[kaliope]

so I got a new pdoc who i have seen twice now. i was stable when i started seeing him. the thing is, one of the meds i was taking, topomax, i had started taking on my own and had no prescription for. that, with my haldol, worked very well for me. i was very nervous at talking about this with the new pdoc but he said to me that he had no problem prescribing the topomax for me. i told him that i was taking 400 mg and this was working very well but since i had run out over a month ago i really noticed a difference in my mood. he prescribed 150mg, not the 400 that kept me stable. so my second appt with him i asked if he was going to give me the 400 that i had been taking that kept me stable with my haldol. i have been stable on this combo for quite some time and the haldol for over a year and a half. he says, "is that what you want to do, sure we can do that" and turns around and writes a prescription for 300 mg and cuts my haldol in half. (this after telling me he wants to take me off the haldol all together) on another note, he spoke to me about selfmedicating and trusting pdoc and about my med stash so i could start antidepressants should i become depressed etc (which old pdoc gave me the freedom and trusted me to do) so i took all my old meds and turned them in as a sign to him that i would trust him to prescribe for me what i needed. then i asked him for a dozen klonopin to have on hand should i need them. he asked what dosage i was on and i told him .5. so he gives me ten .25mg. which the pharmacy doesnt even carry so i ended up with five klonopin.

so i am really confused here. i am getting mixed messages. hes voicing trust me. i will give you what you need, but then he isnt following thru when he is writing the prescriptions. i am trying to figure out how to approach him on this without coming across as some kind of drug seeker. i dont even like taking meds, but i know what it takes to keep me stable and he isnt wanting to go there.

[ECHOES]

It makes sense that you feel confused.
When you see him next, tell him that you need to understand what you are taking and why. And if the dose(s) are going to be increased or decreased, and why.
What is the goal? What is the path to reach that goal? What about the combo you were on before - is that an option?

Write down all the things you are confused about and take that with you so you can write down what he says. It's so hard to try to remember it later.

I think he should welcome your wanting to know exactly what to expect with each of your medications and your overall treatment.

[unaluna]

I would say 400 is kind of a lot of topomax. I was pretty doped up at that level, and having side effects like falling over a lot, plonk! Which was kind of fun, actually, but probably a little dangerous. But I was so mellowed out, my judgment prolly wasn't the best. I don't think he's being TOO unreasonable on that, esp since you were out of it, he couldn't really justify putting you directly back on 400, you would need to titrate back up. As for the Haldol, wow I didn't think anybody was taking that anymore, not since the big stink about the first President Bush taking it.

I suspect since you are a new patient of his, he is wanting to start off at lower dosages and titrate up as needed. Does he have your records from your previous Pdoc? If not, he can't really take your word for it. He has to use his best judgement to start with. Talk to him about your concerns again. Sometimes we have to be patient with a new doc. Frustrating though, I'm sure. Check those prescriptions before you walk out of his office, and if they aren't what you thought was going to be prescribed, don't leave until he corrects it or at least explains his reasoning behind what he is prescribing.

[kaliope]

my issue isnt about amounts or understanding titrating and stuff like that. it is him SAYING he WILL do it and then NOT doing it. that is what i dont understand. i understand titration and if he told me, we can do that we just have to titrate you up on it, i would get that, but when he says "you want to do that, sure we can do that" and then NOT doing it and not saying we have to titrate as a reason for not giving me the dose i requested that is what i dont understand. why say you are going to do it and then not without explanation? i am wanting advice on how to approach him to discuss this issue, him saying he will do something and then not doing it. how can i have a trusting relationship with my doctor if i cant trust him to follow through on the things he say he will do?

[unaluna]

Now I gotcha, sorry for the misunderstanding. I guess from his point of view, he may be thinking the same thing, can I trust this person? maybe that's why he wanted to do the homework thing, as a way of getting to really know you?