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Pdocs - very entertaining ( I am not high!)
I had my third app with pdoc on Friday. I saw one doc in my previous two appoitments, got another app at the end of January. I went there to tell them that' I need to see my doc sooner - and find out that he is not there any more. The first one was kind of funny: 'do you want meds?' ' yes, I do.' ' ok so which one do you want?' ' Lamictal' 'ok' lol OMG so my next q: ' does it work like this here that patients pick their own meds?' And he than explained everything why Lamictal is good choice etc.
And now the new doc. 'How are you' ' very well', 'so we can carry on on 50mg' , me: ' we can't as effective dose is at least 100mg' ... And he took the book and red about lamotrigine. He: ' so we can go to twice a day 50mg', ' we can't, I don't want a rash. I want to go in 12,5 mg steps rather that to blow it'. He:, we usually increase in 25 mg. We even don't have 12,5 mg tablets'. Me: ' I will cut them in half!'. 'Ok'. So I will see you in two months and call me when you need your meds! Uhh, ohhh lol Lucky me as I am well now. Don't think he would fancy me unwell.
Have you got such experience?
And now the new doc. 'How are you' ' very well', 'so we can carry on on 50mg' , me: ' we can't as effective dose is at least 100mg' ... And he took the book and red about lamotrigine. He: ' so we can go to twice a day 50mg', ' we can't, I don't want a rash. I want to go in 12,5 mg steps rather that to blow it'. He:, we usually increase in 25 mg. We even don't have 12,5 mg tablets'. Me: ' I will cut them in half!'. 'Ok'. So I will see you in two months and call me when you need your meds! Uhh, ohhh lol Lucky me as I am well now. Don't think he would fancy me unwell.
Have you got such experience?
How lucky you are! I so enjoy clever people and caring doctors. And so can't stand the opposite lol.
You have really the good one.
My story is both funny and sad. I can't trust them, can't relay on them, can't feel safe with them. I can only hope that I will be fine on meds I picked forever- or at least for a very long time. Or if unwell go rather straight to A&E.
i like to see you writing here - means you are reasonably ok. I am this year quite fine - much better than years before. Marie
You have really the good one.
My story is both funny and sad. I can't trust them, can't relay on them, can't feel safe with them. I can only hope that I will be fine on meds I picked forever- or at least for a very long time. Or if unwell go rather straight to A&E.
i like to see you writing here - means you are reasonably ok. I am this year quite fine - much better than years before. Marie
Yes. I make mistakes. This one from one finger typing. I meant Steven Johnsons Syndrome.
I really enjoy your postings, because they put a smile on my face and sparkle. In answer to your question, I had a psychiatrist early on, who didn't really do much for me.
He never changed the med I was on, and the appointments didn't really delve into what was happening to my mind. He was assigned to me after I left the inpatient ward after my first hospitalization because he was the only one who was willing to work with my longtime therapist, who wasn't in the same network or who he didn't know. He was funny and I liked him, but if I was in trouble, i wasn't sure if I could count on him, because he asked me at one point, if there was an antidepressant I would like to try. This was in the first year that I ever had a major psychiatric diagnosis where I was confounded with my usual coping tactics and therapy. It was severe clinical depression with psychotic features...a few years before I got the bipolar disorder diagnosis. I didn't stay with him very long.
Many pscychiatrist later, I ended up with my psychiatrist now, and he's been my pdoc for 14 years now. He exceeded my expectations, and proved to me over and over again that he watches my back and doesn't give up on me. I like it that he can't really hide his emotions. He has a very readable face, and I don't think he could do well playing poker. I also like it that he can read me pretty well and he doesn't assume anything. He is also able to be able to come out with solutions that are tuned to me and what is feasible and do-able. When I really couldn't make sense of something because I was so lost in the bipolar disorder, he had insight and decades of experience and real listening skills to let me know when it is the bipolar disorder, meds or me. He's also a very good psychopharmacologist...really knows the drugs. Luckily, he is open to challenges, and we enjoy those times because we come out with more than what we came in with. I also like it that we can admit being wrong or that either of us can say, "I don't know." What is even better is that each of us will come back and let each other in on an answer if we came up with one.
I lucked out with getting him as my doctor. He can work with me and my other doctors and therapist and work well with others. My family and friends love him, because he can work with them also without compromising me or my privacy. In any situation where there is collaboration required, he and they keep my welfare and privacy always in the forefront. We have the same level of work ethics and standards--high. He isn't like that with just me, but with his other patients.
He's not my friend, although he can easily be one. He's my psychiatrist. More than friends, a good psychiatrist I can trust and work with is hard to find. One of the cues that made me realized I got a "good one" was when he told me a few times that he wished I called him earlier and more. He said, "You don't call me enough. I would like it better if I can be be told as soon as things start to happen and not after the fact or a day later. It makes it easier for me to tackle and keep you from suffering." It isn't just "verbal candy" because he follows through and he also thinks. There were a few times when I left the appointment, and hours or a couple of days later, he will say he thought about something a bit more and sounded out what he came up with. He always ask me if I agree AND if it able to be done. When there seems to be an obstacle, he will try to make it easier for me. For example, I had a bad ER experience and he made it possible for me to skip admission and registration through ER and just get me admitted directly into the ward and registered and admitted there instead.
My therapist is the same way. When I wasn't eating because I was too depressed, we spent time in and over the appointment and she helped me grocery shop. Then, she called my pdoc and then he called me. They have my back covered.
He never changed the med I was on, and the appointments didn't really delve into what was happening to my mind. He was assigned to me after I left the inpatient ward after my first hospitalization because he was the only one who was willing to work with my longtime therapist, who wasn't in the same network or who he didn't know. He was funny and I liked him, but if I was in trouble, i wasn't sure if I could count on him, because he asked me at one point, if there was an antidepressant I would like to try. This was in the first year that I ever had a major psychiatric diagnosis where I was confounded with my usual coping tactics and therapy. It was severe clinical depression with psychotic features...a few years before I got the bipolar disorder diagnosis. I didn't stay with him very long.
Many pscychiatrist later, I ended up with my psychiatrist now, and he's been my pdoc for 14 years now. He exceeded my expectations, and proved to me over and over again that he watches my back and doesn't give up on me. I like it that he can't really hide his emotions. He has a very readable face, and I don't think he could do well playing poker. I also like it that he can read me pretty well and he doesn't assume anything. He is also able to be able to come out with solutions that are tuned to me and what is feasible and do-able. When I really couldn't make sense of something because I was so lost in the bipolar disorder, he had insight and decades of experience and real listening skills to let me know when it is the bipolar disorder, meds or me. He's also a very good psychopharmacologist...really knows the drugs. Luckily, he is open to challenges, and we enjoy those times because we come out with more than what we came in with. I also like it that we can admit being wrong or that either of us can say, "I don't know." What is even better is that each of us will come back and let each other in on an answer if we came up with one.
I lucked out with getting him as my doctor. He can work with me and my other doctors and therapist and work well with others. My family and friends love him, because he can work with them also without compromising me or my privacy. In any situation where there is collaboration required, he and they keep my welfare and privacy always in the forefront. We have the same level of work ethics and standards--high. He isn't like that with just me, but with his other patients.
He's not my friend, although he can easily be one. He's my psychiatrist. More than friends, a good psychiatrist I can trust and work with is hard to find. One of the cues that made me realized I got a "good one" was when he told me a few times that he wished I called him earlier and more. He said, "You don't call me enough. I would like it better if I can be be told as soon as things start to happen and not after the fact or a day later. It makes it easier for me to tackle and keep you from suffering." It isn't just "verbal candy" because he follows through and he also thinks. There were a few times when I left the appointment, and hours or a couple of days later, he will say he thought about something a bit more and sounded out what he came up with. He always ask me if I agree AND if it able to be done. When there seems to be an obstacle, he will try to make it easier for me. For example, I had a bad ER experience and he made it possible for me to skip admission and registration through ER and just get me admitted directly into the ward and registered and admitted there instead.
My therapist is the same way. When I wasn't eating because I was too depressed, we spent time in and over the appointment and she helped me grocery shop. Then, she called my pdoc and then he called me. They have my back covered.
Hi Midjane. Just wanted to do a friendly clarification about the rash reaction from Vancomycin. That isn't the deadly rash associated with Lamictal, Steven Josnsons Syndrome, although you are right that it is a drug reaction. The drug reaction rash with Vancomycin Iv Is called Redman's Syndrome, which comes from infusing Vancomycin too fast and in too little IV concentration. It usually clears up with antihistamines and steroids, and not as bad as the lamictal rash.
I've seen both in others and personally experienced the bad lamictal rash, SJS. The bad lamictal rash isn't really a rash although it starts out looking like that. It is actual skin and mucous membrane cell death or necrosis. It doesn't clear up with antihistamines.
There are times when people just get a rash with lamictal that is a rash and not SJS, and it could also be just a rash that isn't caused by lamictal at all.
I've seen both in others and personally experienced the bad lamictal rash, SJS. The bad lamictal rash isn't really a rash although it starts out looking like that. It is actual skin and mucous membrane cell death or necrosis. It doesn't clear up with antihistamines.
There are times when people just get a rash with lamictal that is a rash and not SJS, and it could also be just a rash that isn't caused by lamictal at all.
Yes I agree Lamictal works in low doses. I noticed a difference very fast. At least by the end of the second week. And I do remember very vividly my hands itching like crazy at different times after I would increase my dose. It scared me enough to call my doc about it, but he said to watch it and things never got any worse than just my hands itching off and on for a few weeks.
Don't worry too much about the rash. The person I saw who had the rash, had it because of a bad reaction with vancomycin... the anti-biotic.
As long as you stick to the prescribed titration schedule you will be fine.
M
Don't worry too much about the rash. The person I saw who had the rash, had it because of a bad reaction with vancomycin... the anti-biotic.
As long as you stick to the prescribed titration schedule you will be fine.
M
That is wonderful to hear... That you like your doc. I find that I am such a creature of habit and hate change, that I stick with the same doc instead of taking the energy to find a new one that I like. I have been going to the same guy for just over a year now and really need to find a new one. Personally I like a doc who gives his opinion and feedback, rather than just listening.
M
M
The titration schedule I followed (which I think is pretty standard) was start with 25 mg/day, stay with that at least 2 weeks, and then increase by another 25 mg/day. After you reach 100 mg/day, it should be safe to make jumps of 50 mg with a minimum of 2 weeks between increases. Smaller increases and more time between increases are of course fine.
My psychiatrist is great. I get a lot of input on medical decisions, but she does know what she's talking about.
My psychiatrist is great. I get a lot of input on medical decisions, but she does know what she's talking about.
He wouldn't! that's for sure. He would be scared to hell lol. I would end up in the hospital or in the police cell lol
I am going up slowly so so far on 62,5 mg and have still Citalopram 20 mg which I would like to get rid of. It made me high last two summers. it was fun but no thanks no. Not sure if Lamictal will be enough but it is not a problem to add Citalopram again. Seems to me that Lamictal works even in such low dose but would like to get it to 100 mg. And we will see. Marie
I am going up slowly so so far on 62,5 mg and have still Citalopram 20 mg which I would like to get rid of. It made me high last two summers. it was fun but no thanks no. Not sure if Lamictal will be enough but it is not a problem to add Citalopram again. Seems to me that Lamictal works even in such low dose but would like to get it to 100 mg. And we will see. Marie
Lol, the part about your new doc handling your nastiness cracked me up. I would say the same :)
I'm on lamictal 200/day and haven't had any problems, just remembering to take my meds is problem enough. It definitely changed everything for me in terms of leveling out my ups and downs. I also take a couple meds for depression. The combo I'm on now is perfect for the time being. Hope it stays that way.
M
I'm on lamictal 200/day and haven't had any problems, just remembering to take my meds is problem enough. It definitely changed everything for me in terms of leveling out my ups and downs. I also take a couple meds for depression. The combo I'm on now is perfect for the time being. Hope it stays that way.
M
I think the same Jane. I had a nasty rash few years ago. I had a palm 'burnt' and massive red swollen mark on my leg, itching all around my body. I couldn't sleep or do anything. After two weeks of trying this and that I end up on steroids. It was probably from sun bed as I started to be allergic to sun :(. Well sometimes! SO I have some rash now and than. Piriton is my best friend. lol
Not sure what to think about such discussion with doc. I had discussion with one doc related to different problem - a thyroglosal cyst. I found everything I could so we could talk. BUT he knew. He even asked all his colleagues elsewhere if they had such thing ( I had three surgeries to get rid of it) with so many complications. He was very good. Very good doctor and very good person.
I refused to be treated by my GP - I mean to get meds from her for my mental problems. So now I have a specialist. lol Comfortable? Hard to say - I saw him once for about 20 minutes. As I said I am ok now. Not sure if it would work with all my nastiness when I am unwell. I simply don't know him. And he didn't do his homework.
ANyway: How is Lamictal work for you? Are you still on it?
Not sure what to think about such discussion with doc. I had discussion with one doc related to different problem - a thyroglosal cyst. I found everything I could so we could talk. BUT he knew. He even asked all his colleagues elsewhere if they had such thing ( I had three surgeries to get rid of it) with so many complications. He was very good. Very good doctor and very good person.
I refused to be treated by my GP - I mean to get meds from her for my mental problems. So now I have a specialist. lol Comfortable? Hard to say - I saw him once for about 20 minutes. As I said I am ok now. Not sure if it would work with all my nastiness when I am unwell. I simply don't know him. And he didn't do his homework.
ANyway: How is Lamictal work for you? Are you still on it?
Hi Bunny, yes my old pdoc was just like that. It used to worry me a lot but that doc retired. Don't you love the med discussions where you are leading the way?
I did the same thing with my Lamictal dosing. I cut the 25 mg tablets in half and increased my Lamictal that way. Safer in my opinion. I'm a nurse and have seen the rash they talk about.
Are you comfortable with this pdoc?
I did the same thing with my Lamictal dosing. I cut the 25 mg tablets in half and increased my Lamictal that way. Safer in my opinion. I'm a nurse and have seen the rash they talk about.
Are you comfortable with this pdoc?
I am from the UK so I do not pay anything. It is a part of National health system. We pay National insurance on the top of income tax. That's why they messing with appointments. I have to wait for psychologist 6 months.
I saw many great doctors around as an interpreter. But I am really disappointed with THIS. They also have nurses. I saw them twice. First time I went there as I crashed due to being accused by 'friend' that I assaulted her son ( obviously not - long story). She was very good. The second one was a male. Second question where I am originally from and why I am in this country. Yupp. I am here 10 years and won't go anywhere. And next time when someone will ask me where I am originally from I will ask back if he/she reads Daily Mail every day (stupid very right paper full of lies, always attacking immigrants). If he wanted to know he could read from notes, couldn't he?
I also saw fantastic pdocs at psychiatric hospital - again as an interpreter. She was great. I wish I could have her but it is not going to happen.
I can't go private as I can't afford it.
Contribution to medicines is flat £7 ( 15 $) per one item. I don't pay as have certain benefits (as half people here).
As I said it is entertaining. I can say that as I am so far well on medication I picked. But what if not? Is such pdoc safe? Can I trust him? Certainly not. :(
I saw many great doctors around as an interpreter. But I am really disappointed with THIS. They also have nurses. I saw them twice. First time I went there as I crashed due to being accused by 'friend' that I assaulted her son ( obviously not - long story). She was very good. The second one was a male. Second question where I am originally from and why I am in this country. Yupp. I am here 10 years and won't go anywhere. And next time when someone will ask me where I am originally from I will ask back if he/she reads Daily Mail every day (stupid very right paper full of lies, always attacking immigrants). If he wanted to know he could read from notes, couldn't he?
I also saw fantastic pdocs at psychiatric hospital - again as an interpreter. She was great. I wish I could have her but it is not going to happen.
I can't go private as I can't afford it.
Contribution to medicines is flat £7 ( 15 $) per one item. I don't pay as have certain benefits (as half people here).
As I said it is entertaining. I can say that as I am so far well on medication I picked. But what if not? Is such pdoc safe? Can I trust him? Certainly not. :(
A Big Amen to that. I get no returned calls, rushed through appointments,no face to face contact, no answers to most questions. Dr out on 2nd appt, female APN comes in gives her name and as I had some issues and questions there is an obvious distance and lack of compassion. Put on 2 anticonvulsants and buspar, tried nurse over and over to return my call, finally mentioned to front desk that this was a problem. She calls back (notable dull and flat response) I asked for something to calm my agitation, and nerves was told to go to ER if Im having problems and he was not ordering anything else. Lamictal, Nuerotin, and buspar. I feel as if they think Im asking for a controlled drug which I see many on under supervision. I feel degraded and angry towards how I have been mistreated, greatly. Sorry you are experiencing this, is there another MH facility near? I'm not even given info upon asking what the charges are?
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Herpes sores blister, then burst, scab and heal.
He has a paper for you to write all these answers before you see him. Then you go in & he asks all the questions that were just answered.
I feel like getting Snotty sometimes & tell him, what is this a quiz? To see if I remember what I wrote down 4 min ago. Or even Snottier & feel like saying
"Why don't I just sit here while you quietly read my answers. "
Then he does what your Pdoc does too, Marie. He says, well Maxy
What would you like to try- Abilify ( that was$647 our copayment. )
Or he'll get his samples out & say how bout some of this- ( Cymbalta )
& I say, I'm already on that, have been for 6 yrs.
The great things about my Psychiatrist,I really see him, not some Micky mouse nurse. He sees me for 1 hr 15 min sometimes 1 hr 40 min. Charges 1 hr. When I didn't want to go inpatient to hospital, he gave me his cell phone # & had me call& update him every day. 15-30 min. No extra charge.
& my first DBSA Support Group meeting, he accompanied me for the 90 min. Also when I call he usually will find a way to see me by the next day.
We pay upfront & submit to our insurance for reimbursement. Pamela