This is all quite foreign to me. As an outpatient patient, I can't contact my doctor at all. She just does not do calls--not for emergencies, not for non-emergencies. She has not once returned a phone call to my psychologist who tried to work with her (over the course of years). According to him, that's not atypical for any psychiatrist he's ever tried working with. At my last appointment I explained to her how with my cardiologist I am able to successfully make medication changes because I can ask him about side effects and how to proceed between appointments (he does e-mail). If it weren't for that, I wouldn't be as successful at treating my autonomic issues as I am. I am less successful at making psychiatric medication changes because if I have an effect and am not sure if it something is safe to wait out or not, I have no idea what to do until my next appointment.
So, I came in with what I thought was a fair proposal: I will pay you whatever you want for either an e-mail or phone call between appointments. She said no because she wouldn't know how to work it out at a practical level—she didn't elaborate.
I came in with a video recording I made of the convulsions I started having since my last drop in Valium. I asked her if they were seizures. She said she they were either brain shocks or seizures and that she couldn't tell. I asked her if she could prescribe an ambulatory EEG. She told me to go see a neurologist.
So my visit resulted in nothing, which is how each visit is. A long drive, a co-pay, no results.
I know I'm venting at this point, but I'm sick of seeing a pissed off doctor. She's an unhappy person. The only thing she seems to enjoy talking about are the ways her daughters are so successful and yet put-upon (I know more about her daughters than she does about me) and money. The fact that she enjoys talking about money so much makes me think she's less than scrupulous when it comes to the only medicines which seem to interest her, which aren't even medicines at all, but are supplements. She's been trying to get me on Deplin for over a year claiming it will help with benzodiazepine withdrawal. It's a very, very expensive form of folic acid, a methylated form, which you can buy over the counter in the same form. In fact, the company that makes Deplin (a prescription) also makes an OTC version. Asking her how it works for benzo withdrawal is like asking a crocodile to give you a kiss. She will get pissy and spout some non-medical nonsense. But she actually claims that Deplin will work as well for preventing seizures during withdrawal as Neurontin. OK . . . So I got the MTHFR test which she said I needed--I can't remember why. One gene is completely normal. One gene is heterozygous. She claims I can process NO folic acid--as in none, and that I *need* Deplin (which remember is about $140 a month for FOLIC ACID). So I go home and research it. I see that being heterozygous means nothing clinically. I tell her this and she gets . . . pissy. So this last time I bring a print out from a medical journal which describes how even being homozygous at this gene in a mutated way means almost nothing and that being heterozygous means absolutely nothing. She tells me, "I've heard that bunk before, I don't need to see it. Everyone knows heterozygous is just as bad as homozygous. It's all over the Internet." That's my explanation: It's all over the Internet. She won't even look at the print-out. Since that appointment I have scoured the Internet and not even found an online nut who supports her position let alone an article. It's not that I want to prove her wrong. I actually care about this and am interested. And if she is so sure of this, why doesn't she recognize that I am a data-driven person who loves science and wants to be convinced? Every other doctor I have says things like, "Birchswing, I have this cool new test/device/computer program you're going to want to see." Not with this doctor. I did a $2,000 genetic test without being given a reason for the test, I wasn't even given the results (I had to ask for them), and she can't explain the results other than through her distorted viewpoint that I need Deplin (which was her claim before I took the test). If she honestly believes my MTHFR mutation is so serious she should have called my GP to have him test my homocysteine, as that would be the most meaningful implication of the MTHFR mutation (but again, for my heterozygous mutation, there's no evidence that I'm deficient compared to someone with two normal genes). My psychologist seems to think I should keep seeing her as he thinks the rest are even worse, or I should go to rehab to get off the benzos faster. I don't want to go faster because of the increased risk of prolonged PAWS and because it's a 12 step center that doesn't seem to know much about benzo withdrawal.
I know you all are wonderful doctors who would never addict a child to benzodiazepines, but I get so sick of it I need to vent. I try to be good when I see threads like this or the one about counter-transference. My psychiatrist does not suffer with counter-transference. I walk on eggshells around her and her temperament. I am the one who sits silently as she takes phone calls from her family and doesn't even apologize for it, which is kind of a big deal in a 15 minute appointment.
EDIT: I am not sure if my rant, which I've wanted to express somewhere on the forum but have withheld until now, will be sustained. But to try to generalize this so it could be discussed if anyone wished:
I've often thought I'm difficult but other people don't seem to think so. I've been extremely lucky with the doctors I've had. I would assume I'm a more difficult and/or annoying patient, but with my dentist, cardiologist, GP, etc., I feel like I have good working relationships, and I've been told my assistants and family members who have gone to appointments with me, that there is something about me that these doctors seem to like. I know there is something different about me--I need to understand things very clearly. There are things about myself that even I don't know, but I know I am different, and with other doctors they seem to get that and treat me in a certain way that seems very copasetic.. I have found consistently that this has never applied to my experiences with psychiatrists, whom you would expect to be more humanistic. My very first visit to a psychiatrist was rather a rough ride. I am always being asked to trust blindly with psychiatrists, which I think is what is so different from other doctors. I remember being told I had panic disorder and that I had to take Ativan. I didn't know what it was. I can't remember the moment well, but knowing me, I'm sure I had a million questions of the side effects, etc. I had thought I was going to get to talk about being gay. I was not expecting medication. I do remember what he said, "Do you tell the pilot how to fly the plane? I'm the pilot. I fly this plane." This was in a very thick, intimidating accent. And it's the same today. When I called the rehab center and ask how they do benzo withdrawals, I'm told that I can't know--I have to blindly trust, and I have to 12 step, even though I've never taken a single recreational drug or taken a single prescription other than it's been prescribed exactly. It's come full circle. I have to trust that the medication is safe. And now I have to trust that the unsafe medication's withdrawal is safe, again with no details, just promise of a 12 step program.
