Lazy Psychiatrist (Office)?

What the heck kind of psychiatrist office is this?  I've called in with side effect symptoms before and gotten an answering machine (they haven't been responsive to these messages); this time, I got the secretary.  I told her I wanted to leave a message for (insert name of psychiatrist) and said that I had been nervous to tell about the symptoms I'd been having two weeks ago, after we'd upped the Risperdal half a milligram, because of awkwardness at the appointment due to being late and it going into her lunch hour, and stuff, so I was only calling now about these symptoms and what I'd done about them. 

Within a day of upping the Risperdal, I starting having horrific nightmares, multiple times a night, and after 4-5 nights, they'd gotten so severe they'd started waking me up, besides being so bad they were images and feelings you'd not want in your head.  So I was desperate to do anything to get rid of them, yet I was so awkward about an interaction we'd had at the end of our appointment that she could have handled more tactfully, that I was too afraid to call her about this.  I remembered an off-the-wall comment she'd made in the summer, when she'd stopped the clonazepam and replaced it with lorazepam, to be used as needed only for potential agitation that might be caused on Geodon, then, and I asked, what if I get my parasomnias that I sometimes get, that the clonazepam was for?   She told me that the topamax that I was on (that she was giving me the Geodon to replace, oddly enough) would do the same thing as the clonazepam.  I thought, why, after all these years on topamax, am I just being told this now?  That it will affect sleep problems like clonazepam?  Obviously it doesn't make me sleepy, but that it might affect things that happen IN your sleep.

So I remembered this, and thought perhaps it might work for the nightmares.  I tried, in the middle of one night, half a pill, which was 50 mg.  It somewhat worked, so to completely clear things out I upped it the next night to 100mg, which has worked like a charm.

Now, I know I should NOT be messing with my meds on my own.  That is why, today, after close to two weeks since I did this, I finally called her office to leave a message about the side effect of the nightmares and what I'd done about it; after all, knowing about side effects is one of the main things a psychiatrist deals with, and needs to know about in between appointments, is it not?  These issues aren't necessarily emergencies, but if they have some side effects that make me desperate, I feel they are important information for her.  In this case, obviously important because it made me mess around with what I was taking, though I'd only just tapered off the topamax a few weeks before, anyway.  About a week to a week and a half before I started it again, in this case.  I kind of was so used to taking it I tapered off it slow, out of habit, really.  Forgetting to step it down.  She never actually said to get off it, even, I just assumed that since she wanted me on something more effective (that she DID say) that I was supposed to taper it down (see, she should have addressed the issue of , well, what should I be doing about getting off the topamax, back November 17th appointment when we started the Risperdal in the first place.)

BACK to the point.  You want to know what her secretary said after I relayed the symptom information and what I'd done about the nightmares?  I was incredulous!!  She said, "Well, you're okay now, so you can tell her that at the next appointment, or you can leave her a message on her cell phone if you want".  I stammered, and asked if she'd leave a message but she said I could tell her at the next appointment since I was okay.  I was stunned; what the heck kind of psychiatrist office is this, that the psychiatrist doesn't have her staff taking messages about symptoms that patients want to let the psychiatrist know about?  The psychiatrist says that the cell phone is for emergencies, and this doesn't fall under emergency, I don't think . . . . . there's no guarantee I'd get the voice mail on the cell phone, either, and not get the doctor herself, so I don't know WHAT the secretary was thinking!!!

I mean, what kind of liability issues does this put the doctor under, if it makes patients think that the doctor doesn't want to know about side effects of meds, or makes patients think that they have to come up with solutions to side effects themselves ii-between appointments?  This is seriously reckless and irresponsible, in my opinion, if not just a bit lazy, on the part of the office staff . . . . why not take a message?  It doesn't have to be detailed!!!

WHY have someone answering phones, anyway . . . is it just to deal with scheduling issues, and payment issues??  ARGH!!  Now I feel like, unless there's an emergency, I pretty much DO NOT HAVE A PSYCHIATRIST.  I feel like, if I have side effects or issues with a medication, that I have NOWHERE to turn for advice, help, or ANYTHING.  I feel lost and alone and without support or ANYTHING AT ALL.  THIS sucks, and I think SHE SUCKS as a psychiatrist, now.  WHAT THE HECK kind of psychiatry practice doesn't want to know about non-emergency side effects?????  Things that are important enough to the patient that they'd want to call in to the doctor's office about them?

I feel dismissed and sidelined.

Comments

[sarebear]

Dinah,

It's the feeling that the office is more of just a business office, and not somewhere I can leave a message for my doctor, I guess. I guess since you say that options for me to contact my doctor WERE given (on this or other occasions) that that isn't the case, but I feel that email wouldn't be a route given for a regular doc so why would it for this one?

Despite the detail I go into on my blog, I leave out stuff that I don't want to blog.

As for the cell phone voice mail, I felt that had I gotten the actual doc and not her cell phone voice mail, that I would have been reamed out for it not being an emergency. I feel like I was being told to use a method of contact that I was being given conflicting messages vs. what they'd told me before about using it, so how am I supposed to resolve that conflict without getting caught in a conflict? I've been on the receiving end of the psychiatrist's unpleasant surprise at me calling her cell phone once before, and that may be why I am so reluctant to call it for anything other than an emergency, I don't know. Another issue to bring up, I'm sure.

But even if the cell phone hadn't been conflicting reasons, the feeling that the office will NOT ever take ANY messages that relate to symptoms or medical issues at ALL, makes me feel like I don't have a way, short of emergencies (since the cell is supposedly for such), to communicate such things to her at all. At least, via the conventional routes one would communicate such things to a doctor.

Do I really need to contemplate having to resort to email to, say, report side effects to my GP if I start reacting to, say, my omeprazole? That would seem wierd, no? The emailing my GP, not the made up side effect thing. So then why should I have to put my medical needs via email because I guess she doesn't want her office staff taking any medical messages for her? My doctor's office takes medical messages all the time. My previous psychiatrist's offices took messages about symptoms on those few occasions I had any, so maybe I'm spoiled?

I dunno, why am I upset, I guess I just have a notion that a doctor's office should ACT like a doctor's office, and not like a business office who doesn't want to touch medical issues with a ten-foot pole. Or like a place that is forcing me to emails only for medical communication, just for the convenience of the people at their office.

Perhaps I'm just being a whiny patient. Perhaps thinking that administrative assistants (I used to be one) or secretaries (that too) should actually, well, gasp, take a few messages now and then! I just feel like the ONLY way distressing, non-emergency symptoms are going to get conveyed to my psychiatrist, are through means that involve the least amount of time and/or effort on anyone's part there at all, not to sound insulting; what I mean by that is, they want me to use the most automated process, whether it be voice mail or email, so that nobody has to deal with it but the doc; in an ideal world, if no one but the doc had to deal with the messages, that would be most efficient for them, but it seems awfully cold and distant to me. Like I say, the other psychiatrist offices I've dealt with, you just called the front desk and dealt with PEOPLE. As is the case with any regular doctor's office I've dealt with. I think I've not explained too well, but gone on too long. Ah, well.

[sarebear]

I need to say that I don't expect a person on the phone every time I call; I'm happy to leave a msg on the voice mail for the office (though not for this one, anymore, if it deals with medical issues, because I highly suspect they'll "ignore" it and not take down the message for her, since such would be "medically based"). I'm happy to just convey the information. I guess if that's the case, I should just swallow whatever is sticking in my craw about the email thing, since I don't really understand what is, myself, and handle things that way.

I think part of what bugs me is that her staff is, then, not running a doctor's office, where you can leave msgs for the doc; they're only running a business office. You can't convey anything through them, no matter the need, and for some reason, that makes me feel disconnected and helpless, which I suppose I ought to explore in therapy with my psychologist.