Connect
Using physician for medication management
I don’t have insurance and on the advice of my former psychiatrist am having my primary care physician prescribe my meds. He (psychiatrist) said I’ve been on my current medication long enough to know if it’s working or not, and how to tell if my levels are too high or too low. (There are specific physical side effects to both.) Since I see her (doctor) once a year anyway, it saves me a lot of money having her order my labs and then go over them with me and, as my psychiatrist noted, frees him up to see people who need him more then I do. The problem I have is that she is not a mental health professional and I’ve disagreed with her assessment of my results.
I take carbamazepine. Normal levels for bipolar and bipolar II disorder is 8-12. For epilepsy it is 2-6. The last 2 times I’ve had my blood checked I’ve been at 4 and she says that’s ok. I disagree but, I’ll admit, I didn’t stand up for myself enough. I just took extra meds. (My prescription is 600 mg per day. I started adding an extra 200 mg every 2-3 days.) Thing is, I feel so much better. I don’t feel down all the time and I even find myself listening to music and dancing around my house.
I will be moving soon so don’t see any point in telling her. Problem is, what if she is doing this with someone else? She isn’t the type of doctor to be egotistical but I hate confrontation of any kind. I don’t handle it well. Any suggestions?
Like
Helpful
HugInterested in more discussions like this? Go to the Depression & Anxiety Support Group.
Connect
It's a tough call. Each doc has his or her own protocols and "normals." These may be dictated by lawyers and not doctors. If a doctor gets adventurous with treatment and anything goes wrong, boom! Lawsuit for millions, so they treat the verdict, not the patient.
Let's say blood sugar is 116, right at the margin of diabetes. One doc says "You are not diabetic." Another is upset with your numbers and keeps reminding you you are diabetic and to test. Or, one is laid back and doesn't give you a Hep B shot, another, when she sees the chart goes ballistic.
Doctors can be OCD and have personality quirks too.
A danger in shopping around is finding one who agrees with you, and you like. What if you're both wrong? Doctors like good patient ratings, so some may just tell you what you want to hear.
If a higher dose works better for you, it's your call. If you tell your doc, she may take offense as in "What do you need me for, if you're gonna self prescribe?"
You may have more leeway with your physician than psychiatrist, but don't get on anyone's "wrong side."
There is no one answer. It's complicated. Good luck dancing around 💃.