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Old 03-02-2009, 03:12 AM   #1
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Best and Worst Pdoc?

Hi everyone,

I'm curious to know who your best and worst pdocs were. What did you like about them? What did you hate?

My worst pdoc was the one I recently switched from. He never listened to me and whenever I told him I was rapid cycling or manic, all he did was tell me to come back to his office in 3 months. The scenario always went like this:

Pdoc: "How are you feeling?"
dreams: "I've been rapid cycling and manic."
Pdoc: "Here are your prescriptions. Come back in 3 months."

My best pdoc is the one I'm currently working with. He listens to me, addresses my symptoms immediately and lets me participate fully in my treatment. He allows me to dictate what kind of med changes I'd like to have provided that it's reasonable. He also has a wonderful sense of humor and is very patient. He's a true gem.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
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Old 03-02-2009, 03:34 AM   #2
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Re: Best and Worst Pdoc?

My best pdoc and tdoc are my current ones:

My pdoc is very compassionate but also doesn't let me get away with anything. He also tell's it like it is, no sugar coating, which I like, because that's how I am. His methodoly is patient involved and includes, vitamins, herbals, CBT, and hollistic therapie's He treats the whole person, not just the BP dx. He also expects the patient to be involved in meds. and med changes, what you want to try, etc. When you go in for an appt. he doesn't just sit there and stare at you until you say something, man I hate that.

My last pdoc was the worst. He would just sit there and stare at you until you said something, incredibly uncomfortable. Never really seemed to be listening to me. Never let me be and active participant in med choices. Tried to change my dx from BP to GAD.

My tdoc is great she genuinly cares about her patients. She's always available by phone no matter what time of day or night. I've had to call her several times in the evening to try and stop a cutting spree and she'll sit and talk to you on the phone for however long it takes to deal with whatever issue you called to deal with. She tries different approaches such as DBT excercises, mindfulness management, etc., her practice philosophy goes hand in hand with my pdoc, as he referred me to her. She and my pdoc talk every 2 weeks to review my case, see what's going on, whether suicide ideations are worse, better, etc. She herself deals with Chronic Pain in her own life, so she has that connection with me also, and that makes it a whole lot easier. And although she's pretty much forcing me to go to the DBT Group, I've come to realize that it's for my own good. If I have any chance to stop the SH/SI this is it, and it will also help with the suicidal ideations/thoughts. On the weekends when Nick is at his dads, she calls and checks on me, to make sure I"m doing okay. And I never gave her that schedule, she'd kept up with it on her own. She's just very dedicated to helping people regain their lives and well being.

Worst tdoc was last one. It was like paying someone to be my Buddy. She spent more time talking about herself then she did me. One of my suicide attempts was while in her care and all she did was say, well you shouldn't have done that. And when I started with my current pdoc and told him what tdoc I'd been seeing and why I didn't like her, he was like, "yeah that's what we hear about her in our professional circles." The only good thing about her was that she was in network for my insurance at the time and it only cost me $25 per visit.

Kat

 
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Old 03-02-2009, 03:54 AM   #3
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Re: Best and Worst Pdoc?

Kat,

It's funny you should mention discussing one of your tdocs with your pdoc because that's exactly what I did with my new pdoc. I happened to mention my old pdoc and how I never felt comfortable asking questions, how he never explained what mania was to me or what I should do in the event of an emergency. My pdoc knew who he was and said, "Yes. He tends to be a very efficient pdoc which probably explains why you didn't feel comfortable asking him questions. It's no wonder."

As far as tdocs are concerned, I think the best I've ever worked with is the one I'm seeing now. Although there have been a few times where we've been short with each other (when I was manic), for the most part, we get along extremely well. He's very knowledgeable about BP and seems to know when I'm struggling. He also adjusts to my deafness and takes note of when my difficulty hearing is more pronounced. He's very in tune to how I'm feeling and can recognize my mania instantly way before I can. I owe him so much because if it weren't for him, I'd still be living in the land of confusion when it comes to BP. He has educated me so much about this disorder. I've also been doing my fair share of research ever since my diagnosis 3 years ago, but my tdoc always has something interesting to share about new med combos, treatments, psychotherapy, etc. All in all, it has been a real joy working with him.

As for my worst tdoc, I really can't think of one. I've been lucky that all of the tdocs I've worked with have been compassionate and willing to do everything they can to help me with whatever I'm dealing with.

Back to my current tdoc: I now understand what atypical bipolar I is. At first I was confused because I thought atypical bipolar was the same as bipolar NOS, but he explained the differences and told me that atypical bipolar I is considered its own category just like BPI and BPII.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 03-02-2009, 08:09 AM   #4
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Re: Best and Worst Pdoc?

I love the post heh I actrually love my Pdoc,but she is very expensive and doesn't accept any insurance.She's the best in my state and is on call for her patients 24/7,it's awsome.As for Therapy,I already went through two in the past year 1/2,that's realy frustating.I need counseling most of all because I have alot of issues with handling stress with expelling the right emotions from the Boarderline PD.I tried a female Therapist and then a male,didn' get me anywhere,prob because they didn't know to much about the mental disorder.It cost alot of money as it is for my Pdoc,I don't have insurance either.I tried applying for short term disability,so I hope that works out for me.
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Old 03-02-2009, 09:21 AM   #5
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Re: Best and Worst Pdoc?

Best: My current Pdoc--very patient, encourages me to do my own research on medications and take my time making decisions, is litterally available 24/7 if I need him, extremely careful and through.

Worst: Previous Pdoc who prescribed drugs that can, and did, cause a dangerous interaction, refused to move up my appointment when I did my homework and figured out what was going on, and then when I did meet with her didn't know what to do and denied that she'd caused the problem. She prompted me to find now very good pdoc.

 
Old 03-02-2009, 09:53 AM   #6
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Re: Best and Worst Pdoc?

blondeangel,

After I was IP back in 2006 following my first manic/psychotic episode, the hospital referred me to a pdoc who they claimed was the best in the city. If truth be told, nothing could be further from the truth. She never read my hospital discharge paperwork to find out what my diagnosis was and after only 3 months of seeing her, told me that it was my choice whether or not to remain on meds even though she knew I was bipolar. Needless to say, I ran as far away from her as I could and never looked back.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 03-02-2009, 09:55 AM   #7
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Re: Best and Worst Pdoc?

bunny,

Wow. Your worst pdoc should have had her license revoked. Did you file a complaint to the AMA? (I filed a complaint against my last pdoc and the first pdoc I was referred to after my manic/psychotic episode 3 years ago). Having said that, I'm glad she at least had the decency to recommend that you find another pdoc. I think she was probably aware of how much damage she caused you and didn't want to risk a lawsuit.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 03-02-2009 at 09:56 AM.

 
Old 03-02-2009, 03:18 PM   #8
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Re: Best and Worst Pdoc?

Dreams,

I'm telling you we're twins that were seperated at birth! You know I think that we have to have some level of "arguementativeness" with our pdocs to make a real "relationship". Just like any relationship, you can't get along all the time and if you do, somebody isn't doing their job or being honest.

I can remember once about 6 months ago when my severe BP Suicidal Depression kicked in and my husband was out at some female co-workers house getting drunk till all hours, and I had just had it. So I took like 12 or 13 Ambien because I really didn't care if I woke up the next day or not. Well my pdoc had taken me off Ambien the month before because of the "halluceagenic dreamstate" where I cut up my arm really bad in my sleep and had to get 26 stitches, because he said the Ambien had something to do with it. Well I told him I'd thrown them out...but ummm...well I lied. So when I saw him a couple days later, after I'd been to the ER to make sure I'd had not lasting effects from the Ambiens....I sat down in his offfice, in my usual comfy couch spot, and he said, "Didn't we agree that you weren't going to take the Ambien anymore?" and I said, "yes", and he said, "You know I'd rather you say Fu** you to my face, if you're just going to do whatever you want." So yeah my pdoc and I have our moments, but I think if we didn't something wouldn't be working right.

That's just one of my theological observations.

kat

 
Old 03-02-2009, 03:24 PM   #9
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Re: Best and Worst Pdoc?

I just got home from seeing my pdoc and it's been a really rought week with lots of triggers, I'm BP with severe suicidal med resistant depression, so my suicidal ideations, and prospect of completing suicide right now are very very high. So as I'm walking out the door, my pdoc asks for my blackberry, pulls up his profile and makes sure that his cell, office, home numbers are all there and correct. I was so out of it and just didn't really care one way or the other, but he wanted to make sure that if I needed to contact him wherever, whenever, I had all the correct information. I know that caring pdocs like that are few and far between, I'll never change pdocs, even if I have to work at Burger King to afford it!

kat

 
Old 03-02-2009, 10:05 PM   #10
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Re: Best and Worst Pdoc?

Kat,

My pdoc is the same way. When I called his office 5 days ago to let him know that I was rapid cycling pretty badly, the receptionist told me my pdoc would return my call if he thought it was an emergency. That got me a little worried because after my experience with my old pdoc, I was concerned that he wouldn't call me back. To my pleasant surprise, he returned my call within 10 minutes and even suggested (or actually strongly recommended) that I go IP. I told him I didn't want to only because I just got out of the hospital and didn't want to go back. Instead of scolding me, he told me he understood and said that was perfectly fine. I feel the same way you do, Kat. I'll travel to the end of the Earth if I have to in order to see my current pdoc. He's definitely worth it! Not only that, I've been stable for the past 5 days thanks to my Clonazepam. Funny how my pdoc took 2 months to figure out what was wrong when my old pdoc couldn't even put 2+2 together after a year and a half.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
Old 03-02-2009, 10:09 PM   #11
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Re: Best and Worst Pdoc?

Kat,

I haven't had any run-ins or disagreements with my new pdoc yet (because I've only been seeing him since December), but I have with my tdoc. Whenever this happens, it makes me feel uncomfortable and as if I'm a 6 year old child once again. That being said, I wouldn't trade him for the world because like I said, he has taught me so much about bipolar. At my last appointment, he explained my diagnosis to me, going through each BP category and explaining why I didn't specifically meet each one. I consider myself so fortunate to have this tdoc. It's been a long time coming, but I *finally* have a tdoc and pdoc I can put my complete trust in. By the way (according to my tdoc), I have trust issues due to the abuse I've experienced in the past, so I know that when I'm able to trust someone -- really trust someone -- I've struck gold because that doesn't happen very often.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 03-02-2009 at 10:17 PM.

 
Old 03-02-2009, 10:37 PM   #12
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Re: Best and Worst Pdoc?

Dreams,

yeah us BP/SH/PTSD'ers tend to have those major trust issues from our lovely childhoods don't we. Once again we land on the same plane in the universe, my pdoc at times when I answer questions in a certain, how should we say, petulant way, I guess I get a certain look on my face and he'll say, "So, we're gonna be six years old today?" hmmmm....hope we don't have the same pdoc...*l*

Man this day has really sucked and I better sleep tonight or I'm really gonna be ticked. He doubled the Abilify, doubled the Buspar, took off the clonazapem, and added in Trazadone.....I hate med changes!!!!!! I don't know why I hate them, my meds only work for 2 or 3 weeks at a time, I should be used to it by now.

kat

 
Old 03-02-2009, 10:51 PM   #13
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Re: Best and Worst Pdoc?

Kat,

I'm sorry that you're going through yet another med change. That has to be very frustrating. Have you ever thought about having ECT treatments? My pdoc recommended that I have ECT, but I can't due to my cochlear implants. As far as my moods are concerned, I think the Clonazepam is what is responsible for it. I'm sure my Depakote, Fluoxetine, Geodon and Trazodone are helping, but I really think the Clonazepam is largely responsible. By the way, someone on "the other" site told me after I was personally attacked that I should have a med change since my Depakote, Fluoxetine, Geodon and Trazodone alone should help my rapid cycling. I'm sorry, but I disagree. If I have to take a benzo in order to maintain a sense of stability, what difference does it make as long as I'm not rapid cycling? That's the ultimate goal, isn't it? Better yet, I'm not even cycling once a day even though my pdoc's treatment plan is to reduce my cycling to once or twice a day. With that being the case, I think I'm doing better than expected.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

Last edited by dreams in neon; 03-02-2009 at 10:54 PM.

 
Old 03-02-2009, 11:05 PM   #14
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Re: Best and Worst Pdoc?

Dreams,

I can't do ECT because I have a Seizure Disorder and that has something to do with it.

My Pdoc is really carefully of my meds because of the Oxycontin and Percocet that I'm on daily for the CP. I was on a pretty high dose of Clonazapem and it's the strongest benzo, and I was taking it for anxiety/panic attacks. He was concerned it was impairing my cognitive abilities, so he stopped that and doubled the Buspar, which is strictly for anxiety without the benzo problem. Whatever he suggests this and that and normally I chime in, but today I just didn't really care one way or another. He did write all my scripts for 3 months worth so I'll have them all before my insurance runs out in a couple of weeks, I just had to get extra bottles and take the 2 extra months worth of each med to him next week, and he'll give them to me when I need them. So that saved me a ton of cash, Lamictal and Abilify can make you homeless without insurance.

kat

 
Old 03-02-2009, 11:12 PM   #15
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Re: Best and Worst Pdoc?

I know how that goes. When I used to take Risperdal, it cost $591/month. All of my meds total (as I'm sure yours do) well over $1,000/month.
__________________
Atypical Bipolar I Disorder with Rapid Cycling
Meds:
Depakote 1500mg
Prozac 40mg
Risperdal 1mg titrating to 6mg/day
Klonopin .5mg (2x/day)
Trazodone 100mg or 200mg PRN

 
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