Soooo, I finally have time to prepare for my pdoc appointment. I have kept it as brief as possible, and it’s to one A4 page…
Do you think this will be achievable to cover in just 30mins? Or do I need to cut anything?
Help will be appreciated. I have not had a face to face appointment for over a year and I want it to be constructive
Letter:
Rules for Appointment (All parties)
No apologies for anything
No ■■■■■■■■
Current Medication:
400mg Amisulpride BD
150mg Pregabalin BD
4mg Diazepam
20mg Atrovastatin
DIY Med Plan:
Based on withdrawal severity, 1mg drop of Diazepam each week for three weeks, and two weeks on 1mg before stopping
Based on withdrawal severity, drop 75mg Pregabalin morning for 1 week, then 75mg drop evening for 1 week – then repeat until zero
After 9 weeks….
Based on withdrawal severity/symptoms returning… 100mg drop every 2 weeks of Amisulpride for target dose of 400mg per day
Points/Questions to raise during appointment:
Are there counter measures to combat withdrawal on the above? (EG: For Diazepam, found Travel Sickness and paracetamol meds useful in past)
Stated to GP in letter that I spoke to duty many times. Did they email each time to ask the above? This simple question I asked repeatedly to different people over 5 weeks and never heard back? Hence urgency and anger developing…
Is there anything else wrong with me that causes me to act badly when dealing with Mental Health services? With ref to the comment that I engage and disengage in hours or days?
Can the GP be spoken to about taking a more active role (Ideally led by me) in adjustments to medication (s)? If you don’t have resources, I need to have a way to get a ‘quick fix’ sometimes
Is therapy able to be reviewed again, as I think my mental state needs some work? Still a work in progress, and don’t believe that previous intervention was executed appropriately?
I am moving out of area in c3 months. Not prepared to start off with a fresh team. Will still be working in ATS catchment, can I keep everything the same as I am not moving far?
I don’t want to offend you, but it sounds like you want to be the in charge expert. But you’re not a dr. Your pdoc and gp went to school for a very long time to become experts. You should have input, but not total control
In my course of Public Health they were advocating ‘shared decision making’. This implies that the doc has to inform the patient of the various options and that the patient then decides which course of action they would prefer.
Just to be clear your plan is to first come off the benzo and Pregabalin and then start lowering the Amisulpride dose right? It might be a good idea to leave some time in-between for your brain to adjust so lowering the Amisulpride is more likely to be successful. I’d wait at least a month after no benzo before considering changing the AP dose.
I do understand your desire to address these concerns, but i feel it will distract from your time. These have a high chance of turning into blame-based discussions, which will eat up your time and give you zero solutions. The first point is already restated in a more solution-oriented way with your question about your GP and the clinic’s lack of resources. The second question has already been answered by your autism diagnosis.
As for the rest, I think it is well-formatted. I also think your withdrawal plan is a recipe for failure, and i hope that if your doctor proposes a slower alternative that still respects your goal of getting off the addictive meds, you can see it as a win and not an attempt to undermine you. But I think those are good things to talk about at your visit.
That will not be constructive. My point was to show him that he’s not as accessible as he thinks he is… On reflection I agree and will remove.
I have been thinking I might have some sort of personality disorder. Do you think this acting out is because of ASD? This is not something I’d really thought about, but not sure?
I will take his advice. Wasn’t going to, but now I have slept on it, your comment is reasonable and makes sense.
Despite this, I will leave it in so he knows where my head is at. Might be best as if I try to explain all that it will take up time
One of the hallmarks of autism is rigid thinking. Meaning that you have a clear mental picture of how something should go, and get furiois when reality doesn’t line up. Another hallmark is a strong sense of justice and fairness, and a very low tolerance for things that are not fair and just.
As i am writing this, my autistic child is cleaning up the literal pile of broken glass in their room from their hour long meltdown this evening because i told them they couldnt have a second soda today.
Ok that makes sense. What you just wrote feels like you have been inside my head when this happens. No one has told me that this is ASD behaviour before.
If it is ASD, then why don’t they mitigate? This is why I thought I might have a personality disorder, as they don’t seem to know how to deal with me.
You just succinctly summarised it however many thousands of miles away you are from me. Why do the people around me not understand?
That sucks about the glass. I used to trash things when I got upset. Kids need to have boundaries though, and I think the life lessons something small like that teaches will prepare for later life for sure
