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Brave face for new doctor [rant/support]

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Aggrax
InkAndComb
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Post by InkAndComb Wed Feb 18, 2015 4:06 am

Hey everyone! I posted here once before about being anxious about a doctor's visit and, you guessed it, I'm getting panicky about an appointment I have tomorrow.  Specifically, I am anxious because I have ADHD and have been putting off seeing a psychiatrist locally (was driving 2 hrs back to home town to see my old one); the first time I tried to do this (locally), I had 3 meetings with a Psychiatrist (on campus) who tried to convince me it would be 'easier' if I had Bipolar Disorder (I don't actually fit most of the DSM criteria for this so it wasn't so much a problem as frustrating when he'd ask questionairres, then get angry if I didn't answer them the way that 'confirmed' bpd).

The medication he prescribed is primarily used to treat Bipolar...and also anxiety.  I had awful, AWFUL effects from it.  Monthes later, here I am going for a second go with a new rec'd individual, and I am ready to seek the treatment I need.  Yet I am afraid I'll be labelled a drug seeker, or be forcefully encouraged to start a treatment plan that hasn't worked for me in the past/is not one that meets my needs.

I'm also anxious because I get asked a lot of family history questions (Especially regarding addiction). This is fine but I'm adopted and this always seems to startle them.  

Can I get encouraging comments/suggestions for how not to be nervous with a new doc, especially when I know they will be prescribing medication? Any tips for how to calmly explain my medical history, or politely say I don't want a line of treatment (especially if I've tried it?)  Has anyone had bad experiences in the med field, and come out of it to seek treatment on their own terms like myself?
Rationally, I know if it's a bad fit, I'm an adult and I can go look for another psychiatrist.  I also know if they treated all their clients poorly, I probably wouldn't have gotten a suggestion for them.  However my brain is a jerk-brain and keeps reminding me of all the BAD psychiatrists I've had, and how wary they are of ADHD diagnoses, and it is really bringing me down.
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Post by Aggrax Wed Feb 18, 2015 4:36 am

InkAndComb wrote:Hey everyone! I posted here once before about being anxious about a doctor's visit and, you guessed it, I'm getting panicky about an appointment I have tomorrow.  Specifically, I am anxious because I have ADHD and have been putting off seeing a psychiatrist locally (was driving 2 hrs back to home town to see my old one); the first time I tried to do this (locally), I had 3 meetings with a Psychiatrist (on campus) who tried to convince me it would be 'easier' if I had Bipolar Disorder (I don't actually fit most of the DSM criteria for this so it wasn't so much a problem as frustrating when he'd ask questionairres, then get angry if I didn't answer them the way that 'confirmed' bpd).

*blink* That...doesn't sound like the right approach for a doctor to take at all. Sorry to hear you had to go through that.

InkAndComb wrote:The medication he prescribed is primarily used to treat Bipolar...and also anxiety.  I had awful, AWFUL effects from it.  Monthes later, here I am going for a second go with a new rec'd individual, and I am ready to seek the treatment I need.  Yet I am afraid I'll be labelled a drug seeker, or be forcefully encouraged to start a treatment plan that hasn't worked for me in the past/is not one that meets my needs.

I'm also anxious because I get asked a lot of family history questions (Especially regarding addiction). This is fine but I'm adopted and this always seems to startle them.  

Can I get encouraging comments/suggestions for how not to be nervous with a new doc, especially when I know they will be prescribing medication? Any tips for how to calmly explain my medical history, or politely say I don't want a line of treatment (especially if I've tried it?)  Has anyone had bad experiences in the med field, and come out of it to seek treatment on their own terms like myself?
Rationally, I know if it's a bad fit, I'm an adult and I can go look for another psychiatrist.  I also know if they treated all their clients poorly, I probably wouldn't have gotten a suggestion for them.  However my brain is a jerk-brain and keeps reminding me of all the BAD psychiatrists I've had, and how wary they are of ADHD diagnoses, and it is really bringing me down.

I sympathize with being nervous about seeing a doctor, especially a new one. One thing I've tried recently in order to get myself ready for the inevitable appointments I'm going to need to make with a mental health professional is writing down various questions/ideas that I have and points I want to make. For instance, if you don't want to pursue a line of treatment, maybe make a short list of why that treatment didn't work for you in the past. Try to keep the reasons and notes concise. In the past when I tried things like this I would almost script out a full conversation and then be completely flummoxed when the other person went "off-script" and all my prep was useless.

This one may sound a bit childish, but damnit if it didn't help me at least a little. When I went to see my endocrinologist for the first time, I was super nervous and afraid that they would rip me apart for my poor health management. As I left the house, on impulse I grabbed a small Blind Bag Pinkie Pie that I keep on my shelf and put her in my coat pocket. Every time I would start getting worked up in the waiting room, I would reach into my pocket and squeeze the toy a little and think "cheer up Aggrax, Pinkies right here with you." Silly as it was, it helped me out. Maybe just something to remind you of a friend or someone/something that makes you feel calm can help ground out your emotions a little? Just some food for thought.

I really hope this goes well for you and you get a great doctor that listens to you. Good luck ^_^.
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Post by caliseivy Wed Feb 18, 2015 12:03 pm

I completely understand how you feel, Ink. I've been to so many doctors over the years that I've lost count (the majority of doctor changes were due to constantly moving around though, very few were because of the doctors themselves).
Aggrax is right. No doctor is supposed to react that way and people don't always fit perfectly into a disorder. Not to mention trying to treat you for something you don't have is ineffective at best and risky at worst.
I'm terrible at offering advice for being less nervous (I tend to be fairly nervous about things on the regular), but maybe you can try to keep reminding yourself that it's just a doctor's visit, similar to the initial visit you'd have with a general practitioner where they ask you questions about your history to get an idea of you and what would/wouldn't work for you.
I don't think you have to worry about being labeled a drug seeker; most doctors will ask you the questions and talk with you then suggest something, and from there you can ask them more about their suggestion or turn it down. That goes for any treatment plan they suggest. They can't force you into any treatment plan no matter how much they press you to agree to it. If you feel it won't work for you then you have no obligation to take part, and you are allowed to tell them so because it's their job to work with you to find the best solution you both can agree on. It's your treatment, not theirs.
It was hard for me in the beginning to advocate for myself on treatment and not just take what they offered me because they know best, but I actually had a psychiatrist (one of the best ones I've ever had) tell me what I'm telling you and it time that made it easier to put my foot down or just leave offices where I wasn't okay with the doctor and how the appointment was going.

Was not intending to type so much...But I hope something out of that helps. I can clarify if need-be. I think you'll be okay, but internet hugs just in case. Smile
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Post by reboot Wed Feb 18, 2015 12:13 pm

One option is to type out the types of treatment you had, the dates, your age at time of treatment, dosages of medication, side effects experienced and what worked and did not work in a table. Tell your doctor you did it in advance in the interest of efficiency. For some reason, people tend to take things that are written out and presented "scientifically" more seriously. It will also spare your having to give the litany.
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Post by Prajnaparamita Wed Feb 18, 2015 1:14 pm

InkAndComb wrote:Hey everyone! I posted here once before about being anxious about a doctor's visit and, you guessed it, I'm getting panicky about an appointment I have tomorrow.  Specifically, I am anxious because I have ADHD and have been putting off seeing a psychiatrist locally (was driving 2 hrs back to home town to see my old one); the first time I tried to do this (locally), I had 3 meetings with a Psychiatrist (on campus) who tried to convince me it would be 'easier' if I had Bipolar Disorder (I don't actually fit most of the DSM criteria for this so it wasn't so much a problem as frustrating when he'd ask questionairres, then get angry if I didn't answer them the way that 'confirmed' bpd).

Hey Ink, I’m sorry to hear you had such a shitty experience with that psychiatrist. I’ve had something very similar happen to me, in which I had a psychiatrist without any evidence decide I was bipolar (I’ve met bipolar people, nope nope nope) and refuse to treat me for anything but that, even when my anxiety was clearly the major issue. That’s just something you unfortunately end up facing sometimes, and its scary because they’re medical professionals who have the prescribing power, but its an unfortunate aspect of a scientific field that we don’t really understand yet that there are some quacks in there too.

InkAndComb wrote:
Monthes later, here I am going for a second go with a new rec'd individual, and I am ready to seek the treatment I need.  Yet I am afraid I'll be labelled a drug seeker, or be forcefully encouraged to start a treatment plan that hasn't worked for me in the past/is not one that meets my needs.

Don’t worry about the drug seeking thing, really. One, most people engage in seeking drugs by going to ERs, where there’s less oversight, and doesn’t involve the hassle and time commitment of referrals and intakes. Two, its not uncommon for even the most benign cases to have gone through a lot of different medical practitioners. I for one once went through six different prescribers in one year, between not finding a good psychiatrist, going in and out of partial programs and seeing the psychiatrist there, and the hospital psychiatrist.

InkAndComb wrote:
I'm also anxious because I get asked a lot of family history questions (Especially regarding addiction). This is fine but I'm adopted and this always seems to startle them.  

Wow, you think the radical concept of some people being adopted wouldn’t still be something that absolutely blows the minds of doctors anymore… That’s a little weird, but I’m wondering if I can talk down your jerkbrain for a minute about those fears here. Mental illness is largely hereditary, so knowing your family history is a) a question they are mandated by their training to ask, and b) often a useful diagnostic tool. That being said, its not like they can’t come to understand your situation without that information, but when they ask about family history of addiction they’re not doing it to rat you out, they’re doing it as sort of the equivalent of your primary care doctor asking if you’re in any pain today as part of your general physical.

One of the things I do, because I’ve seen so many people and I know doctor’s won’t remember everything I say is before I go I type out a detailed family tree of mental illness among my immediate relatives and a list of all the medications I’ve been on (two pages long now), how long I was on them, and what side effects they had on me for me to give to the doctor for them to keep in her notes. I know the first won’t be applicable to you, but given that you said:

InkAndComb wrote:
The medication he prescribed is primarily used to treat Bipolar...and also anxiety.  I had awful, AWFUL effects from it

I think writing down what you’ve been on and what effect it had will be really useful for advocating your needs and letting the doctor know what hasn’t worked for you. Just in general I think writing down what you plan to say in the visit is a good idea, because then if you panic you can read what you wrote to them, or just hand it to them to read. If not that than at least rehearsing what you are going to say with someone else before you go helps. I know that when I panic at intakes (which happens a lot, because let’s face it, intakes are just uncomfortable) it sometimes comes across the wrong way, and that is their first impression of you and what you need. Plus you’ll just feel a lot more confident in advocating for what you need.

InkAndComb wrote:
Can I get encouraging comments/suggestions for how not to be nervous with a new doc, especially when I know they will be prescribing medication? Any tips for how to calmly explain my medical history, or politely say I don't want a line of treatment (especially if I've tried it?)  Has anyone had bad experiences in the med field, and come out of it to seek treatment on their own terms like myself?

You can do this. I know you can. Ultimately the power is in your hands, they can’t force you on anything you don’t want to be on. And sometimes a psychiatrist might not be great, but he’ll be good enough and you’ll get what you need from him, even if you don’t agree with everything he thinks. And that’s okay. As long as you don’t feel pressured into something you don’t want to do, you can roll your eyes at comments about, say, DBT for the Borderline Personality Disorder he thinks you might have. The most important thing is being able to advocate for your own needs.



InkAndComb wrote:
Rationally, I know if it's a bad fit, I'm an adult and I can go look for another psychiatrist.  I also know if they treated all their clients poorly, I probably wouldn't have gotten a suggestion for them.  However my brain is a jerk-brain and keeps reminding me of all the BAD psychiatrists I've had, and how wary they are of ADHD diagnoses, and it is really bringing me down.

Sigh, I hate to end this on a discouraging note, but… This isn’t necessarily true. Medical professionals make referrals based on whom they have had connections with previously. And that doesn’t necessarily entail quality, and sometimes there are “missing stair” professionals. For instance, there is this somewhat dodgy psychiatrist in my town who is well known because he takes everyone, regardless of ability to pay. Because he takes so many patients, he’s often on referral lists, but when my friends have said things like “hey, isn’t that the guy who is really med-happy and has someone questionable practices regarding prescribing potentially addictive substances?” other doctors have said “Yeah, I’ve heard things like that about him...” but not actually mentioned that from the beginning. One of the best resources I’ve found is other mental health patients for getting honest assessments of local psychiatrists, but if you’re not attending support groups/therapy groups/partials/day programs, its harder to find that out from people. Just… Be cautious and willing to listen to that voice in your head that might say that you’re uncomfortable with what’s going on.

On a more positive note, have you ever considered getting neuro/psych testing? Having an assessment from a place like that gives definitive proof that you have ADHD, and you won’t have to worry about people doubting your diagnoses. Also those offices often have recommendations for resources you can use.

Good luck and let us know how it goes! If you need any more advice I’ll see what I can provide from my experience.
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Post by Conreezy Wed Feb 18, 2015 5:37 pm

reboot wrote:One option is to type out the types of treatment you had, the dates, your age at time of treatment, dosages of medication, side effects experienced and what worked and did not work in a table. Tell your doctor you did it in advance in the interest of efficiency. For some reason, people tend to take things that are written out and presented "scientifically" more seriously. It will also spare your having to give the litany.

This is a good idea for anyone seeing any doctor for anything. You've got to be your own advocate.

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Post by InkAndComb Thu Feb 19, 2015 12:59 am

So! I dressed up in my favorite outfit, grabbed a toy and stuffed it in my pocket, wrote out a list of my symptoms and concerns, and tried to keep what everyone said in mind. I also tried to be appropriately wary; Prajna your'e right, even though they are recommended that doesn't necessarily indicate quality. Turns out she's one of the most rec'd, and her coworker is the 2nd most (the gentleman I switched over for). In addition, all the therapists she suggested worked right upstairs xD Not that I am accusing her of bias but I definitely know there are therapists beyond the ones on campus so a point for that.

I DO need to get retested apparently; I didn't know this, but in my state (is this nationally?) records can get expunged for testing after 7 years....which means all my tests have been annihilated *facepalm* I have my mom going through the records I have at home, but my actual medical records are in about 12 different books (as opposed to people's usual 5, if I remember correctly), and most of my testing happened in gradeschool-junior high. Does anyone know what adult ADHD testing is like versus child adhd? I was also tested in the 90's, which I feel like had a ton of differnt stuff.

I managed to get my scripts though! I have a new sleep aid (I've been sleep walking and eating and also trying to sleepshower....?) so she suggested something that worked well with that, and I also got a stimulant (what worked versus the nonstimulant) ,and she was very understanding about it. At first it would have taken 4 weeks at least, but when she realized midterms were coming up she renewed the prescription I had last year and everything is fine. Phew!

I know I didn't respond individually but thank you, thank you, thank you everyone who posted here! I read this before my appointment and after, and it was a great comfort. You guys are the best :3 and I appreciate you patience and understanding too. There are so many jedi hugs going out right now

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