Talking About Treatment Choice

In my Google Alerts yesterday I received a link to a revolutionary article posted on The Sun website. Now I don’t know the politics of The Sun, yet you can bet I’m more than willing to link to the article that appeared in my inbox.

I stopped taking SZ medication in 1992 under a doctor’s supervision. Yet even though I had a mild form I relapsed within 3 months and had to go back on the Stelazine. It’s why I choose to take a maintenance dose of Geodon every day.

It’s why I’m going to link at the end of this blog entry to an article in The Sun online.

My ancestors arrived here in the 1890s from Italy. Yes, mental health issues have run in my family since the 1890s–no kidding, this is a fact.

The quote is: “Genetics is the gun. Environment pulls the trigger.”

We each of us deserve better than to be told we’re wrong for choosing how we want to live. This choice might include taking medication for those of us who need it. We each of us have the right to choose recovery in whatever form our recovery takes.

Here’s the link to the revolutionary article in The Sun:

Neurotypicals Need to Cool It with the Advice

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Women with SZ and Menopause

I find myself drawn to wanting to write about health topics.

Yet again I’m going to be the first person to write about a hot topic in recovery.

NAMI isn’t doing this and neither is MHA.

No one except me has dared to focus in detail on SZ and recovery at mid life. We need to have this conversation now.

For women, you’ve hit menopause when you’ve gone 12 months without your monthly period. As you approach 50, your primary care doctor can test your hormone levels.

Reading the book Menopause Confidential: A Doctor Reveals the Secrets to Thriving through Mid Life by Tamara Allmen, M.D. might be helpful.

It’s a short book yet has vital information. You can also read Body-for-Life for Women by Pamela Peeke, M.D.

Women as we age gain fat in our abdomens–the dreaded “menopot” according to Peeke.

Her book talks about the 4 stages of a woman’s life and how to cope with the changes we experience in each stage.

It’s possible to not have it so hard when you’re in menopause. Taking 400 mg of Vitamin E is thought to help with hot flashes. You can ask your mother what kinds of symptoms  she had at menopause if you’re able.

The average age of getting menopause for American women is 51. I’m 52, and I have 2 months to go. So far, I’ve had no hot flashes, I’ve been the same weight (because I strength train), and I still have a photographic memory and no fuzzy thinking.

It’s a joy not getting your monthly period.

Yet if you’re having sex, make the guy wear a condom and get tested for HIV/AIDS. People diagnosed with SZ have a higher risk for HIV/AIDS, according to research I reported on when I was the Health Guide at the HealthCentral SZ website.

A More magazine news article years ago reported that a significant number of women over 40 develop HIV/AIDS. If I remember right the statistic was 1 in 4 women over 40. They’re not having a guy use condoms, and they’re at higher risk.

I’ll end here with what I think makes sense:

If you have to take SZ medication, or thyroid pills, or whatever you have to take, do this to have a better life at 40 and beyond. You shouldn’t have to be in any more mental, physical, or emotional pain than is absolutely necessary.

A therapist told me years ago: “Suffering for the sake of suffering is bullshit.”

In coming blog entries I’ll feature a guest blogger–a guy who’s a peer in his fifties–to talk about mid life from a male perspective.

I’ll report more about the female view of mid life in the coming months.

Holiday Season

I want to write about the holiday season.

At my Left of the Dial blog you can read about my experience with the United States Postal Service.

In here I want to talk about how the holidays are often hell-idays for a lot of us living with a diagnosis.

I lost my father in January 2016. I lost a beloved aunt in March of this year.

You are not alone if you are actually depressed at this time of year and not in a good mood during the festivities.

What can help us feel better when we’ve lost our loved ones or otherwise don’t feel like celebrating?

A modest amount of retail therapy could help. Doing a bout of spring cleaning now might seem counter-intuitive yet it might help too. Helping others by volunteering at a soup kitchen could help you.

My friend who is a soul mate to me I really think he is told me:

“Just be a good person and do good.”

That was his advice for helping yourself overcome having a hard time.

Just be a good person and do good is what I urge my loyal blog readers to adopt as a life ethic.

When all else fails, strive to get at least 7 hours of sleep straight through every night as often as you can.

I will end this blog entry by thanking you for reading this blog.

I’ve reached 5,000 visitors so far which is a great thing.

Gracias. Merci. Grazie.

A million thanks.

Ongoing Psychiatrist Questions

Questions to Ask Your Psychiatrist (Ongoing)

  1. What is my diagnosis and how did you come to that conclusion?
  2. What medication do you propose to use? (Ask for the name and dosage level.)
  3. What is the biological effect of this medication, and what do you expect it to accomplish?
  4. What are the risks associated with this medication?
  5. How soon will we be able to tell if the medication is effective, and how will we know?
  6. Are there other medications that might be appropriate? If so, why do you prefer the one you have chosen?
  7. What are the side effects of the medication? How long should I “wait out” any side effects before calling you?
  8. Are there other medications or food that I should avoid while taking this medication?
  9. How long do you expect me to be on this medication?
  10. How often will I be seeing you until the medication takes effect?
  11. If I’m taking more than one drug, when and how often should I take each one?
  12. How do you monitor medications, and what symptoms indicate that the dosage should be raised, lowered or changed?
  13. Are you currently treating other patients with this illness?
  14. What are the best times and what are the most dependable ways for getting in touch with you?
  15. What do you consider an emergency if I have to call you after hours?

Feel free to add your own questions.

New Psychiatrist Questions

New Doctor Questions

  1. If I need to call you, how long do you usually take to respond?  Do you have another doctor on-call if you’re on vacation?
  2. If I ask you questions, will you give me detailed information about why you think I need a certain treatment? I need to know the rationale behind your suggestions.
  3. What drugs do you frequently prescribe to your patients? Have you had success with these drugs?
  4. How much experience have you had with atypicals?
  5. Will you prescribe drugs “off-label” if you think it will benefit me?
  6. Will you discuss any side effects of the medication you’re treating me with, and do you have a plan in case I develop a side effect?
  7. Is your focus on mental illness treatment and recovery, or do you have a general clientele? Are you willing to be creative in custom-tailoring solutions to my treatment needs?
  8. If my parents or a third-party person needed to speak on my behalf or talk to you about my treatment, how would you handle that?
  9. What would a typical session with you be like?
  10. Do you have an area of expertise with certain illnesses?
  11. Where did you get your degree? Are you Board Certified?  How long have you been in practice?
  12. What do you feel challenges and inspires you as a doctor? [This could tell you a lot about their personal work ethic.]
  13. What hospitals do you have admitting privileges with?
  14. Are you willing to coordinate my treatment with my primary care doctor or get the results of blood work or tests from this doctor to integrate my whole health care outlook?
  15. Do you have evening or morning or weekend hours?
  16. Do you test for tardive dyskinesia? Have you ever had a patient who developed this, and what has been your experience with treating TD?
  17. Do you take my insurance? Will you bill my insurance company or do you expect me to pay up front and then submit my own claim form for reimbursement?
  18. Do you believe someone can recover from a mental illness? [This question is the gold standard. If at all you get the idea that this doctor doesn’t believe recovery is possible it will benefit you to keep looking until you find a professional who is interested in seeing his or her patients succeed in life.]

Feel free to ask any other questions that come to you that aren’t listed above and when you begin treatment also develop your own questions in addition to the ones listed below.

How to Find a New Doctor

This upsets me: I made a promise I couldn’t keep, and I regret this.

As the Health Guide at the HealthCentral SZ website I was sometimes asked to recommend a shrink, from people in India and Saudi Arabia of all places.

When I talked to a colleague recently, he suggested it’s not as simple as handing a person the name and number of an M.D.

In the interest of providing a better answer, in this blog entry I’ll detail my experience with choosing a doctor.

Then in the next entry I’ll list Psychiatrist Questions you can ask any prospective shrink.

The M.D. has to know the patients history: their unique constellation of symptoms; track record with taking meds–and numerous other details.

In 2003 I researched the names of three doctors and called them on the telephone to screen them.

One shrink required that I sign a waiver of liability releasing him from any responsibility.

I thought: if he doesn’t trust me, how can I trust him? Further: it revealed that he wasn’t confident enough in his own judgment and expertise in treating patients. If he was confident, no waiver would’ve been needed.

Shrink #1: ruled out.

Doctor #2 operated out of a low-income clinic. The person who answered the phone told me point blank that I wasn’t a candidate for a low-income clinic. (I kid you not.)

M.D. #3 had decided to retire and no longer had a practice.

Dr. A was the final choice that a former friend recommended.

As soon as I entered his office and he shook my hand, I thought: “This is the guy I want treating me.”

He hadn’t even opened his mouth. He hadn’t even started the intake.

You should always go with your intuition. The first time I met Dr. A I grilled him in detail. I had walked into his office with a list of 20 questions.

I recommend grilling 3 doctors and using your intuition to choose the shrink you think is the best one to treat you or your loved one.

(I’ve also had success using my intuition to choose a therapist and an apartment I wanted to buy.)

Now I’ll sing off and post another blog entry with a list of Psychiatrist Questions.