Outrageous experience with my daughter's PD's office...

[BeHereNow]

Until Friday last, as you know I had extreme confidence in my daughter's PD.

Briefly, let me describe what happened and please share your thoughts on the matter-

The PD prescribed Risperidol for her insomnia.
It was a miserable FAIL.

He switched her to Abilify-
Again, a disaster.
Increased insomnia and heightened agitation.

I called his office on Friday- told the person who answered the call
that I had an urgent situation and needed to speak with the doctor
about what to do.

Waited, no return call.

I called again- repeating the emphasis on "URGENT."
I was assured by the same person I spoke to earlier
that the doctor had the message on his desk.

Hours roll by- no call from the doc.

I call again at closing time and learn that the doctor has left for the day.
I also learn that he never received my messages.
As in, the receptionist LIED to me.

I ended up calling our pharmacist to get advice on getting her off the Abilify safely.
Finally heard back from the PD yesterday- told him I found
it totally unacceptable that my message/plea for help was not conveyed,
and furthermore that I had been lied to.

He was apologetic and agreed with the validity of my complaint.

FORTUNATELY- My GP, who specializes in BP agreed to see my
daughter during my visit with him about blood work.

He gained her confidence, after an initially BAD first meeting months ago,
and gave her a script for Zanax to sleep.

For the first time in THREE weeks, she finally got a full night of sleep. 12 hours actually.

My instinct is to dump the PD and put her under the care of my GP.

What say you?

BHN

[Tuesday Afternoon]

1. I am inclined to say DUMP ... no excuse for lying, at all ... I hate to say this but,

that receptionist should be fired for that breach. That is totally unacceptable. If she is lying to patients she will lie to the Doc and if he is dumb enough not to see that then he would be too dumb to treat my daughter....ymmv

[BeHereNow]

2. She is actually a he- and by my gauge, not playing with a full deck.

Normally, I always hear back from the doc within a few hours when we are having med
problems.

He does have another person in his office who is the best of the best as far as
taking care of urgent calls for help.

I'm not sure why the guy has a job there- he is a royal pain in the ass, rude
and now we know, dishonest.

It is so painful to watch your child suffer on the med merry-go-round.
To not be able to reach the doctor under extreme ADR circumstance because
a member of his staff is negligent is just WRONG!

I love my GP- he swooped in and relieved her suffering.
Seriously, she had not slept a full sleep cycle in three weeks!

I think I call the PD tomorrow and have her records transferred to my GP.
I trust him FAR more at this point.

BHN

[fizzgig]

3. i think your instincts are right

if your gp has the knowledge and your daughter's trust, it seems like a good move. the receptionist's behavior is simply unacceptable.

eta: i'm glad your daughter finally got some sleep. the lack of sleep makes it so much worse.

[BeHereNow]

4. She is sawing logs at the moment- second night in WEEKS.

1 mg of zanax- not my favorite drug, but hell, if it lets her get some sleep-
I'm all for it.

She is a wreck from the Risperidol and Abilify faliures.

What REALLY bothers me is that the doctor was aware of the
"Fail" on getting my messages on Friday night- he did not call us
until Monday afternoon.

Does that sound right?

I'm thinking, not so much.

On edit: shouldn't a patient be able to reach a psych doctor 24/7?
Don't most of them have emergency access numbers for a crisis?
Or did I dream that...

BHN

[fizzgig]

5. if he knew friday night, then definitely dump his ass

and, yes, they should be reachable 24/7, i know all mine always had an emergency number on their voicemail.

[BeHereNow]

6. He knew Friday night and his response, through the one GOOD receptionist he has was...

She can safely take up to 30 mg of Abilify.
Hello? This drug was proving to be a catastrophe at this point and his response
through his ONE good secretary was to increase the dose?

HMMMM.
NOT GOOD! NOT GOOD AT ALL, upon reflection.

Fact is- the pharmacist I ended up calling was FAR more helpful
than the prescribing doctor.
What's wrong with that picture?

BHN

[elleng]

7. What's wrong is the Doctor part;

what's right is the helpful pharmacist.

Happy to hear she's gotten some sleep and now will have a good doc, whom both of you trust.

[HuskiesHowls]

8. Trust in a doctor is most important

When my daughter was a minor, and I had a say in what therapist she saw, I interviewed them. Even when she was handed off to a different therapist at the same practice, I went with her to her first appt, to find out what they were like. If I didn't trust them, she didn't see them again.

Later on, after she turned 21, she had a problem similar to yours. The difference was, she wound up in the psych ward of a local hospital. After she got out, her mother and I both did some research, found out who was the top person at the office, and had personal meetings with that person, explaining (calmly) the lousy service my daughter had gotten. The end result: two months later, that doctor was gone.

If you and your daughter trust your GP, and that person is equipped (either personally or through good referrals) to handle the situation, it would seem to be a good solution to lousy service by a specialist.

[Odin2005]

9. Dump him.

[BeHereNow]

10. Consider it done Odin!

My GP has proven more help in one visit than all others combned
with our PD.
He treats more BPs as a GP than any doctor in the city.
I love the guy and am so grateful my daughter gave him a second chance.

She saw him once earlier this year and totally freaked out-
mind you she had not been on proper meds when she first met with him.

He has helped greatly to get her to neutral, so we will see what happens
tomorrow when we see him again-

I have hope for the first time in a long time.

BHN

[momto3]

11. Go to the GP.

When you are a dealing with mental illness, and trying out new drugs, it is necessary for 24h access to a physician.

BTW - my daughter had similar problems with Risperiodol and Abilify. Abilify was by far the worst. She could not even sit still. Her current drug regimen works pretty well, but we also have to resort to xanax occasionally for sleep issues.

[BeHereNow]

12. Saw the GP yesterday- he is so good.

He knows the language to use when some one is in pain and struggling
and knows how to offer hope.

We go back in ten days to see how the new med is working out...

(((((((Hug))))))))

BHN

[MineralMan]

13. Finding the right doctor is never easy.

Sometimes it takes going through several until you find one with an interest in solving the complex problem.

Xanax will work for sleep, at least for a while, but won't address the underlying issue, and often stops working as well once someone becomes used to it. It's always there when things get screwed up, though, and it's needed. If your GP is working with you and your daughter, that's good. Ask him or her for a new referral, after explaining what didn't work so well with the last doctor. Maybe the next will be the one. If not, keep trying until you find the doctor who will take the time to work toward a long-term treatment concept.

I know it's discouraging, but once you find the right doctor, there's a combination of medications that will work best. Every person is unique, and it can take some experimentation to find the right combination. The problem is that there are no tests that can measure brain chemistry to determine what is needed. Frustrating. Maybe one day there will be such tests.

[BeHereNow]

14. Our GP specializes in treating BP.

I love him.
He has more BP patients than any physician in the city.
He is extremely knowledgable and I'm sticking with him for now.
The old doc is history.

He gave her Zanax for short term use because she had not
slept a full night for nearly 6 weeks- insomnia ADR from Risperidol
and then Abilify.

I know it takes time, and time is all I have right now.
Thankfully, she and I are extremely close and can work together on the solution.

Tonight will be her second night on Depakote-
Doc said it takes 4 or 5 days in most cases to see therapeutic results.
So we watch and wait.

Hopefully it will work as intended- it is very frustrating for both of us
to see medication after medication FAIL to help.

Good news about advancements in treating BP that you may or may not be aware of-

Brain imaging can now monitor the effects of medication in treating BP.
This is a major breakthrough for doctors and patients alike!

Thanks for your support MM,
BHN