Friday, July 23, 2010

This Guy Needs a Review

And I'm just the person to give it to him. After two sessions with who was supposed to be the new psychiatrist treating Holland, I decided I AM a pretty good judge of character. I didn't really like him the first time, but people encouraged me to give it a second chance. Mostly because of the hospitalization issue, but also because we just don't have anyone helping us right now.

After the first appointment, I immediately made a second appointment so our interpreter would know her schedule. It was more than two weeks away. Then the major melt down happened and I didn't know what to do, so I called this guy's office hoping to either get some really good advice or an appointment sooner than our already scheduled one. The soonest they had was for a week later. She told me to "take care of the interpreter" for her. I didn't bother telling her that I wasn't going to get an interpreter. Super Hero had been taking so much time off from work to see Holland at the hospital, the first doctor's appointment, etc. I didn't feel he needed to go in with me (seeing as the then third appointment would also be with an interpreter and I didn't want to cancel that one). On Wednesday night when I left the hospital I spoke with the doctor and they wanted to keep him until Friday to be able to monitor his sleeping and the reduced med in the morning. So I was expecting to have him come home on Friday. Thursday morning (the day of the appointment I was to have with the psychiatrist), the hospital calls and says, "come get him." They had 5 new kids come in the night before between the ages of 9 and 11. They just didn't have the staff for that large a group of younger kids and Holland would be doing nothing productive for that time.

Big quandry here. I was supposed to drop my kids off at my mom's and drive up to Portland for this appointment. There was no way I could keep the appointment and pick up Holland from the hospital. I called the doctor's office and pleaded my case. I just couldn't make the appointment. Under the circumstances, would they not charge me for a late cancellation. No. Doctor's policy said I would be charged $130 for a canceled appointment. I couldn't believe it. They have no feelings. No empathy. I would understand it if I canceled and it wasn't an emergency. But I wasn't running off to the beach. So I emailed Super Hero and asked him if he could go to the meeting for me. No interpreter. Last minute change. We both thought a $25 copay sounded better than $130 for no services received. He came home with a bunch of paper work and items the doctor requested. Interestingly enough, he requested the discharge papers. Which he would have had, HAD HE WAITED FOR ME TO BE THERE. This guy is unbelievable.

So, now we're up to Thursday, yesterday. Scheduled appointment with the interpreter there. We arrived early. We waited 10 minutes past our appointment. No explanation. No - "doctor will be with you shortly." Nothing. Then when we get into his office, he starts directing everyone where to sit. Now first off - he knows nothing about deaf people and their needs. His office staff wondered why I couldn't just "sign" for him. (They even said 'well, if you REFUSE to do that, I guess we'll get one.') The interpreter and I just looked at each other. Usually people are very accommodating and ask where would the best placement be. But not this guy. He states "I prefer all my vision to be in THIS direction, mostly." He wanted the interpreter to sit next to Super Hero. Excuse me, hearing person who knows nothing about deaf people. If a deaf person sits next to the interpreter, then he can't see you and her at the same time. We finally got it figured out (I figured out that this guy liked to be in control and have his needs met. It mattered not one whit if we were comfortable. Super Hero and I were not sitting next to each other. Calculated move on his part.)

He starts going over paperwork from the hospital and says right away that he doesn't understand the diagnoses. I was told it wasn't bipolar. But I was also told that insurance companies don't like the diagnoses "severe mood dysregulation". So I was sure that this doctor felt it was better to put bipolar so our insurance would cover it. This new doctor says "That Crombie just likes to make up his own diagnoses to fit whatever he wants." I just sat there stunned. Who talks about a colleague like that? More talk about what Holland did in the hospital. He threw a chair. I knew that he had trouble a couple nights. Separation anxiety from me. Not wanting me to leave. Threw a chair? I doubt it. Knocked it over? More likely. He goes through the list of grievances and the whole time, he's very condescending about it. Like I didn't already know that Holland had problems and how bad his behavior could be. This guy needed to tell me again how awful he was. The killer part came, though, when he said something about the meeting last week with Super Hero. He said "it's too bad you chose not to take care of that." (meaning me getting an interpreter). Again, stunned, I sat there. Then I had to ability to say, "There wasn't anything to "take care of." I wasn't planning on having my husband come. He had missed so much work with the first appointment and all the times coming to visit Holland in the hospital that I didn't find it necessary to have him be there a third time. Knowing that we already had this appointment scheduled. Your office told me I would be charged $130 for canceling and I felt that $25 was better than $130 for nothing." Then he says, "Well, it was about 15 minutes of productivity." I said "good, at least you got something done." I really can't believe I was able to utter any words. I have never been so insulted and belittled in my life by a professional like that. There were many other things he said. Off-hand remarks about things, like "even though you are a saint, even YOU can't do everything." Believe me. It wasn't a compliment the way he said it.

At one point after reading through parts of the report, he tells me that Holland's reaction to being there was NOT normal. He told me that 90% of kids who come in do not have the severity of adjustment issues that Holland did. I said, "you mean that kids aren't scared and don't react that way?" No, he said. The only explanation for that is that this guy is talking about drugged up, comatose kids. Because there's no way on earth, if you dropped a kid off at a hospital, and said, you're staying and I'm not. Here are some security guards that you don't know, look really scary and you have to go with them. You're telling me that it's not normal to freak out about that?

He also requested more testing. I'm sick of testing. Holland's sick of testing. I said I didn't think the psychologists at his office were covered. "That's going to be a problem." he says. I said, "I'm sure my insurance has psychologists in-network." "yes, but then I wouldn't just be able to talk to them. I would have to wait for their report." Oh. So sorry that you're inconvenienced by all this. What can I do to make it easier for you? (that's what was going on in my head. Really wishing I had said something like this.) I knew within the first five minutes that hell would have to freeze over before I went back to this guy. I offered very little information (didn't bother telling him about the meth use. Why give him the satisfaction? The egotistical jerk didn't need any more pats on the back). I just nodded and took the prescriptions (he gave me a year's worth of refills. He has some major confidence in himself). Then when I got out into the parking lot, the interpreter and I just looked at each other, stunned. Then we both signed "jerk, with a capital J".

So that's why I need to write a review on this guy. People out there need to know that this person is a horrible doctor. Has horrible 'bedside' manners. Doesn't care about people and has been in the business so long, he's right and doesn't need to listen to the parents or care about their feelings.

There is a light shining dimly at the end of this hellish tunnel. On Monday, Holland and I have an appointment with a Nurse Practitioner that the social worker at Emanuel recommended. She said she's even better than most doctors (after seeing this guy, I don't doubt that.) She can prescribe medications and also will do counseling. And she's close by. No more four hour productions of dropping off kids, fighting traffic to and back. And you can look for my review of Dr. Turner from The Children's Program in Portland, Oregon, coming soon to a yelp app near you.

Wednesday, July 14, 2010

Wednesday with Holland

Today I got a late start and didn't get to the hospital until close to 4. Traffic was horrible. Car on fire on I205. Major construction on MLK. Four lanes squished to one for a few blocks. Took me close to an hour to get there. As soon as I walked in, he announces that the doctor said he could leave. I didn't really think this was accurate because he tends to hear things the way he wants them to go. When the doctor did come in to chat, he said that they talked about Holland leaving on Friday, so I understood why he got excited. All he heard was "go home". So he was a bit upset. He's also not eating. They've started to monitor his caloric intake because they don't want him to lose weight. I know it's just because he doesn't like new things. The hospital did a fantastic job with all the gluten free food, but with Holland's issues, I'm really not surprised he's not eating it. They did start offering him Boost drinks and I had given him those before when he went through a spot of not wanting anything at home. I've also brought tons of food he likes: gluten free bread I made; blueberries from our garden; snap peas from Aunt Heather; strawberries; cantaloupe; cherries. He loved it all and that ended up being his dinner.

The bad thing about not being able to leave tomorrow is the social worker can't meet until Friday. So he has to wait two extra days until I can have an exit meeting with her. Totally not good. My dad's birthday is tomorrow and when he found out he might be missing a party, he got really upset. They talked about doing an hour pass, but getting him back into the unit would probably get ugly. I see no reason to make him go back. Once we leave, that's it.

So far the doctor has eliminated or reduced with the intention of eliminating, 3 meds. So happy about that. Simplify. And since we are treating Severe Mood Dysregulation instead of Bipolar, I think the treatment is going to be way better. Tomorrow I'm meeting with the psychiatrist that Super Hero and I met with a few weeks ago. I don't plan on continuing that relationship, but the social worker thought it was very important to meet with him since I already had the appointment. I still have not had a chance to call the nurse practitioner that was recommended. But what can I say? The hospital staff lock up my purse and phone and I'm without technology (and bored!!) for 6 or more hours.

Updates Galore

I guess I thought I posted about our doctor troubles, but I looked back and saw that I never did. I deja-vued Twitter. Or Facebook. Or the mom board I'm on. I'm getting old if I can't remember where I write something. Or I have too many places that I can write.

A few months ago I got a letter from the psychiatrist Holland has been seeing for over 4 years that he was closing his practice. He was taking a new position in another state and wished us well. He gave a few names of doctors he might recommend (no doctor ever should have to commit to any advice, you know). But all of those doctors were either not on my insurance list, were full and not taking new patients or didn't think they could help us because we were too complicated. I so misunderstood what a psychiatrist does. Someone might want to add a definition to Wikipedia so we lay-people can understand their job. After calling about 8 different doctors, I finally found one that was on my insurance but couldn't see us for a whole month! Ridiculous. The mental health care in the U.S. is appalling if I can't get an appointment for a month. And he also didn't want to see Holland first. He wanted to see Super Hero and I. So then I had to call around for an interpreter ("why can't you interpret? You sign, don't you? Well, okay. If you're refusing to do it, we'll find someone".) I just ignore people who put it this way. They are clueless and me trying to educate them will just frustrate me more. After 45 minutes of talking, explaining, answering questions, he tells me it's not bipolar, but looks like results of meth use in-utero. He said lots of babies born in Portland have moms that used meth. I explained our son was born in San Diego. Whew! We're in the clear. Turns out, he was exactly right. I contacted the gramma and found out that in fact she (birth mom) had used meth and probably other drugs (but she would never admit to them).

So skip forward about 2 weeks and I've hit my limit. I tried to take him to his new summer school program. Sparing the ugly, ugly details, I had to call the police and then my sister and I ended up driving him to the emergency room to have him admitted for observation. My intent was to get him in inpatient care and the only way to do that is through the emergency room. It was a horrid 5 hours of sitting, waiting, filling out paper work and Holland begging to go home so he could swim in his aunt's new pool. When we finally found out he'd be able to be admitted, it was 10 p.m. He was exhausted. I was exhausted. And then I noticed 2 big security guys come into his room. They actually had to use big security guys to strongarm him over to the pediatric psych unit. That was the most horrible day. But I had run out of options. There are really no options left when you have to call the police and take your son to the ER in hopes they see a need for inpatient care.

He's been there over a week. And apart from yesterday's little encounter with an on-call nurse, the staff have been wonderful. His inpatient psych is smart, to the point, doesn't mince words and lets me ask any questions I want to. The nursing staff is friendly, patient, and respectful of Holland as a human being. The only problem we're having is food. He won't eat anything they've given him. The dietician and I worked on a gluten-free menu that was great. Lots of options. Food did not look like hospital food. I've wanted to eat most of the meals. They've resorted to giving him protein drinks and said I could bring in anything I wanted. So today I'm bringing in his GF oatmeal, lots of fresh fruit and veggies and I also made GF bread that he's been munching on.

I don't know exactly when he will come home. They've adjusted his meds and want to make sure he's on good doses before they send him home. They've given me lots of doctor resources and counselor's names that hopefully I will find someone wonderful and close by. The first few days were the worst. I couldn't even say goodbye because he got upset, anxious, mad that I was leaving. But he's been better the last few days. Knowing that I'll come back. Now he just needs to make the connection that when he's finished doing what they need him to do (group meetings, individual counseling) he can come home. His lack of executive-functioning is not making that connection. Pray that he will just make a compromise and talk so he can get out of there quicker.

Friday, July 2, 2010

Hard News

Want to know what it feels like to get punched in the stomach? Have a doctor tell you your child shows the symptoms of a meth baby and he doesn't think that he is bipolar, which you've been treating with toxic drugs for 5 years. Then get word that in fact, birth mom was taking meth and probably other drugs as well. Any treatment now is useless. He will not get better. Drugs will not help his underdeveloped brain. I don't see how I'm going to be able to do any type of discipline knowing his brain is damaged from drugs.

Romans 8:26 In the same way, the Spirit helps us in our weakness. We do not know what we ought to pray for, but the Spirit himself intercedes for us with groans that words cannot express.

Thursday, July 1, 2010

The Dog

Well, instead of paying for medical necessities, I'll probably be paying for my neighbor's dog to get its leg fixed. Today after lunch I gave Holland permission to go outside and play in the front yard with the neighbor boy. A while later, I got a call from my neighbor across the street. She wanted to know if Holland knew how her dog got hurt. I didn't even know he was in her yard. Apparently kids migrated over to her yard and there were probably 6 or 8 kids in her yard. They were running around, playing with the dog. When she went back there, the dog was limping. She asked him about it and he said he was petting the dog, but he didn't know how the dog got hurt. I got two more phone calls asking if he remembered anything else and I kept saying no. We already knew his memory is terrible. Then I get a call from the husband saying that one of the neighbor girls said Holland was chasing the dog and jumping on it. She is the only one saying this, but what does that matter? They assume that Holland is the one who did it, so I'm sure I'll be paying for this. At least if it was a person that got hurt, I'd only have to pay for what insurance didn't cover.

So not only is he destroying my property but now this involves the neighbors as well.