[WikidPissah]

My pdoc referred me to my new(er) T. He did a good job, in spite of several bumps I like the guy and am starting to feel a connection I have never felt in T before. I have been with pdoc for about 5 years, and I really like him as well...he is wicked easy on me. That's the problem. He sees me as very competent and lighthearted. I am a whole different person with him...easy going, calm, relaxed. Because I don't have to say anything, he never asks questions and I'm a non-talker so it's become a "don't ask/don't tell" type of thing. So he has no idea how unstable I am, or have been.

After an overnight section last week I have come to the conclusion that I need more med management. I need an overhaul, and pdoc (since he sees me as stable) will not do it. T has tried to tell him "the real deal" and he still doesn't believe. And I just can't stop the charade, it's become a ritual. I need someone who will be a little tougher on me and work to find the right meds. I need a pdoc that will ask me the right questions and get what's going on.

I don't want to fire current pdoc though. It feels wrong to break this relationship, even if it is based on falsehood. And a newer pdoc may not let me keep my benzo's. I don't use them often, but when I do I REALLY need them. Of course I don't need an rx for every benzo on the market, like I currently have, I just need something for major anxiety in social situations, and sometimes to help fall asleep at night.

Really worried about this. Really worried about having to be honest with a new doc, and really worried about continuing the charade I've been putting on for 5 years.

[Perna]

You have to do your own work; get real with your pdoc and tell him what you want. He cannot ignore an overnight section. It's your life, get serious about it and stop the charade. If you want it sooner rather than later, print out your post and take it to him to read.

[WikidPissah]

Perna...you're right (as usual). But there's a lot more to it than just my inability to talk.

A couple years ago I was referred for psych testing by a hospital and a T, and he wouldn't sign off on it because he "already knew" my dx. Finally after another hosp stay he signed off on it and I got it done, but he refused to read it. He looked at the dx's on the front page and said "well we both know those are wrong" and I kind of laughed along with him. At that same time he broke confidence by discussing me needing testing with a t I hadn't seen in years. He even said "I'm not sure it was ethical but I talked to Xyz and he doesn't think you need the testing either". Again, I laughed with him about it. That's what I do, I laugh and joke about with him, that's our relationship. He has never agreed with any hospital's med change for me, and always puts me back on what he had me on.

But again...I LIKE him, personally. He's easy.

[lastyearisblank]

That's tough...
Maybe you could talk to another psychiatrist and tell them you currently take the xanax (not all of them are against it) on the phone. Not to be blunt but it might be easier to find a doctor who will prescribe it if you can prove that you are not one of the people who will pop it every 5 minutes and are not trying to switch doctors to get it? Lol.. I feel like they are so touchy about that.

For talking to the current pdoc; I don't think psychiatrists go as deep as therapists by habit, it kind of sucks that he is not listening to your perceptions, but the upside is they tend to be less rigid if you specifically ask for what kind of medication upgrade you need. I agree with Perna, the best thing would be to go in with a pre-formed plan of what you want and ask for it specifically. As in, more of this symptom, so more of this kind of medication. If no... oh well, you didn't fail- there's only so much you can do on that front!!!

[sunrise]

WP, it seems like your relationship with your pdoc is based on falsehood (as you wrote) because you are not being honest with him. You are the one not telling him honestly how you are really feeling, that you are unstable, etc. (I would think, though, that the fact that you were hospitalized would be a wake-up call to him that you are not doing as well as he thinks you are.) Before you discard this pdoc, could you give him a chance to help you by really being honest with him? If you switch pdocs due to your own inability to communicate and be honest, what's to prevent the same problem from occurring with the new pdoc?

To get the ball rolling and inform this pdoc how you are really feeling, would it help to schedule a three-way meeting with the pdoc, you, and your T? You would have your T there for support and encouragement in telling pdoc how things really are. Then once all the cards are out on the table, it might be easier to continue being honest with him in future meetings on your own.

I don't put a lot of stock in psych testing either. This pdoc had known you for years so didn't need the testing (probably more useful for a practitioner new to you who doesn't have time to get to know you). He probably was trying to save you some money on what he saw as unnecessary testing by not signing off on the tests at first. If other practitioners you go to have been helped by these test results, then great. I'm not seeing how this past incident with testing plays into the issue you have with not being honest with this pdoc? Perhaps it is part of a mental list you are compiling about why you are dissatisfied with this pdoc?

[WikidPissah]

Originally Posted by sunrise

Before you discard this pdoc, could you give him a chance to help you by really being honest with him?

I called pdoc to schedule an earlier appt (my scheduled one was next month). I told him on his voice mail I wasn't doing well and I thought we need to look at meds. Then I vm'd my T to tell him I did that. T spoke with pdoc before pdoc called me back. Pdoc said "I heard you've hit a little bump in the road" then he laughed like he usually does and I laughed back. I did manage to say "it's way more than a bump." He wanted to just up my rxs over the phone to get me thru the month, but I managed to also tell him I really needed to talk with him about this.
T won't be with us, but I see T first and he can help me figure out what to say

I don't put a lot of stock in psych testing either. This pdoc had known you for years so didn't need the testing (probably more useful for a practitioner new to you who doesn't have time to get to know you). He probably was trying to save you some money on what he saw as unnecessary testing by not signing off on the tests at first. If other practitioners you go to have been helped by these test results, then great. I'm not seeing how this past incident with testing plays into the issue you have with not being honest with this pdoc? Perhaps it is part of a mental list you are compiling about why you are dissatisfied with this pdoc?

Well, since pdoc only sees me for 10 min every 4 mos, and T saw me every week, you would think pdoc would take the lead from T. and I was mentioning it as part of a history of issues over the past few years. Pdoc has never read any hospital reports (and there have been quite a few) nor has he spent any time speaking with T's. He is friendly with the one I have now so it's a little different and shows a bit of hope.

again...I really like pdoc, I like his sense of humor and that he laughs easily. I laugh when I am nervous so it doesn't make me feel odd. And I do have a history with him.

[pegasus]

Sounds like you are already starting to share the real you with your Pdoc from what you have just written and I see a good plan with you talking to T first before you see your Pdoc again. This is real good! I do think your current Pdoc is a keeper and I think you'll find it easier to talk with him honestly than have to start again with someone else. Better the devil you know!

Hugs

[SpiritRunner]

perhaps better to just keep the current Pdoc and drop the charade, I'm thinking too......it's the charade that is hurting you the most. I think it's insightful that you see that you have keeping up a charade....that's a step toward being able to drop it. My pdoc saw right through my charade at the first appt, it's not comfortable, but I know I need to drop my own charade...