Fighting Back Against the Okay
Pushing through the red tape of medicine
I had an appointment at my new clinic, in this tiny corner of the PNW, to discuss my insomnia and weird side effects I was getting from medications prescribed over a month ago.
Little did I know the secret to getting an appointment with my PCP on the same day was to call at 8 a.m.
I called at 10 a.m. yesterday, and scheduled with an ARNP. My PCP is a PA, so I’m not knocking credentials — but there’s a lack of experience, education, and knowledge between even these two, let alone an MD with decades behind them.
I left the appointment in tears, almost screaming at the girls in the reception area. I was having a meltdown because I was so damn tired, and this provider just wanted over 7 labs (I think 9 total) and prescribed a sleeping pill so uncommon the local pharmacy only carries TEN — yes, just 10 — pills in stock at a time. Insurance obviously didn’t cover this (that’s another story, quite literally) and I ended up sleeping like total shit, as the med’s half life of one hour kicked in and I woke up with only two hours of sleep.
My insomnia is from many things, none of which are a (mis)diagnosis on my chart (or EPIC, if you know this scene.) The ARNP wanted to run all the labs to find out why I was so dang tired. He didn’t ask about my life at all. Could it be I was tired for lack of a normal life for many, many years? Nah. But…okay….
My life has been totally crazy, and I now live next to a superstore that receives deliveries from 3–5a.m. (This works out well during the day when I need a snack, ASAP, though I pay the price for it with the functions of a freight truck). My brain is also racing due to my ADHD, so when I’m barely sleeping and hear a truck, I’m awake. For good. Even if that’s only with 2 hours of sleep.
Welcome to my hell. And my insomnia.
I tried to fight back, only to be handed the business card of the clinic manager. I didn’t even say okay.
“I’ll send the director an email,” I said with wavering assertiveness. I was still fighting back tears. But I was also fighting for a semblance of sanity.
I sent the email, and then had a strange intuition to call at 8a.m. and try to see my PCP.
Like magic, at 8:05 a.m., I had an appointment for 11 the same morning (today). I was trimming the red tape. And it was starting to tear at the seams.
When I met with my PCP, she was clearly baffled at what happened yesterday. (To think this all has happened in 24 hours is also baffling — and goes to show how getting medical care is its own full time job.)
He had ordered… a cortisol test… because of my premature ovarian failure? Why did he order a thyroid test when I just had labs at the hospital on Friday (where I was sent by urgent care because they couldn’t clinically diagnose serotonin syndrome and wanted labs, even though that’s exactly how its diagnosed and labs don’t measure serotonin. Again. Okay….)
Why did he prescribe a “dirty” sleep med, as my PCP called it? (The medication is Sonata and it’s already down the toilet, along with my $40 from paying out of pocket for 10 days of the pills.)
My PCP was patient and kind, a form of breed of doctors and nurses you don’t find often, ever, and is a result of living in a small town just miles away from Canada. Clearly, doctors do a lot of dumb shit, but some are truly gems because of our unique culture. We deleted diagnoses that didn’t make any sense to have on a “problem list” (Thanks again, EPIC, for your epic system that enables providers to peg and flag patients who struggle with mental health, scaring other providers away by including obtuse things like “leg length discrepancy.”
The 2 centimeter difference in my legs, as discovered by a chiropractor and somehow entered into EPIC as a “PROBLEM” is actually very normal. So normal, it either would be everyone’s problem… or someone wanted to cause a problem with my EPIC chart.
Once we cleared up that laundry list, we moved onto the right medication. A stimulant was a gateway back into psychosis (or just being really high.) All the ADHD meds are really bandaids, changing the brain chemistry instead of patching it up. We had discussed an antidepressant, Wellbutrin, for almost two months now. I really benefited from the SNRI I was on with its slower affect and pain reduction, but eventually it caused psychosis as well.
I agreed with a wholehearted YES — not a sigh, okay.
This was what I needed, and after even one dose I have reassessed my plans to return to writing full-time and instead balance being a grad student studying cyber security (YES!!!) and a health blogger (YES!!) I sat and watched the tide come in at the Bay just chilled out, a feeling I had desperately missed since Adderall; but not high. Just, calm.
Calm.
That’s the feeling when you slice through the red tape and force the care you need. It’s a feeling that hits when you can sit back, enjoy the sunshine and realize… you not only feel better, but you did it on your own, with strength and endurance that showed me hey, I’m doing better than okay these days.
I’m doing pretty damn well.
