synergy

Not as Good as It Gets

I've been meaning to write this post for the past few weeks, but haven't been able to find the time. Warning: Lots of med and doctor visit talk in here. Right now, I should really be putting a project plan together for work instead of blogging, but the blogging won out for my last few minutes in the office.

K went to see her psychiatrist a few weeks ago. It was another frustrating visit in terms of scheduling. We had actually scheduled the appointment for Dec. 9, directly before we left town to go to NYC. We show up and the front desk people immediately say "Hope you aren't here to see Dr. X. He's been out of town for a week on a trip scheduled since October." This is the 3rd or 4th time that this has happened to us. The front desk didn't call to reschedule the appointment, because K had scheduled back in September.

We were ultimately able to get in on 12/17 and we let the doctor know that we are continuing to have scheduling issues. He mentioned that it seems to keep happening to us that they screw up. I pointed out that some patients may be too embarrassed to mention the screw-ups to him thinking that it might be their own fault. With both K and I standing there when she schedules, we know that it isn't on our side. The only good part is that we live 1.5 miles from the doctor's office, so it isn't a giant problem.

Last December, Dr. X told K that she is in full remission. We weren't quite sure what this meant, but we figured it was good. What we didn't know is whether full remission meant that things were as good as they were going to get or if K could continue to expect improvement. We assumed that it meant that any remaining symptoms, the irritability, exhaustion, lack of sex drive would remain with her. The exhaustion has been the most difficult to deal with as it impacts K's ability to function. At least once a month, she sleeps 18 hours a day. On the weekends, she sleeps 10-12 hours a night. It interferes with her ability to go out and do things. Finally, we mentioned it to the doctor.

Overall, the doctor was pleased with K's progress. He said that every time he sees her she's doing better. That's good news. Then I brought up my concern about her exhaustion. He responded by saying that K's main problem has been anxiety and depression. Thus, her meds have been tailored towards a sedative effect. As she has gotten stronger and healthier, she has also been over-sedated. He immediately developed a plan to reduce the sedative effect of her medication.

Basically, he is hoping that in 3 months when she sees him again that she will be mostly sleeping without the Ambian. Next, she is supposed to reduce the Trileptal down to once a day, then she is supposed to reduce her intake of xanax. K has started doing this all simultaneously. Just reducing, not eliminating. But the Ambian and Xanax are already as needed. And she had made the decision to increase the Trileptal as a response to her increased rage due to her job. Now that things are settling down, she feels confident that she can return to the lower dose.

The positive message that I left the doctor's office with is that he continues to expect that K should improve every time he sees her. Where she is today is not as good as it gets. Rather, we can hope for better things in the future. That was my best Christmas gift. (Yes, that is a sappy line, but it's true.)

posted by synergy @ 4:44 PM