As I age, I do have to face the fact that I will start running into health care professionals who are my age or younger. Sometimes it is magical, watching people begin their careers, taking the things they have learned and applying them in the real world — doing it well. It’s when they botch it that I sigh and despair for my generation.
Take my psych nurse. (Please.)
I admit I was not in the best of moods on intake. I truly was not. Then again, I had gone about a month and a half doing squat to improve my life because motivational anhedonia had its claws in me. Also, it isn’t the client’s job to be in any particular mood. I was sullen. I was tired. But I knew what I needed and I managed to convey that, I thought. By contrast she was… “suburban” is the best way to put it. It’s the only adjective I’ve got for polished-blonde-looks 35 at the most. She looked like she’d never not fit in a day in her life. Like she’d always belonged.
So she intimidated the hell out of me. But I was game. I needed to try. Right? Don’t give up until you give it a chance. We decided I’d try going up to 20mg of Celexa. Nice thought. I was queasy for four days straight. I went back down to 15mg, because that trial failed. I told her I needed to take it slowly, but that I was still interested in going up to 20mg. I was just… splitting pills.
When I got tired of splitting pills into eighths, I asked — or thought I asked — for 10mg tablets. I got ’em, all right. Enough for 15mg. Which hadn’t been working over the summer. Okaaaaay. I called for my next refill and said “Hey, uh, I need to have enough to be able to go to 20” which got interpreted as “Let’s give Maria 20mg tablets again!”
Wegmans was kind enough to get it changed to two 10s instead of one 20 a day. I appreciate Wegmans.
This morning I walk in with my crochet, yes? Prepared to be amiable enough. Not chummy like sisters. Just. Amiable. I get one question about how well the Celexa’s working and then she starts in on the two benzos I’m on.
I expect this from people who don’t hang out their shingle as psychiatrists or equivalent. I do not expect it from people who make their living prescribing these meds, specifically these meds, only these meds, to people whose case histories they should understand well enough to know that I have had enough trouble finding prescribers for one lifetime. That I came to her because the office has no policy against prescribing one person two benzodiazepines. I suppose I assumed this meant their practitioners, all of them, had a handle on said drug class.
From people who do this for a living, I expect, at most, “How do you feel about…? No? Okay, no. Cool.”
But I said no. I said a flat no. Three times. Which should’ve been it. No? Cool. Instead she started in on me like I knew absolutely nothing about the drugs. I told her I’d been on them for eleven years. I told her I knew where my cognitive decline came from. Correlation. Causation. I have fibromyalgia. It does that. I remember when my brain turned soupy. I know what a drug-related decline should look like — a hell of a lot more gradual than what I’ve experienced. As for tolerance issues, honey, I passed the “uh-oh, she’ll have withdrawal!” threshold three months into treatment. I’ve stayed within reasonable limits since then, and that is usually enough for doctors to nod and be okay.
I did all that while she was a sophomore in undergrad. Turns out she graduated high school two years ahead of me. Somehow I’ve tripped blithely through eleven years of medication not caring what it does to me? Somehow I have managed to know nothing about my own case history? Do I really look that ignorant at eleven-thirty in the morning?
I asked her how old she was. Apparently that’s some kind of inappropriate. Okay, it was the wrong question entirely. I should have asked “Exactly how long have you been practicing?” I had to Google to find out she’s only been doing this for nine years and I’ve been stuck with it for eleven!
I told her I needed to function, and that things staying the same would be my best bet. I had — have — people counting on me. I have a degree to finish. I have a family whose patron saint is Murphy. I do not have time to screw around with teensy gradations of benzos, feeling like crap the whole time. There may come a day when I can check myself in and let the doctors screw with my meds all they like! This is not that day! That day is not even remotely in sight!
On my way home, I called the office to request a new prescriber. I’m done with her. Carol on the phone said the practice would have to discuss it. I told Carol my reasons for asking. Maybe that’ll actually matter. I like Rachael a lot; she works with me, understanding that I am a person with agency and sense. In other words, she’s a social worker. Nurse Wretched there must’ve hatched from her university floating happily above real people and their lives, because for the life of me I can’t imagine any better reason for her complete disconnect from who I am and where I’ve been. She’s not discussing this stuff with Rachael? She’s not understanding it? Whatever. New. Prescriber. ASAP. I cannot deal with the cheerleader any longer.