The View from the Science Lab

[cabbitzilla]

It's no great secret that I'm battling severe cyclical depression; it's been part of my existance since I was a toddler. The most recent set of medications for attempting to deal with that have been Effexor XR [venlafaxine HCI, 600mg/day] as an antidepressant, Depakote ER [divalproex sodium, 1000mg/day] as a stabilizer, and Remeron SolTab [mirtazapine, 30mg/day] as a sleep aid. And about three weeks ago, that combo began to unravel.

[This is, of course, in addition to the Duragesic [fentanyl transdermal system, 50mcg/hr], Celebrex [celecoxib capsules, 600mg/day], and Ultracet [tramadol HCI & acetaminophen] that I'm already on for the Fibromyalgia.]

It started with a severe nausea that wouldn't let me eat, and two days after the nausea, I was unable to keep food down. Some hasty research revealed that the Depakote was the most likely culprit. I discontinued it, and was pleased to note that the vomiting -and- nausea vanished completely. Great. I made a note of it on my calender, made a phone call to let my therapist know, and was told to simply bring it up at my next scheduled meeting with the medicating psychiatrist. No big deal.

Except without the Depakote in my system, the efficiency of the Remeron was quartered, so I'm back to not sleeping worth a damn. Joy.

At any rate, my appointment with the med.psych was today. My regular Doc is on an extended vacation, so instead of seeing Dr I. Mutlu, I saw his brother Dr. K. Mutlu. And was astounded. You see, I'd gotten used to the 5 minute 'keep taking what you're taking' appointments with Dr I... minimal feedback, and highly resistant to change. I'd expected Dr. K. to balk at my quiet comments that the meds weren't working worth a diddly... and instead got a concerned look. He then proceeded to go through -every- medication I take (including the pain meds), charting it out to see where the interactions were, and then started going through his drug guide in search of something that would work within that framework.

Astounded. Yes, I most certainly was. I've never encountered a psychiatrist that genuinely wanted to -help-... only the ones that keep me coming back for all eternity and never really -hear- what I say. I've a follow-up appointment with him in two weeks; if the approach is the same, I'll switch psychs.

So as of about 20 minutes ago, I'm completely and formally off the Depakote... the pile of it I have will go in a bag and into the bowels of this desk with the other meds that didn't work. I'm also formally 'stepping down' off the Effexor, with Lexapro [escitalopram oxalate]to start up in its' place. And once the pharmacy assistance paperwork has done its thing, he listed off three other medications that could be tried if the Lexapro didn't cut it. He was managing to juggle -all- of the medications, while avoiding putting me on -any- further meds that contribute to weight gain -AND- trying to find something that would also help with the crowd anxieties.

Astounded is too mild a word, but I can't for the life of me think of a form of 'Stupendous' that fits the context. The appointments with Dr. I. always left me feeling discouraged and helpless, and he not once indicated a willingness to try something other than his first appraisal of my needs. Maybe I simply didn't speak up enough... but honestly, I don't think my approach with Dr. K. was -any- different from what I'd been doing with Dr. I., or before him Dr. Ozedmir (Dr. O.). I'm honestly not sure what to think about this... but I'm pleased that Dr. K. -listened- to me.

At any rate, I'm going to try and forage a bit for something to eat, and then play some Civ3 on the PC for a bit until I need to go pick Megan up from work. Hopefully I won't zone out; I'm so damned exhausted I just sort of fade out of coherency for long stretches. I desperately need to take a nap, but I don't think I've got time.

Of course, it's one of those things where if I don't 'have time' long enough, my body will simply shut down. o.0 Hopefully I can avoid that. Anyway, I've babbled enough. I just... wanted to share a nice surprise.

*sleepihugs*
~Elisabeth

Comments

[kyrlan.livejournal.com]

I'm on Lexapro. The side effects seem to be minimal. Best of luck with it, and I'm glad you've finally found a decent doc.

[elisabeth.livejournal.com]

*nods*
He commented that Lexapro was the 'cleanest' of the antidepressants. A good thing... my chemical stew's already too complex. :p

[ginkage.livejournal.com]

Oh, hon...I spent a year living with someone who took Depakote for seizures. Would it be bad of me to say that I'm glad you're off of it? I know far too much about how nasty it can be and what it can do to you in the long-term.

On doctors

[lys1022.livejournal.com]

Darlin', that's the kind of service that you should EXPECT from a doctor...not what you'd been getting, but what this new guy did. You are the customer, you are paying them for a service. It is up to them to meet your expectations as to what constitutes GOOD customer service. If they do NOT meet those expectations, then you are very within your rights to make the fact that they are currently inadequate in that area known to them. If they STILL don't change, then it's time to move on and find someone who suits you. No one EVER has to put up with an inattentive or unresponsive medical professional. That's something I feel very very strongly about, and I have walked out of a doctor's office before and demanded my records from the nurse. When she asked why, I told her exactly why. She nodded, had me sign a release form, handed me my records, and told me that I was the third person that week to do the same.

Don't tolerate it, hon. They aren't gods. They're humans, and as such, they need to be reminded from time to time that WE are humans too and not just charts and numbers.