Wednesday, November 26, 2008

some progress

I know recently a lot of my blog has been focused on my mental health as opposed to my physical health, but I think we all can underestimate how important it is to keep the former up since it so strongly influences the latter. This is true for everyone, possibly even more true for masto patients since stress and depression can influence episodes of mast cell degranulation, causing a cyclical nightmare of being stressed about getting ill, and having that stress play a major role in having a shocking episode. So getting one's head in order is a big deal.

I have a phenomenal team of doctors. I feel comfortable and confident in all of their abilities, they are all knowledgeable about masto, and none of them seem to conform to that whole disdain for sick people category that I've read about (long story short, chronically ill patients present a problem for many doctors because they are living reminders of the shortcomings of the medical system as well as their own skill. Doctors are human beings too, so of course it is frustrating to them to be presented with a problem they simply cannot fix). My one shortcoming has always been my psychiatrist. Now, I adore my psychologist, but she obviously cannot prescribe medication for me, and since my current psychiatrist is a useless prick when it comes to contacting my other doctors to discuss medicine, this has become more and more of a problem. He's stubborn and lazy about it, which has left me in this going back and forth between him and my other doctors relay that is very frustrating and insulting.

My PCP found out about my struggles with him, and how over the course of the past year I've been seeing this guy with little to no progress...I was infuriated after my last exchange with him as well as the fact that after having been under his care for a year for anxiety he felt "unqualified" to fill out the anxiety portion of the paperwork my lawyers wanted...That just spoke of how little he knew me if he was willing to prescribe Klonopin and antidepressants for me, yet felt unable to articulate why. She suggested that I see the new psychiatrist in her office and I happily jumped on the opportunity.

Yesterday was my first appointment, and it really was a watershed moment for me. By nature I am a pretty stoic person. I can get pissy or indignant, but I rarely every cry. I don't know if it's nature or nurture or genetics or what, but I've never been a big one for crying. Within minutes of meeting her, I was bawling, trying to find the words to explain what was physically wrong, when she stopped me and said, "I've read all your medical files, I -know- about mastocytosis and what I don't know, I'll contact your doctors to fill in the blanks.. I want to know about how you are feeling". I think in that instance alone she expressed more compassion and more interest in me as a patient that my previous psychiatrist did. So we talked about emotions and stress and all of that and she then said, "Well, I hope you didn't come here today expecting a prescription for a new medication. Before I do that I want to research with antidepressants have both the lowest side effects and the highest antihistamine properties. In addition I want to talk to your mast cell specialist, as well as a few I know myself, to determine the best course of action."
I was so happy about that statement, especially in light of the recent issues that I had had with my current psychiatrist refusing to contact my masto doctor regarding the Remaron vs. Doxepin debate that I nearly started crying again. This woman obviously understands that she is dealing with a patient where it is difficult to determine what is a physical vs psychological complaint and also is aware of the fact that due to my underlying illness that it is going to be even harder to figure that out. She also felt that the MMPI was useless in determining anything about me due to the fact that I have a chronic illness, and that the idea that any doctors, upon reviewing my medical charts, would say I had any sort of somatic illness was just ridiculous. So it was awesome all around.

So, I guess what I am trying to say in my overly verbose manner is that it is really important to be happy with the care you are getting. Obviously you aren't always going to get the answers that you want from a doctor, but you need to feel confident in their investment in you, their understanding of your illness, and especially in the realm of mental health, your overall compatibility. For the longest time I just assumed that since my psychiatrist was part of BIDMC (where the bulk of my other doctors are) that everything would work out...and it didn't. I persisted in seeing him even though I didn't feel any sort of connection from the start because I assumed his primary function was just to prescribe maintenance medication for me, when realistically I should've been looking for better medication since in a lot of areas I was simply treading water. My stubbornness to see how negatively the dynamic was impacting me and slowing down my progress serves (to me) as a good lesson in terms of being able to identify when it is time to give up.

So now I am going to call him and tell him I no longer will require his services. Yay!

No comments: