I can already see how this is gonna go

[Dave's Not Here Man]

Needed to get into the Behavioral Health scene with the health group we use down here. I've been doing okay and no acute issues except for the occasional panic attack that leads to my mind and body going bezerk for a few hours, but managed pretty well with ativan and breathing/grounding/etc techniques. My mental load, so to speak, is half or less of what it was when we moved here. Anyway, in order to keep up with the requirements of disability, meds I take, and overall mh maintenance I decided to resume therapy and see if I could get anything from it, from a provider in the area. 

Long story short the appointment was by phone and the provider was a Psychiatric NP, that was about as sharp as a fucking wet waffle. Seemed like his (one of the first problems, I ONLY like to deal with females in those roles) predetermined goals was to get me off the benzos, "I don't ordinarily prescribe benzos"...... sidebar: Would a reconstructive surgeon tell a patient "I don't ordinarily perform skin grafts"?:... anyway, he had mentioned about 400 other meds that were either advisable or not advisable. Then he hit the nerve after telling him a bit of my history with, and I have to paraphrase because it to me was so stupid I wasn't even sure I heard him right... "we all have things and problems we have to deal with". I replied that yes everyone has problems but sometimes we can't see past our own certificates on the wall to realize the real pain and suffering problems of others have on them, and the inappropriate things we suggest to them that minimizes it.

So I will be recapping that conversation in a letter to the top ranks of that medical group along with my thoughts on the subject. My therapy will not be through him anyway but he will be managing my meds. I do not want him involved in my care in any way, shape, or form.

[bobathon]

That dude needs a different jerb.

[minx]

Okay, I can see someone saying "I normally don't like prescribing benzos. Have you looked into other alternatives to them? If so, what, and how did you react to them?"

My psych isn't into benzos unless necessary, but at the same time, he doesn't dismiss them out of hand or demand you immediately start coming off them unless he feels it's physically harming your physical or mental condition. When I started with him, his first question was if I knew my current diagnosis (Bipolar disorder level II). And did I feel comfortable with it. (yes to both)
After that we discussed my current meds, and what I had been on prior to that. We've added one med (Inderal, for TD) and changed one (Ability, which was the cause of the TD to Lamictal), but we had a long discussion about both before doing so.

Needless to say I adore this man and wish other doctors were the same. We have discussed stress/anxiety responses, because when you do have severe anxiety, your mind does lose the ability to differentiate the difference between 'normal' anxiety and 'irrational' anxiety
--Lost my job and I will never get another one even close to comparable - this is normal anxiety
--Layoffs at my job, and terrifies I will be next - this is normal anxiety
---Economy is bad and we're all going to lose our jobs tomorrow - irrational anxiety

So everyone has anxiety and problems where you have to suck it up and deal with it, but living with an anxiety disorder is very different.
I am so sorry you've gotten stuck with an asshole.

[Dave's Not Here Man]

I can't remember the last time I saw an actual MD. It was probably the right wing nut job at Kaiser. He was still an excellent doctor despite that flaw.

I'm thinking... A psychiatric PA is not equal to. If he was, he'd not be a PA right?

He said he'd refill the benzos "for now" and until our next encounter. I told him explicitly that I wanted no changes to my current medications period and that was not what I called him for. So I have 2 months, presumably, to force a change in providers.

[minx]

So did he give any type of rationale for not prescribing them other than "I don't like them"?

What an asshole.

[Dave's Not Here Man]

Oh yeah, he did. "Studies have shown....."

I've heard them all. Not just from him. The problem is the same problem with opioids. People abuse them far beyond dependence. With benzos they have the same reputation as being "addictive" and in turn can lead to overdose, though it's rare to hear of people that OD on Xanax or Klonipin without mixing them with an opioid or multiple other S1 drugs and usually alcohol as well.

Benzos were recently attributed to dementia. How often do "studies have shown" turn out a few years after they come out to "new studies have shown otherwise"? I'm likely going to have dementia based on family history. So I'm fucked either way. How about just letting me live better through pharmaceuticals and have quality of life rather than quantity? Living a long time and suffering is not my goal.

[Dave's Not Here Man]

And Tiger just made it worse for everyone.

[minx]

Tiger was lucid and calm at the scene, so they didn't bother testing him for anything at the hospital. Stone cold sober, my friend.

That accident will be written off to excessive speed and some sort of distraction. Isn't it nice to know that the friendly officer who arrives first won't take any actions if you can stay semi-calm and not slur your words?


And yeah - I get that benzos and opioids are addictive. I get that people can OD on them, and they are not to be prescribed or used lightly.
And I realize there are many alternatives. But if you have been on them long-term, are not asking for higher dosages or more frequent refills, and they are working, then what's the damn problem?

I could see if you weren't on anything and said "Well Ativan has worked well for me in the past...."
Yeah, great. There are many more things we should try before going that route my friend.

But coming in and saying "I'm on Ativan for panic attacks, and have been taking it at XX dose for YY years with good effect", should warrant an answer of "Okay, there are alternatives with fewer side effects out there now - have you looked into any of them? Are you interested in doing so?"

I don't feel that patients who are not currently on benzos or opioids should be prescribed them as the first course of attack. But if you are currently on them and stable, then why change what works?
And if there is a concern that you are giving them away to Tommy on the street corner, then do some random drug tests to verify that you have enough of the shit in your system to show you're using it.

I will say that many doctors are beginning to get smarter in prescribing. Friend had kidney surgery, and doc prescribed T3 - told her that he gave her 2 days worth, and she needed to call if it wasn't enough so he could re-evaluate. 8 pills and she only needed 6 before she felt better. That's how it always should have been done and should be done - you get enough to get you through passing things, but if you are in a situation where only that will do, then re-evaluate before prescribing.

People like you and Pam should not have to beg to get medication you need to simply function during the day.

[k9krap]

I’m almost completely off all prescriptions. I’m down to 3 - two of them for hypertension and the hydroxychloroquine. I’ll be off one of the BP meds and the hydroxychloroquine in about 2 weeks. Then it will just be a water pill.

My mother was on so many medications. Some of them changed her personality. When I came one from the hospital after my official lupus diagnosis with a huge bag of prescription medications, I was panicking because I’d never had to worry about that shit! I was 25! Now that I’m off most of that crap, my legs aren’t swollen like sausages and my kidneys seem to be functioning better. Yes, I’m in constant pain, but to be honest those pills weren’t doing a whole lo t for the pain anymore. I don’t think anything can tackle the pain except death.

[bobathon]

Tiger was probably calm from being in shock. His leg was smashed.

[Dave's Not Here Man]

Totally possible. There's also other possibilities that, given his track record, lean into likelihoods.

He also just had ANOTHER back surgery, which when you have his medical team, means top shelf pain management meds.

[minx]

HE WAS LUCID! And when you're famous, that's all that really counts. Lucid = sober and clean. Regardless of the situation.

They could have caught you in the process of snorting coke, but if you're lucid and they're a fan, you're golden.