them with dinner, which makes me a total zombie the rest of the night. I'm worthless.

And I feel like I'm not allowed to be happy. Any time I feel the slightest bit of joy and happiness in my life, I'm labeled as hypomanic and forced to take more meds to bring me down.

So that said.....there is ONE psychiatrist in town on my insurance network. Problem is, she works in the same office as my pnurse. So it would be awkward to see her all the time after I basically fired her. But my pnurse doesn't work on Mondays & Fridays so maybe I could schedule appointments then.

On one hand, I think I would like the increased expertise and knowledge of a Psychiatrist with an MD over a nurse. I would have gone to this Psychiatrist from the beginning, but when I first tried to get help she had a 3 month wait for an appointment.

But on the other hand, my pnurse has brought me through so much hell, I really owe her a lot. Can I really just switch on her? What will she think?

What should I do?

Keep in mind I just started seeing my new therapist on Monday Feb. 28th. So am I just in a weird spot where I want change, or what?

I am a Borderline. Borderlines switch too much.

[Martina]

Oh, great. They moved my post to Psychotherapy. PSYCHIATRISTS (in my area) DON'T DO ANY PSYCHOTHERAPY THEY ONLY PRESCRIBE MEDICATIONS!

Why the hell do you have to move EVERY flipping post? Doesn't it take more time and hassle to move everything than to just leave it where we put it to begin with?

[googley]

Hi Martina,
We talk about Pdocs here too. Not just therapy.

I have a couple of thoughts. They are just listed in no particular order because I am tired.
1) I don't think your Pnurse would be offended if you changed providers, that is part of the territory of being a provider.

2) If you check with the new provider there may still be a waiting list (it seems like these never go away) so you might still have a couple month wait.

3) Have you considered talking about this with your new T? Just because you were referred to her by your current pnurse doesn't mean that she will feel like she has to defend her. She is there to help you do what is best for you.

4) Have you told your current pnurse that you feel over medicated and your worries that every time you get to be happy you feel like your put on more meds?

5) Just because your provider helped you through that tough time doesn't mean that you are obligated to stay with her. Sometimes providers have reached the limits of their ability to help us and so it is time to move on.

6) If you are worried about your medication load you could also ask for a second opinion from this pdoc and she what s/he says. This would be a way to check out and see if you think you would work well with that person.

I'm sorry that your meds wipe you out so much. That really sucks. I hope you get this all figured out.

Hi Martina

That's one heavy cocktail! What is Invega?
If you don't feel you are getting what you need from your p nurse, find someone you feel more comfortable with. It's your right. I agree with what Googley said. It's great your p nurse got you through hard times but you need to do the best for yourself.

[sunrise]

I don't think you should drop the pnurse until you've had an appointment with the pdoc to see what he is like and to get his opinion. People go to a different doctor all the time to get a second opinion. Why don't you get his and see what you think? Be sure to tell him the part about feeling like you are being medicated anytime you show any joy in life.

Have you told your pnurse about feeling like everytime you feel happy you get meds given to you to take that away? Maybe she can fix that problem if you haven't told her. If you have told her, how did she respond? Since you have been through a lot with her, I think it would be good to tell her of your dissatisfaction with the meds and see what she comes up with. It sounds awful to have all one's joy and happiness taken away with medications. Yes, your pnurse has got you stable--that is great. But now maybe it's time to fine tune that and go for greater life satisfaction rather than just survival.

Good luck, Martina.

[PTSDlovemycats]

I thought that meds don't really work very well for borderline personality disorder..I don't have it but I come pretty damn close to meeting all of the criteria for it. Hardly any meds have helped me. The only ones that have aren't actually psychiatric meds they are ones being used for off label purposes. Just throwing that out there...

Originally Posted by PTSDlovemycats

I thought that meds don't really work very well for borderline personality disorder..I don't have it but I come pretty damn close to meeting all of the criteria for it. Hardly any meds have helped me. The only ones that have aren't actually psychiatric meds they are ones being used for off label purposes. Just throwing that out there...

I believe Martina is also bipolar. Right?

[PTSDlovemycats]

Originally Posted by farmergirl

I believe Martina is also bipolar. Right?

Oops! My bad! Sorry I thought it was only borderline personality. Then I can understand some of the meds but that DOES sound like A LOT of meds to be taking. Are they all helpul?? Any more so than others??

For bipolar disorder, you don't seem particularly overmedicated. I'm not familiar with invega, but your med regiment looks a lot like many people with bipolar disorder.

That said, I'd probably move on to the psychiatrist. I wouldn't be that comfortable with a nurse handling such a complex med regiment myself. It isn't about loyalties; it's about getting the best care for yourself that you can.

[PTSDlovemycats]

Yea I agree with the above post! You need to have someone monitoring your med cocktail...

[Martina]

Invega is an atypical antipsychotic, it's a cousin to Risperdal but newer. Supposedly less side effects. But it's the one that makes me sleep 12 hours a day. I have CONSTANTLY complained to her about the sleep - it could cost me my job, as I often go in late - but she says I can't live without an antipsychotic even though I've never actually been psychotic and I only have hypomanias and not mania, and the only option left is Zyprexa which made me gain 75 pounds. Abilify made me suicidal, Risperdal let me go hypomanic, Seroquel is even worse at the sleepiness stuff, and I forget what else is out there.

I left a voice mail for the psychiatrist asking how long her wait was. She hasn't called me back, but I called on Friday and a lot of people don't work on Fridays.

I found out from other times I've switched (due to insurance) that all my pnurse sends to a new doc is my psych eval from THREE YEARS AGO and short notes from my last session. So the psychiatrist won't be missing much if I just start without sharing information.

[Martina]

Well, I guess this just made my decision for me. The ONLY psychiatrist in my insurance network and one of only TWO in this town, is not accepting any new patients. And probably won't be until sometime next FALL or WINTER!

So I guess I'm stuck where I am.

My pnurse doesn't even listen to me. I sent her a couple emails then called her voice mail to tell her to read them (if I don't, she won't read them for months...) I saw her today while picking up samples and she gave me a lecture about how I need to learn to talk to people face-to-face. I WORK FULL TIME LADY - I can't call her during the day. No way in he[[ I'm going to call from my desk at work. So I leave voice mails, or emails, and expect a response. I guess that's too much to ask. She never did answer one of my questions.

[googley]

I'm so sorry your pnurse doesn't seem to get it. Does she want you to have more often appointments? It seems like she should be willing to answer your concerns if she is willing to allow you to email. I'm sorry this does not seem to be the case.

I know that next fall or winter sounds like a long time (and it is). But does the other pdoc have a waiting list you could get on? So that you can see a future date when you will be able to work with someone who can better suit your needs? Have you contacted the other pdoc in town and checked w/ him/her to see if they would take you on as a patient? I have had a T offer to get on the list of the insurance I had to make it easier for me (there are very few in my area who are on my sucky insurance.) Call the pdoc and explain your situation. Maybe something could come of it?