It is very rare that I have 'oh my word, this person totally gets me' moments. I had the appointment with my new psychiatrist at the end of May. As per my previous post, I was filled with all sorts of feelings and anxiety about this appointment, for all the reasons mentioned there.
The day arrived. I had all my history of Doctors, medications, doses, time on each medication and dose, reasons for changes etc, as well as some questions.
First impressions were not great as he didn't come over and shake hands or introduce himself, just indicated we should follow him. We got led to his office where there was a coffee table with four comfy chairs, and a desk with a few chairs off to one side.
He indicated we should sit in the comfy area, looked at me and simply said, "tell me". Well, that sent me into a tizz, I didn't know where to start, shuffled my papers, started welling up, looked at Mr P for help, so he asked where should we start - at the beginning and work towards now, or work backwards. It was agreed we'd start at the beginning. So I dd.
He listened carefully, asked questions along the way. He got a few phone calls and answered them, which irritated me greatly (until I realised two were from his wee daughter who had a stomach upset, and the other was regarding a patient). I finished my story by saying that I wanted to get a better understanding of my diagnosis, discuss my concerns regarding my current medication, and see if he thought there was anything that could be done differently.
He started by explaining the bipolar spectrum, the different ends of the spectrum (at which point I'm getting impatient and hoping we could move along!), but he was talking, and looking, at both Mr P and at me, and possibly, even more at Mr P. He was explaining in detail what is generally experienced with each disorder. There was a lot of nodding knowingly from Mr P and myself as the Doctor talked.
He then asked questions. How many mood episodes would I have in a year? More than four? Yes. Mood episodes monthly? Um, yes! Mood episodes weekly, or daily? Um, yep again! And, at the end, a more definite diagnosis and explanation than I have ever had.
Turns out, I have rapid cycling bipolar II, and the rapid cycling bit is important, because that can have quite an impact on medication. Depression is my most consistent state, so to try and lift my mood, antidepressants seem like the most obvious medication. Except for the fact that in rapid cycling bipolar, antidepressants can make things worse, can increase the rapidness (is that even a word?!) of the cycling. Finally, an explanation to why I have been feeling that I have been going the wrong way on the wrong hill.
The doctor discussed medication options - wrote them down so I could see them as I can't hold info and options like that so quickly and well. Mr P and I had previously agreed that it was not our intention to come out of the appointment with a medication change. But the doctor was (unbelievably, I know) on the same wavelength as me, so we chose one of the options he listed.
It turns out, one of the medications I've been taking for the last 12 months is not actually effective at the low dose I am taking. I am taking such a low dose because I developed a reaction to the medication so the dose was reduced. According to my new doctor, as soon as a reaction is detected, the medication should be withdrawn. So for the last 12 months I've been putting something into my body that isn't doing me any good. That alone is enough of a reason to stick with this doctor.
Yes, every doctor has different medications they like, different experiences they've seen. But this doctor spoke a language I understood. He has a bio that is impressive and a style that is not daunting or dismissive.
He was open and understanding about my suicidal ideation, and stressed the importance that this is not dismissed, but is taken seriously. He said he was always available to me, and if I had any concerns at all, I was to call him. This gave me comfort (given my previous psychiatrist said she didn't deal with emergencies!), and was proven by the fact he took calls during our appointment.
There was even a light hearted and funny moment that still makes me laugh nearly two weeks on.
Towards the end of the appointment he was packing up the notes he had taken and I told him he could keep the records I had prepared about my history. He picked them up, and kind of laughed. He said that he could tell a lot about a patient who is that prepared. He said it shows someone who actively takes an interest in their health, wants to be stable, participates in appointments and treatment, and then the funny bit - is also very particular, strives for perfection, likes order, and some level of control....
Mr P and I just laughed and said 'yep!'. He summed me up pretty well, and it freaks me out slightly that something as simple as handing over an Excel spreadsheet can tell a psychiatrist so much about me! Hmmm.....must remember this in future!
Result: successful first visit, there will be more, and now we wait for the changes to medication to start making an impact. Apparently there could be a more stable life in my future.
With slightly apprehensive positivity and love, Becs xxxx