VA hospital

On Getting Mental Health Treatment at the VA & Your Psych Saying "It's Time to Kick Your Bipolar in the Ass"

I really can't complain about my psychiatrist. She's really soft spoken but understanding, accommodating, knows her stuff, is thorough, listens to my sometimes disjointed explanations of my symptoms (this is where my mood chart helps, BIG TIME), and lets me barrage her with whatever questions pop up. In fact, if I were to have any complaint at all, it wouldn't really be with her. It would be with the VA hospital. I'm grateful that the Dept of Veteran Affairs has a major hospital in Philly I can go to for treatment. I just hate that it has the all too familiar "hurry up and wait" operational model like the military. It's the epitome of bureaucracy. Their mental health clinic is fairly decent, but because they are understaffed (like much of the VA as a whole), each psych's patient load is pretty heavy and they are always double booked. If you call and leave a message, it usually takes 2-4 days for your psych to get back to you, and their voicemails are always full.

When you come in for an appointment, the wait time can be torture, sometimes taking 2-3 hours. You arrive for your appointment, sit in the lobby with Vets from Vietnam to Iraq, listen to them argue and swap war & treatment stories, and strain your neck to see if your psych is the one walking through the double doors. Fatigued and bored, you practically leap to your feet when your name is called...if it's your psych, you practically skip off to their office. If it's the receptionist handing you the sheet that lists all your meds, you flop back down on your seat in disappointment. Lots of sighs and complaints punctuate the atmosphere.

While you're waiting for your psych to come rescue you from the chaos of the waiting room, two things ALWAYS happen.

  • A fight breaks out...usually between two Vets in their 70's. I've even seen two Vets in wheelchairs go at it. That one was both sad and hilarious to watch
  • A Vet with severe war trauma sits in a corner of the waiting room, quietly mumbling to himself...which doesn't seem out of the ordinary at all until he starts hallucinating. Suddenly he's carried off by memories of combat and everyone in the waiting room is either a comrade or an enemy. This usually throws the everyone in the waiting room into a frenzy of confusion, unease, and fear. Sometimes other Vets are triggered and this adds to the erupting chaos. "Code Red, Level 3 on Floor 7" blares over the loud speaker, security shows up, and doctors come rushing out from behind the double doors to help calm the melee.
I'm not ashamed to admit that I'm either in the hallway or the bathroom hiding when either of those two things happen, keeping an eye out for my psych.

When she does finally come to get me, escaping to her office is a welcome reprieve. She usually only gets to see me for 10-15 minutes because she has so many appointments to keep, but she does her best to take her time with me, asking about the kids, how I'm doing in school, how I'm dealing with things. Sometimes this pushes our time together to 30 minutes instead of 10, but she always reassures me it's ok-she'd rather take the time to make sure I have everything I need than rush me out.

That is why, like I said, I can't really complain about her. She rocks. She treats me like a person and not an object or a file number. I can tell she really cares about my well being and wants to see me get better. This is what keeps me from complaining about her taking 2-4 days to call me back when I'm struggling.

That's why when I called and left a message on her voicemail yesterday and she called me back 10 minutes later, I was in shock.

"Hi, A'Driane. I just got your message and wanted to take some time to call you back before I see my next patient. I've been wondering how you've been doing since we talked on Friday. How are you feeling?"

As I started blurting out the answer, telling her that I've gone from just being depressed to being both hypomanic and depressed, having ruminating, racing thoughts, and have seen my OCD symptoms starting to dominate my behavior, she listened quietly. When I was done, she was silent for about a minute before she spoke.

"You know, A'Driane, while I think the Lamictal has been helping you some,  I don't think it's enough anymore. After we spoke on Friday, I took a good look at your chart and my notes...and...I think it's time we get more aggressive in your treatment. The rapid cycling you've been experiencing is more difficult to treat, more complicated than I anticipated. I...I have to admit I'm going to need some help developing a more aggressive approach. We just got a team of manic depressive specialists on staff, and I think it would be a good idea to go ahead and set you up with a consult to see them. I'm also thinking some CBT will help you develop some better coping strategies, so I'm going to have you set up with one of our therapists, okay? I know it takes alot for you to get here, and you have the boys, but I think if you can get to these appointments they can help us start to really get this under control for you. I guess what I'm trying to say is that it's time to kick your Bipolar in the ass. Let's throw everything we can at this. I want to get you healthy. What do you think?"

Well first of all I'm shocked you just said "ass". Kinda awesome. Sounds good to me. I'm feeling pretty desperate so I'm game for anything at this point. I just want need relief. BAD.

"And that's what I'm going to try to get for you. So I'll set these consults up for you, and in the meantime, let's double your Lamictal dose now, and go up another 50mg in about 2 weeks. I'm also going to prescribe you an anti psychotic to help with the OCD and the thoughts you're having. Let's also try taking some Xanax to help calm you down until we get these meds to you. I'm ordering them now, you should have them before the week is out. Do you have enough to last you until then?"

Yes.

"Good. One more thing-promise me you'll go to the ER if suicidal thoughts kick in-promise?"

Promise.

"Ok. How did the end of the semester go? How are the boys?"

And that, people is why I love her.

So...I guess it's time to start fighting harder and kick some ass.

I'm ready.

"ViSuAl dIsTuRbAnCeS" or "What to Do When Your Psych is More Focused on Your Rainbow Hair than YOU"

English: Close-up of 0.5mg tablets of the bran...

"Come along Ms. Dudley...yes, yes, this way, " sing-sang Dr. H as he led me down the hallway.

"Oh my, your hair....I truly love your hair. It's FUN-KAY," he says stopping and turning to me, his hand on my shoulder.

Um....eh...thank you.

We walk into his office....

I sit down across from his desk, he plops (yes PLOPS) down behind it and props his feet up on what looks like some kind of milking stool or seat.

"So you started on some new meds about 2-3 weeks ago is that right? Can you tell me what you're on? (points at his computer screen)

Lorazepam as needed for anxiety, half a tab of abilify, and neurontin....I trail off feeling like some kind of 5th grader.

"Hmmmm...so you've been seeing things? What kinds of things?"

Stationary objects...words...cups...plants...I've been seeing them move....(voice trails off and I shift uncomfortably in my chair. It squeaks)

"How are you sleeping?

Sleeping but tossing and turning during the night and waking up very early.

"And you're a full-time student? And a mother? How many kids?"

Yes. Two.

"Ages?"

5 in February and 22 months.

"So you deal with alot of stress. "

Duh, I mean, yes.

"And who else is home with you?"

No one. It's just me.

"I see. So are you seeing things beca-wait, did you do your hair yourself?  I mean, because there are people-wow even in the sunlight it just looks incredible, WOW-there are people who do stuff like that and it just looks horrendous, but you, man....that's pure art. Are you an artist?"

Wha-um. No. Not an artist.

"Well you have to be creative right? I mean to be able to  blend but yet separate the colors like tha-"

I guess. I'm creative, yea, I'm a writer. I write. But lately when I write or read I've been seeing the words MOVE.

"Right, you've been having visual disturbances. Hey can you move over just a little? You should really see how your hair looks in the sunlight, it's amazing."

*blank look*

*sinking feeling in stomach*

and then the disappointing BOOM: "Well, I say we just up the abilify and see if they stop, ya know?"

January 8, 2008 - Slim-Fast fashion show

I can't even continue to type out the details of my visit to the on call psych at the VA today because it's just going to cause the low I'm feeling to settle in deeper.  To summarize I've either been hallucinating because I'm super tired, super stressed, or the neurontin I'm on is playing tricks on my eyesight & brain. Either way, it hasn't been a fun couple of days and when I finally got the courage to go to the hospital, my pysch, Dr. C is busy and I have to settle for the on call psych who looks & dresses like Tim Gunn from Project Runway and gets memories of his old acid & LSD days from my hair!

Figures.

After stating that he's never heard of neurontin (gabapentin) causing "visual disturbances" , he CALLS me after I leave his office, on my cell phone, to tell me that he looked it up and it turns out in rare cases, seeing s--- move IS indeed a side effect.

What. The. French. Toast.

I love the VA. But I also HATE the VA. Because they have people like this Tim Gunn knockoff working for them and treating people. Or fondling themselves over their patient's rainbow hair. Whatever.

I'm calling Dr. C tomorrow and demanding to be put on Lamictal and something else. I'm done playing merry go round. F--ing clowns.  Says the chick with rainbow hair that looks fierce in the sunlight.