Let's just change those meds.

Let’s just change your meds.

It sounds so very simple. But there is so much more to it than that. I recently had to go to the VA, Mental Health because my medications that I have been taking for years are now on a refill list of just three months. That means every three months I now have to go in and see the psychiatrist or one of their subordinates. I was low and called to have the refill just put back in again, something that I have done for years. That was when I found out that I am on the three month list….oh yea, something new.

I was told that I could come in that afternoon, if not the next time was in weeks. I was almost out of meds, I needed them refilled, so I put everything to the side and went to the VA. I was not happy about being there, but I knew it had nothing to do with the front staff, or the nurses, so I was very polite to them. I was put in the room with the subordinate of my psychiatrist, someone that I had seen once before. We had not really meshed the first time, it was not a total loss, I thought she had at least listened to what I said, but I had my doubts. I am completely annoyed by “mental health professionals” who think they know so much that they are going to somehow open my eyes to something I never thought of and it will change my life, I just need to…(fill it in with anything, I think I have heard it all).

So I am already annoyed, I have a headache beginning and I am wondering why I have to see someone before I get my medication refilled. I am not in there but a few minutes and she asks if I am upset. Usually I just keep in the annoyance, but I had a headache and did not feel like being there. So I was upfront, I was upset that I had to go in for my medications to be refilled. She started in with the “it was not my idea, I am just following what was in the file.” I understand protocol, I was there so it should be an easy fix, just refill my medications. She starts asking what symptoms I have, so I become completely clinical on her, I list the names of them, so she can just go down the list and check the boxes. She asked what I wanted. I wanted my medication refilled and to add a sleeping pill, one in which I had taken before. So the sleeping pills worked? No, they did not work to the extent she was talking about. I was getting 3-4 hours of sleep and there were some days that I just could not seem to shut down. I had taken many sleeping pills and I was picking one that had the least side-effects for me, but still would knock me out. I usually use them on nights that I have nothing the next day to do. They make me really groggy in the morning and my mind just fogs for most of the day. I have learned how to cope with that, but it does give me sleep, and my body would be worse off without the sleep.

She responds to my annoyance with going through the last appointments that I cancelled. I had no problems, there were good reasons. One is that I try not to have any appointments in the morning, which means if they have scheduled one, I call and cancel and tell them that I want one in the afternoon (as it states on my records). Oh sure there are times that I have to do the morning ones, but they usually are labs, or when I need to see my Primary Care Physician and that is the only times open for the next month. Side bar- my doctor is very wanted at the VA, so I usually cannot get in to see her without an appointment months ahead, and I do mean months. I have called and asked if anyone cancels I will take their, just call. Those are the ones that I suck up the morning time just to be able to see my doctor.

So I tell her, if I called and canceled, it was for a good reason, and I would have, when I canceled asked to be rescheduled, but that does not always happen. So she starts off with, well if she had asked someone to do something, and they had not, she would call back. Very apparent that the VA is not the system she uses for her healthcare. I am not about to wait on the phone, calling all day to be put on hold to get an answering machine that states it is either full and cannot take any more messages, or that it is not set up to take messages. Yea, that is the one that I love. I get an answering machine that is not set up to take messages….oh so VA. So over the years, unless it is an appointment that I really care to go to, I just let it slide until they come around and get one for me again. The therapist appointments are different. I go here and there, if I am not having any real difficulties I cancel and do not get another one. That was the appointment that she decided to get stuck on. I was completely honest, something I have been told over and over (by my husband) not to do with the VA, or I will end up locked away. As I have said in my previous writing, I am not about to be taken alive by the VA to be put in any type of mental facility. I will deny that I am a veteran and pay if I ever need that type of service. I am not about to trust the VA with my life after what they did to me, never again!

So she asks what responsibility do I have in the fact that I do not have any scheduled appointments for the therapist. It was mistake on her part. I said none and she about fell out of her chair. No, if I am given an appointment that it states in my records that I only do afternoons for therapy, and then get one, call, cancel and ask to be scheduled and not be. No, that was where my responsibility ended and the VA’s took over. So she picks this statement off the wall that she had taped up and shows it to me. Really I scanned over it only, but then looked at her like “and?” So she talks about the symptoms that I still have. I tell her yes, I have them and I will have them for the rest of my life. I understand that, accept it, and have created coping skill to deal with it. I also know that every once in a while I will have to add another coping skill, tweak the ones that I have and/or dump some. She goes on the aggressive, as if I have told her that there is no reason for her, to me. But it is true, I was there for meds, I was not there to talk, and I am sorry but I am not about to talk to someone that feels that I am not trying hard enough.

I said that the pills keep me at a level that I can handle. She kept trying to make me agree with her that the medication took care of the symptoms, a VA technique to decrease my percentage if they get the chance. So again I tell her (which I hate to repeat myself at these little get togethers), that no, I am at a level that is an acceptable functioning level for me, that is what I said. She pointed out that I was still have some serious symptoms, and I said that I know what level I function at. So she does one of the silliest things, questions “How is that working for you.” Oh, yes, the ultimate Dr. Phil question. I look straight at her and say that it is working just fine. Another slip off the chair. So she says she wants to try me out on some different sleeping pills, than the ones which I have said I wanted. Why? In all seriousness I believe she wanted to be in control, and I was not about to give her that control. I told her what I wanted and she wanted to try something else.

She said it was a sleeping pill that I would not become addicted to, as if I was to the ones that I wanted. No, I take them as needed, maybe three or four for the month, no that is NOT addiction, that is using a medication to get the results that I want and not relying on it for everyday use. She wanted to drop my current medication in half. She said it was because the sleeping pills she was thinking about were “cousins” to my med, so I did not need that dose. Wait, yes, she did not listen to me when I said that I use the sleeping pills only when I cannot sleep and need to, that occurs about 4 times a month. They are either nights that I have something I need to do the next day, and be awake for, or I just have not had a lot of sleep and it is seriously effecting me. So I ask how do I take the sleeping pills, she says every night. No, I am not interested in having to use medication to get to sleep. I have gone down this road before and all I was was a vegetable. I would sit on the couch, watch TV, well stare at the screen, but that was it, I was a zombie, and not the fast moving kind. Again she had not listened to me.

I flat out told her that I was not about to decrease my medications that I was currently taking and that was what myself and the psychiatrist had agreed upon, pretty much I told her, “you know, your boss.” She said that in our previous session (you know the only one we had had) that I was more willing to work with her. Now I had moved from annoyed to mad. I wanted to stand up and yell “just refill my drugs!” I was done with the little bit of niceness that I had left in myself. I said that I wanted a sleeping pill, one that I did not take every night, one that did not cause weight gain, and had the least amount of side-effects. She said that I had taken it before, but on a level that she never prescribes and that it probably made me feel like drugged because it was an over… she caught herself, but it was out. Yes I had been given a drug to the level that it was an overdose, and it was totally known. And you think I am about to trust you?  Do not think so.

So she tells me that this medication at the level that she would give should help, but she had to tell me about the side-effects, so she began and said that she had only seen it once and it was in an emergency room. Whatever the name of the disorder that had been called, well I did not care, I had been on this before, at a level she thought was an overdose and did not get whatever it was, so I doubt that I would have it. Then she said another one and said that it was really rare and she had never known anyone to get it. Ok, so what the heck? Just tell me that is was a possibility with all the other listed side effects, and if I have a problem then I would definitely not take anymore and get medical attention. Well after all this lengthy conversation she states that she first wants to see if I have this heart condition which can be caused by the lengthy use of the meds that I have been on. She wants an EKG, great. So I go with a nurse and get one, the go back in and she says that I am not to the level yet, but that she does not want to prescribe something. I really was not paying much attention at this point. I knew that I would get the medications that I do on a daily basis refilled, and I would have to wait to see someone who would listen to me for the sleeping pills. So she asks what I want to do from there. Oh, I was so close to just telling her to get over her power trip and do what I asked, and what had been agreed upon before by my psychiatrist.

But why not just change the medication, to try something different, that maybe it would help these symptoms that I have and listed? Well, I do not just have PTSD, I also have been chemically poisoned and have brain damage (to be blunt). I had numerous head injuries in the military, I saw the change after the last and I knew that what I was telling her, the symptoms she kept attributing to my PTSD was not, no, they were from TBI and that does not change after 25 years. It has been increasing in severity and symptoms over the past five years rapidly. We had talked about the whole thing the first “session” we had. I was not dealing with something that I could talk through, that did not have a triggers, it was a chemical imbalance, brain damage, and I was tired that all she kept seeing was “PTSD.” And all she kept hearing was that I had symptoms, so why would I not want to try something new?

Now, after all that, I come to the answer. Changing medications is not like changing your clothes. I have to taper off (at least I should, sometimes I have to remind the doctor, or nurse that there needs to be tapering) the current medication or dose (lowering is not just dumping a pill, instead of twice a day you take one). See the medication that I take is to be on the level of 150mlgs for the entire day, so twice a day I take it, so that it is in my system for the entire day. She wanted me to just dump one, not go down and take a lower dose twice a day, just one. That was a serious red flag for me. Going on and off medication is hard on the body and the mind. I have a very sensitive system and taking or not taking something really messes me up. She wanted me to dump a pill and add something else. Do NOT think so. I am in the middle of a move from one town to the other, that’s stressful, especially for me, and during this time instead of listening to what I know will work, to what I know will allow me to function, let’s just mix it up. Let’s give me more migraines as my system gets used to the medication (if I can stomach it in the first place), and if all of this is a mistake, well, you have to come in to get the increase back to what was working, then wait the days while it is in the mail (our clinic does not have most meds on site, they come from the VA hospital in Louisiana).

Finally I leave, I have my refill, I have some other sleeping pill prescription that she thinks will help. I am skeptical, but really just gave up with her. Again had I said the truth, I think I would be calling my husband to bail me out. The irony is that he screens people in the ERs and jail to see if they need to be immediately hospitalized in a mental facility for their and other’s safety. So I wait, in the mail and the medications arrive. I look at how to take the sleeping pills (every night, love that I was listened to so well for), then on the label it has a warning, to not take this medication with two others, they happen to be allergy pills, they happen also to be the two allergy pills that I currently take….oh, the VA. I have two different medications for allergies, I take one and when it does not work I take the other, off and on I have used them like that and it has been the only thing to help. The “allergies” isn’t seasonal, it is something that is all the time and the rash that I get with it complicates things. So this is what has worked, but to have them on the warning label just makes me laugh. Oh the VA, you can try and kill me off, but I am a lot smarter and very leery of what you “prescribe.” Oh, I do not know if taking the two would actually kill me, but I have been prescribed medications in the past (one from one doctor, the other from mental health doctor) and asked the pharmacist tech I knew to put them into the system, red flag, death was the outcome. So I never take anything that I am given until I go online (back then there was no “online”) and check things out. You would think that the VA system would catch it, that there would be some red flag come on the screen, since they are dispensed from the same place. Oh, yea, they will be hearing about this one. But to not even have to go online to see the red flag, that is just so ironic. Let’s just change up those meds again, okay…. No, I think that I will stay with what I have, it works and I do not have the time to die or go for a really fun ER trip. With the moving I do not have time to play the VA game, so I will take what I know works and wait for the next appointment to get the sleeping pills.