So, it's hard to follow that with some light remarks but I'll try. Some friends of ours from Baton Rouge made their annual pilgrimage to Austin and had a party at Dart Bowl. Nile, Dani, and I went and all of us bowled this time. Know what? That was really some fun. Makes me want to go bowling again. It's such a cool retro bowling alley, not exactly close to us, but worth the drive. www.dartbowl.com Here's a photo of my handsome son and his friend.
Here's something amusing: almost all the correspondence I get from pharmacies, insurance companies, and therapists all address me as "Dr." I cross it out and write Provider, or NP. But jesus, NPs have been prescribing for many years, decades in fact, in the US. And it's not like we are hard to find, there's actually more than 200,000 of us in this country. And Physician's Assistants can prescribe too. One patient asked me recently why I didn't go to medical school and I said, jeez, I like being a nurse. I like being an NP. It may sound corny, but we see the patient holistically. You are not a diagnostic puzzle to me (like Dr. House), I think about all parts of your life and how that helps or hurts you. I'm not afraid to ask if you have a dog or cat (pets are great for mental health) or what your exercise routine is.
I've gotten a lot of substance-abusing patients lately. Another thing that many providers just won't touch. And let me quickly say, that I appreciate my doc not restricting my practice so that I can't accept those clients. But do they scare me? Yes, mostly because I feel that I can't truly help their mental health problems (usually depression and/or anxiety) if they don't either stop or cut way way back on their drinking or drugging. And every single person, when I bring up the subject of rehab or detox, starts with the song and dance to the tune "I Can't Do That", it just won't fit in my life right now, my job's too important, my husband will freak out, blah blah blah. OK darlin'. But you know what they call it when you keep doing the same old thing and expect different results. Yes, I'm a little fatigued by the excuses. It can wear me down. I try hard not to lecture, that's really one of my core principals. I'm not your mommy. But I will speak my truth, especially when I hear baloney, I'll simply point out that's what it is. I'm not going to smile and say "Sure, you get high three times a day, I'll throw 3 different pills at you, and you won't feel any better. Let's keep doing that."
Today a patient walked out on me. In tears. No fun, and that's why I'm up at 2 AM writing this. It was an initial evaluation, and at the end of the hour I tell her what I believe can be helpful in terms in medication. And she didn't like that. You can probably guess why (if you've read previous posts); yes, she wanted Xanax. Such a screamingly awful drug, I must say. And for multiple reasons, that was a very bad idea. I said no, I didn't want to do that, and I even said I wouldn't shut that down forever, just that I wanted to try some other things first that didn't have the serious potential problems that Xanax has in her case. So then she got angry, and insisted she needed relief now. Oh darlin', I said, mental health recovery doesn't work that way. This is a long, slow process and I can't make it all better today. Especially, in my opinion, with that medication. But hey, you're free to go, get a second opinion, and no charge for today. And that's what she did. I'm relieved, so why is that keeping me up? I think two things: I was surprised (usually I see that one coming) and I almost made the wrong call. In fact, I was going to go along with the Xanax until I stepped out of the room at the end of the hour and reviewed it with my doctor. He immediately advised against it, and it wasn't hard to persuade me, he just reminded me of the elevated risks for the situation, which frankly is one I don't see very often (very specific disorder). I am deep in rumination on all the choices I made today, I am a real champ at anxiety it seems. I know it well. God, that learning thing....how many months in on this gig am I? Oh that's right, only five. Five!
Yep, you're wondering what the hell I'm doing in this profession. Ha. Really, it's freaking amazing when it works. So how often is that? Well, sometimes you get dramatic results and boy does that feel good. I have 3 of them right now and I'm so, so pleased to see them in my office. One has postpartum depression (talk about scared the bejesus out of me), one has an eating disorder, one has suicidal depression. All three are basically back to normal after treatment. Happy and able to take care of baby and returning to work this month, gaining weight and no more feeding tube, and happy, productive and back at work after 3 months off. It's hard not to hug them and cry, it's just such an honor to be part of their good work and recovery. And yes, it is mostly them, just a little bit of me. I tell them that, too. You did this. You.
