So I go into see my psychiatrist today for a "med check." It's my third visit with him since he diagnosed me with ADD on August 20th. Each visit goes a little smoother and I'm able to keep the appointment to 30 minutes as I'm not only feeling better but I'm able to express the symptoms that do linger much more succinctly.
I think this man is a genius. Cocky, yes, but totally astute when it comes to understanding the delicacy of the interactions between the mind and body affecting one's mental and physical health. What sold me on his theory and approach was the way that instead of dismissing my distressing symptoms over the last five years (low-grade depression, extreme fatigue, serious brain fog) as being "all in my head" as I often read other psychiatrists do, he helped fill in the blanks by attributing these unresolved yet treated symptoms as residual effects of undiagnosed and untreated ADD.
The Background
In a nutshell, his theory is that my brain's blueprint at birth included some faulty wiring but it (my brain) was strong enough to compensate with the neurotransmitter detour for 31 years pretty well. Increasingly, year after year, my brain and body had to work harder to compensate for undiagnosed and untreated ADD, but it worked away until it couldn't work that way anymore. Year 2003 came along when my mom died in March and Johnny was born in July. Those two major life events happening within 5 months of one another were basically my bird brain's last straws. That's when the symptoms started.
According to my shrink, the physical and psychological stress that a birth and a death caused me, flipped my natural disease-fighting system (immune system) into fight or flight mode. I fought. My brain couldn't get its neurotransmitters the same way it had for 31 years the detoured way, but it was fighting, so it started looking to other systems in my body, namely my endocrine system. My adrenals became taxed; my estrogen and progesterone became unbalanced; and my thyroid started attacking itself. My body and brain were under attack (undiagnosed ADD, psychological pain of losing my mom, physical stress of having a baby) but couldn't detect a foreign invader (like a virus, bacteria, etc.) to fight. What did it do? It started fighting itself, hence my autoimmune thyroid disease.
Ok, so repeated lab tests have shown that I have an under-functioning thyroid, burned-out, barely functioning (alas, not even detectable) adrenal glands, and whacked out levels of progesterone and estrogen. And I've been treated for the three-legged endocrine monster for over four years. Treated, but ineffectively. Why haven't these treatments worked? Because my ADD hasn't been treated.
At my first visit with my shrink, he validated and indeed connected all of my symptoms over the
last four years to my ADD that he thinks I've had for life. He put me on a treatment regimen for all of the above that I've been following carefully since Aug. He said that if left untreated, the effects ADD on my brain and body would eventually catch up to me and create in me a state of being that no matter how much fight and determination I have, it wouldn't do me any good and I would likely become bed-ridden. This is what he told me. I believed him and I've been doing exactly what he says to do. (And I've been feeling better).
The Funny Part
Today at the end of my appointment, my doc is sitting at his desk with my chart open, reviewing my scripts. He asks me how the Ambien is working. Confused, I tell him I have never taken Ambien. Actually, let me tell you the story this way:
Dr. X: How is the Ambien working for you?
Me: Ambien? I haven't been taking Ambien. Did you prescribe it to me on the first visit?
Dr. X: (Looking at my chart) Yes I did. Did you lose the prescription? I'll write you another one.
Me: (Getting the Prescription) I guess I did lose it. I seriously don't remember you prescribing me Ambien because I haven't really had any trouble sleeping lately. Oh, but "Vitamin Z?" Yeah, that worked really well and I'd like to keep taking that if it's ok.
Dr. X: Vitamin Z? I didn't write a prescription for that, did I?
Me: Yeah, you did. You wrote it on Oct. 23 and I got it filled on Nov. 10. See? It says it right here on the bottle.
Dr. X: I must have called that one in to the pharmacy because I don't have a prescription here.
Me: (confused and feeling a little crazy) Yeah, I definitely remember you giving me a prescription for Vitamin Z because I just got it filled a week ago. It says here on the bottle I have 5 refills left.
Dr. X: (seemingly a tad confused). Hmm. Ok. So in addition to the Ambien, I'm writing you a new prescription for Adderall. The insurance companies are crazy and they don't like to approve medications taken 3x a day but I want you to start taking it 3x a day. I'm going to write it that you should take 1-2 in the morning and 1 in the afternoon, ok?
Me: Ok. So, is it going to be the same overall dosage I've been taking now spread out 3 times a day, or is the 3rd dose actually going to be an additional dose?
Dr. X: It's going to be an additional dose, 5, 5, and 5.
Me: (a little confused as I look at my bottle that's currently filled that says 15 mg taken twice a day). Ok, but I've currently been taking 15 mg twice a day for a total of 30 mg a day.
Dr. X: (very confused, looking at my chart and the scripts he's written over the last several appointments). You have a very strange pharmacy.
Me: Huh? I go to CVS...one in Chapel Hill and one in Morrisville.
Dr. X: Well, apparently, they can't read prescriptions very well. Clearly I've written your scripts for 5 mg at a time, and they've filled it at 15 mg.
Me: Oh, My God! Am I over-dosing on Adderall? And here you were going to up my dosage?? Do you think the people at CVS maybe mis-labeled my prescription and I'm really taking 5 mg per dose even though the bottle says 15 mg? What did you prescribe me earlier at my first visit?
Dr. X: (still looking at my chart): No, CVS didn't label it wrong, they read it wrong.
Both of us at this point clearly confused. What the Hell have I been taking? And is he still going to increase my dosage (which I hope he does) even though he thinks he's only been giving me 10 mg a day and I've been taking 30 mg???
Dr. X: I do have one question though. Is your last name *Littlejon or Cooley?
Me: Littlejon? My last name is Cooley. My maiden name is Lightfoot...(me then looking over his shoulder at "my" chart. And my first name isn't *Susan! It's Sarah!!!
Dr. X: (pauses, then chuckles) That explains it then. I grabbed the wrong chart.
Me: Here's the prescription for Ambien back. I thought for a minute I was going crazy. I was right, you never prescribed Ambien to me.
Dr. X: (fumbling with my correct chart) You're right. I think maybe your doctor needs a little dose of that ADD medication you're taking.
Me: I was thinking the exact same thing. You said it though. (we both laugh). I'm glad I was paying attention. So, for me, 45 mg of Adderall per day is ok?
Dr. X: Yes. We can even go up to 60 mg if we have to. (Sheepishly) Thanks for straightening me out.
Me: No problem. I'll mail you your bill.
Dr. X: Mail me some of your leftover ADD meds while you're at it!
The End.
Moral of this true story: Be an advocate!! Double-check everything! Apply a healthy dose of skepticism to even those you trust the most!!
**And don't call me Susan Littlejon!! (name changed to protect the innocent)
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1 comment:
Your psychiatrist sees over 25 people a day for 5 days a week. 25*5=125 people a week. Also, you mentioned that this is your third appointment. Which means he doesn't know your name yet. Most likely the person who pulls patient charts put them in the incorrect order thus the Dr. though you were someone else. The fact that you took the time to write a blog about a simple mistake suggests a borderline personality disorder (which by the way, cannot be treated by psychotropic pharmaceuticals). I suggest therapy because Borderline is not a good stigma to have.
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