The Crowded Waiting Room
I rarely commiserate my trips to the psychiatrist’s office, but I've made the same request, every visit, since I started seeing this doctor about six months ago. This is not a good thing. I ask for a specific medication for a specific problem (not being able to sleep), and she doesn't say yes, but keeps (perhaps I'm insinuating it) not saying no. Now this has become a point of dispute. I came to her with a great attitude about being bipolar and needing a med management doctor because she had been my doctor at MHMR in the 1990s. She didn't remember me, which isn't surprising with the patient load she carried there.
Six months, roughly six visits, and I'm about ready to make an appointment with another psychiatrist. I won't call her by name, because at this point I don't want the world to know how dissatisfied I am with my treatment. but we started off on the wrong foot. She's not read my emotions well, which is important when you pay for seeing a psychiatrist. Honestly, she could be a very good doctor for someone else--but we started off on the wrong foot. My attitude wasn't emotionally stable, or politically correct. But I wanted a specific sleep med that I'd gotten by prescription through my previous psychiatrist.
I have a problem. I can't sleep. My solution is an prescription of a medication called Xyrem, which comes from a government pharmacy. Because she's never dealt with this med or the pharmacy sales people you deal with to order it, my doctoseems to be having a real emotional block about prescribing it.
I'm bipolar and I can't get my medicine because my psych doctor is emotionally confused and sitting on the fence about this. I'm the one who's supposed to be moody. She has not been logical or direct. I've been direct enough to show my annoyance in her office--all the way from her office through the waiting room walls.
A new appointment and the doctor has a new excuse for not prescribing Xyrem. Last time I asked her to just pick up the phone and call the company. I was irate and loud about it because I was upset. It was like she was aware she was pushing my buttons, and she just kept on. I'm not that hard to figure out when I'm being direct. She wouldn't. She wouldn't say yes and she wouldn't say no--it was just that she wasn't going to deal with it on our appointment time.
So I thought that was supposed to be her homework to do before my next appointment. I was angry and quite manic before that previous appointment ended. I was irritated and intent on showing my feelings. You don't want to stuff feelings when you deal with your psychiatrist, right? That would be non-productive.
I got the predominance of my feelings out before I left her office for that appointment with remarks like, "Of all things I never expected you to be close minded", "So what did my Russian doctor know that you haven't learned about yet?" and other aggressive accusatory verbiage. I was out of control about this again. Maybe I said for a doctor she wasn't very smart, and I was real disappointed about the direction her personal practice had taken. I attack full throttle. She had pictures of her kids on her desk. They hadn't been born when she treated me before, and we'd talked about that previously.
It's not a good idea to attack and insult a doctor from whom you want a prescription. I yelled loud enough to be heard in the waiting room during my last appointment. So this time at least I kept my voice low. I had a quiet blowout and meltdown over her reply.
"I need to check with my office colleagues."
"Christ almighty," I said to myself. You need to check with your offic playmates? Have you no spine at all? None of that accidentally vented out.
She's straddling the fence, she doesn't want to write the prescription because it's a new med for her to prescribe. She's afraid of this new thing, new procedure, new responsibilities--that's really what I think it is. How can a doctor be hesitant to learn something new? Isn't that almost a requirement of the profession these days
I stood up, picked up my purse, and walked out after about 10-15 minutes of my appointment. I said, "Then we don't have anything else to talk about today."
I've noticed that two of my psychiatrists consider getting up from being in a seated position as an aggressive behavior. Both times I needed to vent somehow. I wanted to pace a little, or look out the window, but I didn't have enough room in either doctor's office.
I opened her office door to exit, and she asked if I needed any prescriptions refilled. She evidently doesn't know that pharmacy has all my meds on automatic refill. The only ones I'm low on are the mood stabilizers I'm on a real low dose of: Enderal and Clonidine. Those two tiny pills plus about 120 mg of Geodon, and Klonipin as my benzodiapine are what I'm taking to keep my moods stabilized. I need Zyrem. That was the way I responded the previous week to the regular question. I know you can catch more flies with honey than with vinegar, but I don't have the intestinal discipline. I am who I am.
I responded to her query by saying instead, "You have a waiting room full of people, waiting to see you."
The doctor was still sitting at her desk writing, and I moved out of the office, past the crowd who was waiting to talk to the receptionist. It was a group of perhaps three people, but I was in no hurry to schedule my next appointment with her. I wasn't at all in the mood to wait. I don't wait well anyhow. Pre-Thanksgiving grocery store lines keep me from shopping just before, because I don't wait well in line.
I hurried across the entry/exit hall, then I was passing people in the office to get through the doorway to the waiting room exit to be in fresh air again, and actually out of the office. I was getting an anxiety attack. I could tell by my beating heart and shortness of breath. I don't go to a psychiatrist to get stressed. See how it's all going wrong?
I made no return appointment that day, because I can always call her office later to schedule an appointment. What do I do? I can't drop it. I won't drop it. I need a medication that has worked in the past to put me to sleep. When I'm manic, I sometimes stay awake three or four days. I can't get to sleep, it’s because of my bipolar, and this doc won't give me a medication that has a personal history not putting me to sleep. If I have a med to make sure I go to sleep every night, it keeps my mania from getting worse. Everybody needs sleep, but especially the people who aren't getting it.. She won't prescribe until I push this further. You'd think I'd just give up, but this is my life. They say you don;t get what you need unless you ask for it. What else can I possibly do. I’ve yelled, but before that I begged. See, this doctor has me feeling like I'm in an emotional gutter, below the threshold of needs being met.
As a writer, I prefer to be awake nights, and then sleep mornings. Although I'd told her this before, she was telling me to take my pills to sleep at night, which I did, and I've totally lost my hours and concentration for writing. So far, the woman doctor has succeeded in losing my ability to function as a writer.
Have some holier than though doctor insist you take pills that keep you from thinking and functioning. I had told her I was taking more than I actually was. Actually I take 60 mgs of Geodon before I go to bed, unless I'm not sleepy, and I'll take 120 mgs.
But if I'm not sleepy for the night, Zyrem is the only med I've ever had that will put me to sleep, AND put me to sleep in ten minutes.
Trying to do her best and repeating exactly what didn't work before with my Russian doctor, she's prescribed both Lunesta and Ambien. They don't necessarily put me to sleep, but they're going to mess me up from functioning adequately for 8 - 10 hours. Because I took a Lunesta on Sunday night, I didn't wake up till 2:45 pm, when my appointment was a thirty mile drive for a 3:10 appointment. I called immediately, and got an appointment at 3:10 the next day.
I arrived exactly on time, signed in, and joined the four other people waiting for her. By 4:00 one person had gone in, and one person had rescheduled, and two more patients, one toting a little boy with library books which immediately became an integral part of the step over pathway. I was uncomfortable waiting with that many people in a room so small, but when the four year old joined us, I though I was going to have to reschedule, but exactly then was when the doctor opened the door and called my name. I wasn't happy to start with, and if she's not going to treat my all my symptoms with a medication that I know helps me sleep and doesn't cause side
The odds of me staying with this doctor get thinner every visit. I feel like I ought to go head and call another doctor. I haven't had a multi days awake period for about a month, I won't stay in bed if I can't sleep--that's part of my issues than can cause me to need to check in to the psych hospital. I didn't make a return appointment, and I expect to contact the manufacturer as soon as my anger subsides a bit more. I deserve to be more than the short appointment in a crowded waiting room, I deserve medical help. This doctor stuff is by no means free.