But I Don’t Think That’s A Very Good Idea

Or why psychiatrists should listen carefully to their patient’s requests.

I saw a CPN and psychiatrist from the mental health NHS trust where my parents live this afternoon. This is the third time I have had contact with this particular trust this week.

The first time was on Sunday when I suddenly realised that having stopped taking my meds a few days earlier was a really bad idea after I started hearing a voice that was telling me derogatory things and encouraging me to cut myself and seeing things. I called the Crisis Team who sent someone out to see me, gave me a script for a few days worth of meds and arranged for me to be visited on Monday. Without forgetting of course to tell me that stopping taking my meds when I am prone to lability of moods and psychotic episodes was a “very stupid move” and would only be done by “a very silly girl”.

The CPN I saw on Monday was nice enough, in fact too nice enough. She had nothing about her that I could dislike, even though for some bizarre reason I really really wanted to dislike her. I told her that I haven’t been able to sleep since the beginning of February and I am having very bad nightmares and flashbacks about what happened, particularly at night. I told her that I had spent 5 hours on the phone to my boyfriend the day before sobbing my heart out about how much the rape has affected me and how I am trying to put a brave face on life but I can’t do it for much longer. She just shrugged, told me that nightmares and flashbacks were normal after a traumatic event and I could have some lorazepam if I thought that would do any good and to double the dose of quetiapine. She said she would contact Northumberland, Tyne & Wear NHS to get my notes from my most recent couple of inpatient stays faxed down to them and arrange for a full assessment to be conducted on Wednesday (i.e. today).

Yesterday wasn’t too bad on the whole. I did very little during the day and was absolutely shattered. By 2pm I just wanted to sleep so I took the entire daily allowance of tramacet and a few codeine on top for good measure and slept for a good 5 hours. I then woke up and wanted to go back to sleep again so I sent the boyfriend what could probably be construed as a somewhat alarming text and planned to take some Nytol, codeine, tramacet and co-codamol and snooze. I decided against it in the end and spoke to him at about 11pm last night when he was concerned for me and at 4am this morning when I rang him in a complete state after not being able to even close my eyes without panicking, let alone sleep.

I also saw the acute pain management people at the Chelsea & Westminster yesterday in relation to the almost constant pain I suffer through having ankylosing spondylitis and being hypermobile. It was quite a worthwhile visit as the dose of gabapentin I take (for neuropathic pain) has been doubled, I am now taking diclofenac regularly with co-codamol or tramacet to take interchangeably when the pain worsens and have some codeine to top all that off with if the pain becomes totally acute. My GP here in London sent a referral off to a rheumatologist at University College Hospital who specialises in hypermobility as she thinks it is worse than everyone first thought, but the Chelsea & Westminster told me that he is a very busy man and so have cancelled that referral and sent one off to the rheumatology department in Newcastle as I move up there on Saturday.

Today’s appointment with the psychiatrist and CPN was just stupid. Neither of them had to listen to anything I had to say. The psychiatrist decided that the quetiapine wasn’t working and couldn’t see why I had been prescribed that as a first line treatment so has moved me onto olanzapine, must to my utter disgust. I tried to protest the swop as I don’t want to take olanzapine, the concept of a drug that is pretty much guaranteed to cause weight gain scares the freaking hell out of me. When I told him this, he asked me which I thought was more important; my mind and sanity or my figure. I tried to explain that I fall into the bulimic category and was liable to probably become extremely non-compliant with the medication at the first sign of weight gain, but he just told me to stop being melodramatic and threatening him. He also prescribed lorazepam to be taken at night to try and calm me down and to help me get some sleep.

I am insensed that my views have not been taken into consideration. Luckily I am seeing C (the psychiatrist I was under when I was an inpatient in Newcastle) on Tuesday afternoon so will discuss it through with her then. I can’t see that she is going to be too pleased that I have be put on a drug, without her knowledge, that I am not happy about and quite willingly not going to take to avoid the side effects. We’ll wait and see if the proverbial hits the fan next week.

Ruth

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8 Responses to “But I Don’t Think That’s A Very Good Idea”

  1. Alison Says:

    Well first off what a pig ignorant psychiatrist, how dare he talk to a patient in that way. It sounds like he didn’t want to listen let alone actually help. Almost feels like the experience I had on the NHS last year (the phrase head and brick wall spring to mind), which is the reason I decided to finally go private!

  2. Wandering Coyote Says:

    I’d be disgusted, too, with your psychiatrist. The olanzapine (which I’ll Zydis, since it’s easier to spell for me and is what we call it over here) gave me such severe sugar cravings that I was buying a cake to eat for breakfast pretty much every other day. I was eating so much cake, in fact, that my shrink took me off of it because he was alarmed. I am not joking. It’s not about figure; it’s about your health. Cake = potential diabetes, heart problems (which people with depression are more prone to anyways), and all kinds of other stuff. Not to mention lots of money.

    Anyway, I really feel for you. Are you stuck with this doctor, or can you try to find someone you’re on the same page with?

  3. Diane J Standiford Says:

    Gawd hate shrinks, I hear such horrible stories and majored in psych in college, but the students were such creeps; now I wish I had stuck with it because I could have actually HELPED people. AARRGGHH

  4. Ruth Says:

    Alison: One of my first experiences of psychiatric care just over 4 years ago was privately. I was referred into the NHS and things weren’t working or happening so when I eventually ended up as an inpatient because I’d deteriorated my parents thought ‘sod this’ and put my in a private psychiatric unit. From there after discharge I saw a private psychiatrist and psychologist for about 12 months.
    Unfortunately this was on private medical insurance, through my Dad’s old job and even though I have my own cover now they refuse to pay out for pre-existing medical conditions so my cover excludes what they so delicately term ‘psychiatric troubles’. My psych in Newcastle is fantastic, she really listens and understands why I will and won’t take certain drugs and participate in certain activities.
    Trouble with the NHS is, it’s just luck of the draw and as I am ony a temporary patient down here I happened to get whoever was the duty psych yesterday, and it happened to be that total eejit.

    Wandering Coyote: I’m not taking the olanzapine, I’m refusing to on principal and since I have enough of the quetiapine (Seroquel) to cover me until I see my proper psych on Tuesday I am going to continue taking that.
    Luckily I am not stuck with that total idiot, as I said to Alison I am deemed to be a temporary patient here as I currently see a psychiatrist in Newcastle after I was admitted to hospital up there (and I am moving up there on Saturday) so he just happened to be the one I saw at the time. I pity anyone who does have him as their full time psychiatrist though!

    Diane: There are good psychs out there. My full-time psych is lovely and I have had other decent psychs in the past, just the people who practise psychiatry badly really tend to stick in your head!

  5. Disillusioned Says:

    “Trouble with the NHS is, it’s just luck of the draw ”
    Sadly, so very very true. Even within one mental health trust I have experienced vastly different treatment. It comes down to the individuals you are in contact with and their attitudes as much as (possibly more so) than your own. There seems to be virtually no monitoring / equality of standards / coherence which is, to be blunt, a crap state of affairs. Am hoping things improve for you as you see your full time psych.

  6. Alison Says:

    Thanks Ruth, I was initially seen last year three times, each appointment I felt like he was patronising me and not prepared to really listen, he seemed to find excuses for everything. The CPN was the same although I DID actually like her but had not seen her since last June. My 3rd appointment at the hospital was pointless I was not even in there for 4 minutes, a complete waste of my time.

    I got my appointment for the private place today; the price has already increased by £50 since last week so I am not impressed! It’s not like I can really afford to go private, the bills are mounting and it’s been beans on toast for two weeks to raise the cash, I am just so utterly disillusioned with the NHS that I don’t know where the hell to turn to anymore. My parents have no idea what is going through my head I try not to burden them with my issues since my dad would not be interested and my mother is too ill for me to bother her. I admire how your parents know and the fact you can be open with them.

    Sorry for waffling Ruth, I didn’t mean to.

  7. Ruth Says:

    Disillusioned: the really sad thing is that the NHS shouldn’t be luck of the draw. It should be standardised care throughout the country with the same referral procedures and everything. But then I live in a dream world.

    Alison: I din’t choose to tell me parents and be open with them. I was 18 when I was first admitted to a psych unit and they found out. It’s hard when you’re 18 to keep everything away from them, even though I managed quite well as being 300 miles away at uni helped. Now I am occasionally honest with my Mum, don’t really talk to my Dad. I am more honest now with my Mum than I was after I found some things out about her past that explain a lot.
    Don’t ever apologise for waffling on this blog – it’s what it exists for!

  8. Carly Gunn Says:

    5 years on are you any better?


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