What should I do???

[totoro]

So I never heard back from the psychiatrist! I am assuming she is not going to call? So I tried to call our last resort, the Hospital that has a pretty good rep, for psychiatric, Residential Treatment Center (RTC) etc. I was seeing if they had any outpatient psychiatrist's or any leads. Last I had heard they did not. So I talked to a woman in the psychiatric dept, she said oh we work with 2 psychiatrist's... gee, one was our psychiatrist and the other was one who is not taking any new patients and referred me to psychiatrist!!! I told her my dillema. She said that is not acceptable...and she would be troubled by not having the psychiatrist call back either and it was very troubling! But, she said we are saturated here and I am sorry I can't help you. I also asked again about the only developmental pediatrician, who is at that hospital also, same answer, she is so far out still. But I got her number again anyway.(for difficult child 2)

So do I go to my follow up apt with psychiatrist? And how do I breech the subject about her not calling back without getting, very upset??? The apt is in 2 weeks. I have to go by myself with difficult child. I just don't want to lose it on her!!! But I want to get the point across that we need her to be available, I just feel like our backs are against the wall. Because she knows how desperate people are to get in to any psychiatrist... If I complain, who else am I gonna go to? Can I really fire her???
I am going to keep calling all of the ones that told me no and try again...ugh.
I think our pediatrician will work with us if we have no psychiatrist and are desperate, but obviously she doesn't want it this way!!!
This is all temporary until we can figure out how and when to move... we are thinking in a year. So we just need to get through this year. I think, that is our plan so far... we just need to get her some help, somewhere. We are thinking Tucson. So if anyone knows anything about Tucson, good or bad please let us know.
Thanks!

 

[TerryJ2]

Yes, you can fire a doctor. It's a free country.

You can also sue a doctor for abandonment if they have taken you on as a patient and they are unavailable. You have to be able to prove it, though, ie. document phonecalls, paperwork, etc.

I can understand your frustration. I wish I had more to offer. How is difficult child doing?

 

[DammitJanet]

Tot...

I would keep the appointment and try to make appts monthly with her. I would mention to her that you tried to call and she didnt call back. Say something like..."I am sure you must have not got my messages because we were really worried about difficult child and tried to reach you" and see what she says. If she fluffs you off, then just make the appts for monthly and work with your pediatrician as best you can between appts.

Start the move as fast as possible. Do you have a Realtor yet? LOL. Need boxes?

Do contact psychiatrists and therapists in Tucson before you commit. Interview them by phone. Make sure they are available. You dont want to jump from the frying pan into the fire.

 

[SRL]

I wouldn't even start with this psychiatrist. If this is what you are seeing now, this is what you will see later. Given that medications are involved there is a safety factor.

Would your pediatrician be able to work together with the Chicago psychiatrist--as in treat together using consultation/conference calls? I usually wouldn't recommend this arrangement but your geographic area does limit you more than most families and a concientious pediatrician who would work in close consult with a psychiatrist would be preferable to a psychiatrist who can't be bothered to pick up the phone.

 

[totoro]

Terry- oh I know I CAN fire her, but would it be in my best interest to fire her??? I would be without a psychiatrist at that point if I fire her. With no options...We are trying to get difficult child titrated up to a good dose on Abilify and then add the Mood Stabilizer. I would like to have a psychiatrist to do this, but what good is a psychiatrist if she aint calling me back!?!?! At that point she would just be someone giving me a script... like a drug pusher or dealer...

difficult child is an anxious, up and down, insecure, sensitive, morbid, hungry, hyper, inflexible, beautiful little girl!!!
Thanks for asking!!! But her violence and rages are still controlled!!!

 

[totoro]

Janet- yeah can I take a vacation to pick up the boxes??? Here your part of the country is beautiful!!! I agree with your post. We have been looking into school and hospitals, psychiatrists etc, just getting a list together first.

SRL- I asked psychiatrist in Chicago about this and because she will not be able to do a face to face often enough, she feels she really can not properly advise us on how to medicate difficult child, and pediatrician feels she is afraid of the possiblity of malpractice. She said as her psychiatrist she would want to see her a lot more frequently to feel confident about her treatment. Which I love and I wish she was closer!!! She is really good.

Oh I am just flustered... why is it so hard? husband thinks we should just keep her on the Abilify and wait to add anything else until we find a new psychiatrist, be it here or Tucson. But I worry what if the Abilify peters out and she needs something else or she gets worse? She needs a mood stabilizer now, but do we just deal until the move?

thanks sometimes just venting and hearing what you all think helps...

 

[pepperidge]

Totoro,

It is not uncommon I think for psychiatrists to give parents some leeway in raising their medications. (not to defend your psychiatrist for not calling back). I like the idea of monthly appointment's. If you are still going up on abilify, then I owuld try to clarify with her, how often you should raise the dose and by how much. We worked with a psychiatrist at some distance. We had a schedule we were following. The idea was to keep raising the dose of whatever until we reached the agreed on limit as long as we saw positive improvement. We saw negative reaction we titrated back down. I felt comfortable doing that knowing what I was looking for in terms of negative and positive symptoms. Of course, I also did a lot of reading up on medications too on my own.

So I think your best bet for now is to try to work out a systematic plan for what you are doing in terms of medications--and then doing that between visits. You have your pediatrician for emergencies in between times (and I bet she would answer your pediatrician's call). So what to work on in the visit is what your overall plan is re the Abilify and whatever else for the following month.

For me, having a psychiatrist that had some confidence in my ability to follow an agreed on plan and to allow me to make some small judgements on moving up or down doses was a real blessing. I documented and we discussed.

With so many of these medications, there is no one right dose; so much of it is trial and error anyway. Part of the battle is being systematic and trying one thing at a time to try to isolate whether something is helping.

I think as you gain more experience you will feel more confident in your abilities. I might tell your psychiatrist that putting your young child on medications makes your very nervous and is there a way to check in with her via telephone or email briefly bewteen app'Tourette's Syndrome and see what she says.

Not again to excuse her, but if the psychiatrist situation is that dire, the poor doctor is probably totally overworked etc. You might ask if there a pediatric nurse practioner who specializes in pyschiatric issues that she works with for you to have telephone consults with between times when she is hard to reach.

It will be hard to let go of your anger etc before the appointment but it probably isn't going to accomplish too much. AT least, focus on what you want out of her before you unleash the anger!

I agree, it really stinks. good luck

 

[timer lady]

totoro,

You're between a rock & a hard place. Speaking for myself I'd keep the appointments & bring up your concerns with psychiatrist.

difficult child is being prescribed some intense medications that a pediatrician usually isn't comfortable prescribing or monitoring.

I know that you're searching for a more difficult child "friendly" area so you can find help - in the meantime, you shouldn't go with-o some level of support.

I'd be concerned for you.

 

[flutterbee]

Ditto what pepperidge said.

 

[Liahona]

I don't know how far up in Idaho you are, but maybe you could try someone in Utah? There is a university in Logan and one in Ogden. Maybe just for a year until you move?

 

[totoro]

I am as far north up here as you can get!!! Spokane is our nearest "city" that is were I am going to for all of these apts, out of state...

I guess I would not be upset if, when I asked at our first apt. If I had any questions what should I do, because at this point we were deciding if we were going to Difficult Child the Risperdal and the Trileptal, She said to us, "call me" and gave us a card, and I said "so that is OK?", she said "if you have any questions just call".

I don't mind making the decision to increase to a certain point, but we were using her samples and we are taking the trip to Chicago and then Tucson this week and I wanted to discuss the trip and her anxiety... and I needed a script to travel. Luckily I got it from pediatrician.

I think I will suck it up until we can move... I just worry what if something bad was to happen and she is our only choice? What if difficult child gets psychotic again???

Thanks for all of the replies.

 

[LittleDudesMom]

Conventional advise is not going to fly in this case. Most of us would just say "find another psychiatrist!"

I believe that I would call the psychiatrist's office every day until I got a return call. "I called yesterday and left a message for Dr. X. and I haven't heard anything yet. It is very important that I speak with her concerning my daughter's medications. If she is unavailable now, I would like to leave another message." I would do this until you get a call back because the secretary is so embarrased to keep taking your call.

Then, at the next appointment, I would address it in an extremely calm manner. That you understand how thinly she is spread with her case load but you do expect a doctor to call when a patient has a medication question or concern. Is there a problem with that?

Then, I would make monthly appointments as Janet suggested.

You are a year off from moving. I would not wait to work on stabalizing your duaghter. You will have monthly pdco appts. and your pediatrician for emergencies.

I can only imagine how incredibly frustrating this is for you.

Sharon

 

[oceans]

Sorry that things have been so crazy! I guess you have no choice but to stay with this person for awhile. I would make standing appointments in advance, and I would say to her in a non angry way that you had concerns you were trying to talk to her about and did not hear back from her. Ask her the best way to reach her if you need to contact her again. Did she give you her pager number? There needs to be someone on call to be paged anyway if she is not available. Perhaps next time find out how to either page her or the other psychiatrist on call, and if she does not call you back then page.

A year sounds like a long time to be going through what you are on a continuous bases. I hope your trip to Arizona goes well and you find the support that you need there. Perhaps there will be a way in which to move there sooner!

 

[timer lady]

totoro,

Are there resources at EWU? I lived in Spokane for a year or two; my brother went to school there for speech pathology. He was an intern but I forget at what hospital there.

I can't remember if EWU has a teaching hospital or not.

Just a thought for you to check out.

 

[Fran]

Absolutely don't lose it. You end up with no credibility to the pdr.
I would ask what the call back policy is and will continue to be in the future. If it is not satisfactory to you then you may have to look around again but in the meantime you don't want to throw out the only dr. around. It is not safe to have a Dr. not return calls but it is not a good idea to not have a Dr. who has a specialty in pediatric psychiatry.

 

[Wiped Out]

Totoro-
I have nothing new to add to the great advice already given-just wanted to say I'm sorry this is all so difficult-it shouldn't be-it isn't right. Hugs.

 

[rejectedmom]

Totoro, With my difficult child's when they were in therapy I got a set weekly appointment. Occasionally the therapist had to re arrange due to a crisis but with a weekly slot we were never far out from a visit. -RM

 

[pepperidge]

totoro

you don't need to wait to move to begin a mood stabilizer. again, the advice is be deliberate in what you do. Have you maxed out on Abilify? Get to whatever limit the docs thinks is good there, then discuss what mood stab you are going to add.

Assuming at least that your psychiatrist has a good sense of medications, you can do this before you move.

just get those monthly appts and clear indications of what negative side effects to really look at for and you can do it. you are doing the go low/slow and that's good.

Again it is so much of a trial and error thing anyway that you may have to try one or two before you find the one that really helps.

sorry that you are going through all this.

Chris

 

[TerryJ2]

Good advice, as usual. :smile:
Sounds like you've made a decision, Totoro, and having a scrip for a trip is a good plan... you don't want to be with-o.
So, how long has it been, exactly, since you left a msg with-the psychiatrist and didn't get a call back?
What exactly did you say on the msg? Did you say it was an emergency? A gen'l Q? Did you give the receptionist a very specific time you will be leaving town? Otherwise I'm sure there are zillions ahead of you.
Stay calm. :smile: