Arrogant psychiatrist

[JJJ]

Despite Kanga going to new Residential Treatment Center (RTC) with oodles of paperwork documenting her mood swings and her constant hallucinations - not tied to her mood swings (aka schitzoaffective disorder), the Residential Treatment Center (RTC) psychiatrist says he doubts that it is the right diagnosis. He thinks it is 'just' PTSD. Seriously, you've spent ~ maybe ~ 2 hours total with my kid in 2 months and you want to overrule a team that spent two years with her and completed extensive neuropsychologist testing. Not if I have anything to say about it.

Arrogant...arrogant...arrogant.....UGH!

 

[AnnieO]

JJJ - Kanga's issues are "just" PTSD? IS HE KIDDING?

OK, I've never met you or her in real life, but I have read enough (and know enough from Onyxx...) to think this guy needs a figurative pantsing.

Wow. Hugs.

 

[JJJ]

Yes, it completely freaked me out when he said that. And, of course, he can't be bothered to call me to discuss it. He just announces it at her staffing. Idiot. Thankfully I found out that we can fight him changing the diagnosis since her other diagnosis came from an MD also. I'm waiting for a call back from her case manager to develop a plan to block him.

 

[TerryJ2]

Just what you need. Arrgh.

 

[nvts]

I'm up for a "blanket party in the parking lot" for this clown!

Gimme the time and place!

Beth

 

[Farmwife]

I don't know if this should go without saying but..

Is there any situation or way you can insist he back up his findings with a written report substantiating his opinions and explaining determinations clearly. Or heck, just a verbal report at a staffing? You know, reasons and FACTS based on difficult child's extensive history why he would feel confident in changing the established diagnosis? (plus a realistic treatment plan that hasn't already failed) I'm probably stating it too simply because the more professional, researched and legalese sounding it gets the better. Get copies of his files and clinical notes on difficult child. Treat it kind of like an IEP process gone bad, you know? Get all "by the book" on this Dr. doodie face!!!

I enjoy the Socratic method of asking a series of leading questions that get the responder to essentially back themselves into a corner and state your opinion for you.

Then spice it up with irritating stuff like..
"...and you concluded this based on what...?"
"...and this was after how much time of difficult child in your care..."
"...what symptoms in particular are caused by the ptsd?"
"...and what about these symptoms, do they not sound like something else? Possibly related to original findings, no?"
"...you are confident dismissing the exhaustive amount of testing that went into the original diagnosis? Why?"

I have a twisted sense of humor and when a person in authority decides to rattle my cage I have a bit of fun making them eat their words. I know you must be stressed to the max so don't take that the wrong way. I just prefer to take the bull by the horns rather than bother with trying to plead my case or contact supervisors. I have no patience for civil formalities when it comes to wasting therapeutic time or benefits for my difficult child.

After the blanket party make sure no one punches him in the face. That is a rather unpopular therapy program. I would however like to join the blanket party. I'll bring extra socks with bars of soap in them if anyone forgets theirs.

 

[klmno]

Well, let him treat her for PTSD, which probably won't hurt, and then see that there are still issues there.

 

[Fran]

There is nothing that annoys me more than someone coming in and changing everything with no real understanding or experience
with me or any of my family. I can understand your frustration.

 

[susiestar]

Why do so many psychiatrists and tdocs want to continually reinvent the wheel, figuratively speaking? I have found very few of them to have much in the way of facts to back up the changes. Mostly it seems like an ego thing. "The other docs spent years and never did "fix" things. I KNOW what is wrong and I will "fix" her and show everyone how great I am" ****.

They are doing research on whatever they diagnosis and they want guinea pigs to test their methods on, regardless of the actual problem and what has been done before to treat the problems. Some of them are trying to push certain medications and/or products because they have a relationship with a drug co or rep and are getting some kind of compensation or reward for pushing some treatment.

Regardless of their motives, don't let it happen with-o some serious wrangling. Farmwife has some great questions.

 

[timer lady]

Triple J, I don't know if you remember the posse's I'd put together for various & sundry reasons but I'm sure we could get enough members in the midwest to come "picket" this psychiatrist. I'm sure he'd not like taking on a group of CD parents.

Will the team from other Residential Treatment Center (RTC) talk with this psychiatrist ~ get him to get off his high horse long enough to listen to common sense? Every psychiatrist seems to need their own diagnosis for their new patients whether it applies or not. I've lived long enough with complex PTSD to put in a word or two if necessary.

 

[JJJ]

I read and reread the DSM IV and the last set of testing on Kanga. There is no way this is just PTSD.

DSM IV for Schitzoaffective (abbv.)

Two or more of the following during a 1-month period:

(1) delusions
(2) hallucinations
(3) disorganized speech
(4) grossly disorganized or catatonic behavior
(5) negative symptoms (eg. affective flattening, alogia, avolition)

Note: Only one criteria needed if ... two or more voices conversing with each other.

Let's see...

(1) delusions
Well documented by testing in 2007 and 2009

(2) hallucinations
Documented by various psychiatrists and tdocs in 2006, 2007, 2008, 2009 and 2010
Auditory hallucinations consist of a main voice (female, distinct personality and a name) as well as at least one male voice and occasionally many other voices. Voices converse and even argue with each other. Visual hallucinations include two men, one girl and at least one angel.

(3) disorganized speech
Reported by mother and documented in testing in 2007 and 2009

(4) grossly disorganized or catatonic behavior
Brief catatonic states witnessed and documented by therapist in 2007. Disorganized thought processes documented in testing in 2007 and 2009

(5) negative symptoms
Every psychiatric hospital report says 'flat affect'. Other negative symptoms also documented by numerous psychiatrists and tdocs

Delusions/Hallucinations in absence of mood symptoms.
She actually spends most of her time 'in the absence of mood symptoms' and hallucinations 75%-100% of the time depending on which report you read.

Symptoms of mood disorder present for a substantial portion of illness
She has 3-4 documents mood episodes per year. Usually one depressive in the fall and two manic in the spring.


Hmmm, looks like Schitzoaffective Disorder to me. A really bad case of it too!

 

[JJJ]

I have a message into her case manager that this will be the #1 topic of our weekly check-in call on Monday. That and Kanga's report that she borrowed money from girls and had to pay them back and that is why she is broke. (Who ever heard of an Residential Treatment Center (RTC) allowing the girls to lend money???)

 

[gcvmom]

Like you don't have enough to do... sheesh.

 

[whatamess]

I have found that t/p docs tend to diagnose according to their area of interest. How frustrating that he might actually have the authority to over ride other diagnosis's.

 

[JJJ]

So, no call this morning for our weekly check-in. I'm hoping they are just running late. Ugh!