Another Damn Referral

January 3, 2007 at 3:11 am 2 comments

So, as mentioned in a post yesterday, I was going to see my GP urgently. I was waiting for half an hour in the waiting room. At one point I was seriously considering asking the receptionist if there was somewhere quiet where I could wait by myself. I was feeling very disorganised and agitated. I felt like I was shivering. It was like the world had been turned up to maximum volume. Everything looked very visually active and the normal sounds of the waiting room seemed terribly loud and oppressive. It was like a low-grade panic attack, but longer. It’s worn off slightly now and I feel like I can organise my thoughts better, but it’s still there. I’m having difficulty keeping still.

My conversation with the doctor was strange. There’s always a part of me that remains the calm, rational observer, checking off boxes and noting down behaviours. That part of me thought I was acting crazy. I was finding it difficult to speak coherently and I felt like screaming at myself to say things right. My GP wanted to see the cuts that I did earlier. I’m not sure if I’m just paranoid, and it’s not as if I really care, but I definitely got that freak-under-the-microscope feeling. I told her that I’d been getting worse these past couple of weeks, that I’d been off work and my sleep cycles were completely screwed up.

“I don’t know what I can do for you,” she said. This did not inspire confidence. She wanted me to see her husband, another GP who works at the same surgery. She would discuss it with him and they would see what could be done. Then she called the receptionist in. I still had my cuts on display when she walked in. Some warning would have been nice. It’s not like I show these things to everyone if I can help it.

The appointment’s tomorrow morning. This will be medical person number 4 who I’ve seen since this all began. None of these people have been mental health professionals. Is it just me, or is that completely fucking insane? I know damn well that the mental health trust has provision for at least a community psychiatric nurse (CPN) to do proper assessments. As a self-injurer, I should, according to the government’s own guidelines, have been assessed immediately. Waiting a month for a counseller to come back off holiday so I can get an initial assessment of my needs is ridiculous. Being passed from doctor to doctor is not what I need. Seeking help is hard enough without these people making it even more difficult.

Here’s what I want to happen: I want the GP to refer me directly to a psychiatrist. I’ve tried counselling before and it wasn’t very helpful then. I have no reason to suppose that it would be now. If the psychiatrist believes it would help, based on his expert medical opinion, then I’ll be happy to try it. And I want to be prescribed something that will help with the anxiety in the meantime. Hotsandybeaches suggested Seroquel, and I want the doctor’s opinion on whether that will help.

So, I’m making a list of questions to ask tomorrow.

  1. Can you refer me directly to a psychiatrist?
  2. Can you refer me directly to a sleep specialist?
  3. If not, why not? Who can? What are the chances of me actually seeing someone with the skills and training to properly help my long-term, potentially fatal condition?
  4. Is there anything that you could prescribe to help me while I’m waiting?
  5. I’ve heard that low doses of Seroquel can help in these situations, would that be helpful for me?
  6. I’m worried about the impact this will have for me at work. I want to be back at work as soon as possible, but don’t feel capable of doing anything at the moment. Can you sign me off until I have this under better control?

If anyone has any suggestions on other things I should be asking, please comment in the next seven hours or so. Thanks.

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Entry filed under: Circadian Rhythm Sleep Disorders, Depression, Docs and Shrinks, Self-harm, Seroquel. Tags: , , , , , , , .

Mothlight (a poem) Signed off

2 Comments Add your own

  • 1. sisiphus  |  January 3, 2007 at 4:38 am

    Good post and list of questions. They are all very pertinent and it is a shame that you have to do the asking; that your GP hasn’t suggested the answer to these when you initially saw her. I’d have thought that she would have talked about all these with you when you showed her the self inflicted injuries. Any half-decent GP should. But, as I have pointed out in my own various posts, many GP’s have done little or no training in psychiatry and their ignorance manifests itself when presented with a patient whose needs are straightforward enough for any GP who has some knowledge and understanding of the subject.

    Be prepared for your GP to appear irritated by your questions and suggestions. I hope that this doesn’t happen, but I have seen it happen, so remember that if that does happen that is not your fault; it probably stems from the doctor wanting to remain in charge and his/her own agendas.

    I can’t advise on medication; it would be unprofessional of me to do so over the net, without knowing you and seeing you as a patient, but if your GP gets ruffled by your question about seroquel, ask him/her whether there is any other medication that would help….there are a number that could. If you have been feeling suicidal ask him/her if they can arrange for the pharmacy to dispense the medication in small doses e.g. one prescription but the pharmacist will dispense only a week at a time. It will mean more frequent trips to the chemist for you, but it will help to take away a potential source of more harm if you suddenly and impulsively thought of overdosing.

    Ask if there is anyone in the local community psychiatric team who can see you; if you are unable to get a referral to a psychiatrist soon, then a skilled member of the community mental health team should be able to see you sooner and they will be able to hasten your assessment by a psychiatrist if they are concerned about you.

    Ask if there is a psychologist who might be able to see you. It is rarely possible via GP referral, but worth a try.

    Ask who you could call if you are feeling desperate (apart from the Samaritans). Ask what the GP thinks would be a good idea to do if you are feeling suicidal.

    If all else fails, if you find yourself in a desperate state, then there is A/E. I don’t know what your part of the country is like, so it may or may not be a helpful suggestion. Keep enough money in an envelope for the fare (if you can afford a taxi, keep that fare in the envelope) to A/E, as you may not be in a fit state to drive/take public transport when you need help urgently.

    I wish you luck and hope that you are successful in getting the answers to your questions and help for your problems.
    I will be interested to hear how you get on.

    All the best,
    Sisiphus

  • 2. experimental chimp  |  January 3, 2007 at 6:31 am

    That’s great advice, Sisiphus.

    I think the attitude of the healthcare system towards me so far could best be described as concerned apathy. Everyone was concerned, nobody’s actually done anything to help me.

    What concerns me is that I’m fairly intelligent and am reasonably good at finding information about things and it’s still a struggle to work out what the medical system should be doing about me, what kind of treatment I should expect, what should be available, and what to do if it’s not. I have no idea how people who are less able to do the research, or whose illnesses are more imparing, are supposed to be able to understand what’s going on. I suspect that they’re not. At least not in primary care.

    Hopefully after my appointment tomorrow I’ll be able to at least see a path forwards.

    Thanks for your help.

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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