As if we don't have enough issues

[hexemaus2]

difficult child 2 was discharged from the psychiatric hospital a couple of weeks ago. The hospital staff made an appointment with difficult child 2's old psychiatrist for us for today. I didn't want to take him back to the psychiatrist we've been seeing. We worked much better with his old psychiatrist, so I asked to have him discharged back to her.

We had an appointment today at 4:30. We get there, they don't have him in the book. Hmm...strange. Receptionist does some checking. Apparently, the psychiatrist's office called the psychiatric hospital back the next day (the day after difficult child 2 was discharged) to say they could not see difficult child. Apparently, old psychiatrist has moved to private practice from the organization she used to be with. As such, she "can't provide the services your son needs."

No one felt the need to call me and let me know this??? Two weeks into a 30 day supply of his medications & it normally takes 3 or 4 weeks to get an appointment with a new psychiatrist???

For two weeks we've had this appointment on our calendar. For two weeks, we thought difficult child 2 had a psychiatrist. Now he has no one.

Luckily, I was able to get an appointment with another practice for the 14th. Hopefully, difficult child 2 won't need too many doses of his PRN Geodon, as we may have to use those to limp by until he sees this new psychiatrist & we can get refills. (He takes 40mg 2x daily - his PRN dose is 20mg as needed for aggression. Hopefully, he won't need too many of his PRN doses, as we'll need to double that up and use 2 20mg capsules twice a day when we run out of the 40mg capsules.)

I called the psychiatric hospital with a "what the heck happened?" attitude. I basically got an "Ooops. Sorry 'bout that" response. And no, sorry, we can rx a refill on difficult child 2's medications to get him through because he's been discharged. He's not our patient any more.

Great. Just lovely. If he runs out of medications, we're all in trouble. He'll nut up at the slightest provocation & then he will be the psychiatric hospital's patient again.

I swear, if there is a way for this kid to fall through the cracks, we've found it. Sometimes I think he's not just falling through them, the system's freakin' stuffing him into the cracks!!

Ugh. As if we don't have enough issues without professionals and members of the system dropping the ball too!! And we (difficult child 2 and the rest of us) are always the ones who suffer as a result. It's just so not right. All it would have taken is a simple phone call to let me know she couldn't take him back as a patient. I would have had the last 2 weeks to make other arrangements. But no, instead I have to stress & scrape together enough medications to get him by until the 14th. (He'll run out about 4 or 5 days prior to the appointment. So long as I have at least half of his PRN prescription come then, we'll be able to limp by. But geez, we shouldn't have to do that.)

 

[klmno]

What a disaster- which place wouldn't write a script for you? Was it the place where psychiatrist went to or the place where psychiatrist left? There's something stinky about that situation. I can't imagine a prof dr not leaving some contact that can keep patients going for a while. I hope difficult child can make it through this unscathed- and that you can, too!

 

[DenitaS]

How FRUSTURATING!! Could you contact the psychiatric hospital and explain the situation to see if they could give you enough medications to make it to the appointment??? Just an option, not sure if it would work!

 

[hexemaus2]

See, back in May when difficult child 2 was in patient, the psychiatric hospital wanted to send him for follow up through our local Community Mental Health. At that time, he was seeing Dr. S, who was part of a local program called Georgia Safe. In order to have him seen through CMH (Community Mental Health) the psychiatric hospital had to call Dr. S and ask her to release difficult child 2 as a patient and agree to the transfer. She was fine with it, since we would then have access to respite care, in-home counselors, and other services that we couldn't get with Dr. S.

Well, those services never materialized. In fact, all they did was heap MORE tdocs on us. In fact, the therapist in charge of our IFI services would constantly bring up issues during therapy that sent difficult child 2 into rages by the time we got home. Not a good experience, to be sure.

Before this last inpatient stay, I had decided to discontinue have difficult child 2 seen through CMH. I just hadn't started the process yet before difficult child 2 wound up having a huge meltdown which landed him back in the child psyche unit at our local children's hospital. One of the requirements for discharge from this particular psychiatric hospital is that difficult child must have a follow up appointment with a psychiatrist within 14 days of his discharge. I had told the staff that I did NOT want them making a follow up appointment with his psychiatrist at CMH. They asked who to make the appointment with then. I said his old psychiatrist, Dr. S. So, they made the appointment & discharged difficult child 2.

The next day is when Dr. S's office called back to the psychiatric hospital to say they couldn't take difficult child 2 back as they were no longer equipment to provide the services he needed. (I did not know that she had move to private practice since we saw her back in May.)

She (Dr. S) can't rx a refill because difficult child 2 technically hasn't been her patient since May.

The psychiatric hospital can't rx a refill because difficult child 2 has been discharged from the hospital. He's no longer under their care, so they can't write a script for him.

The old psychiatrist out at CMH can't rx a refill because they have been terminated as difficult child's psychiatrist/tdocs. (Because we were taking difficult child 2 back to Dr. S.)

So basically, difficult child 2's under no one's care except his pediatrician. The pediatrician won't rx Geodon because it's outside his realm of experience & causes a liability issue for him. (He's not a psychiatrist, doesn't not routinely rx SSRIs, antipsychotics, etc. so he'd have trouble explaining any issues with an rx he wrote to his malpractice insurance carrier should some sort of issue arise.)

Dr. S did make a referral for us to this new practice. I called them on the way home from Dr. S's office. Apparently, she had had her staff call ahead and let them know what was going on & to please help us get the earliest appointment we could. That's the appointment we now have for the 14th. Hopefully, we won't have a long, drawn out intake process with these folks that would prevent us being able to get refills on the 14th. (We ran into that problem when difficult child 2 was initially transferred to CMH. Our first appointment was with an intake counselor/therapist, rather than a psychiatrist. We didn't get to see the psychiatrist until a week or so later & difficult child 2 ran out of medications in the meantime. Hopefully that won't happen with this organization.)

 

[maril]

I called the psychiatric hospital with a "what the heck happened?" attitude. I basically got an "Ooops. Sorry 'bout that" response. And no, sorry, we can rx a refill on difficult child 2's medications to get him through because he's been discharged. He's not our patient any more.

It was their error - they need to find a solution. in my humble opinion, I would call the hospital back and ask to speak to the doctor, who was the admitting at the time of your son's hospitalization, or ask to speak to the on-call doctor. Obviously, you recognize your son needs the continuum of medications and they should, too.

Like life is not difficult enough then these folks we're paying for a service pass the buck (not acceptable) in an important circumstance! I am sorry this has happened to you and hope they take care of this for you. Hope I have not overwhelmed you.

 

[svengandhi]

I would call the patient advocate at the psychiatric hospital and explain the situation to see if they can arrange for even a week's worth to be prescribed/given to your son. I would also call the new place every day to check for cancellations so you can move your appointment up.