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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22099
Experience:  Over 20 yrs of Family Practice
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How do i tell the new guy everything

Customer Question

How do i tell the new guy everything
Submitted: 11 months ago.
Category: Health
Expert:  Dr. Chip replied 11 months ago.
Well, first off, with your perfectionistic tendencies, I don't think you'll come away ever thinking you did a good job even if you do. Like I said before, you can start with just the basics--who did it, what they did (briefly--not all the details at one time), how you think it was all your fault and how it bothers you to this day, and how you need to get rid of the anger and resentment towards them and towards yourself
Customer: replied 11 months ago.
Indont care if i think i did a good job. I just want to go in there and say everything
Expert:  Dr. Chip replied 11 months ago.
Then start with what I just said and let the guy respond and then you can add the details
Customer: replied 11 months ago.
Is it ABSOLUTELY necessary to add all the details
Expert:  Dr. Chip replied 11 months ago.
No, not at first--you just need to get the basics out like I mentioned above. The work on all this can begin even if you don't start out with all the details. The important part is your feelings and thoughts about what happened and not so much every last detail
Customer: replied 11 months ago.
So i can keep secret everything my dad did and not tell him the details besides my dad molested me
Expert:  Dr. Chip replied 11 months ago.
That's all you need to start with. As time goes by, I promise you, it will be easier to fill in the details
Customer: replied 11 months ago.
If you promise
Expert:  Dr. Chip replied 11 months ago.
I do
Customer: replied 11 months ago.
What else
Expert:  Dr. Chip replied 11 months ago.
That's the basics--nothing more to say about that
Customer: replied 11 months ago.
Ok. Am ever going to be able to be off all my meds
Expert:  Dr. Chip replied 11 months ago.
Which ones?
Customer: replied 11 months ago.
All of them
Expert:  Dr. Chip replied 11 months ago.
I think with therapy you can get off all the psych meds. Hard to say about the GI meds
Customer: replied 11 months ago.

So with therapy I can stop the lorazepam and sertraline forever. That still leaves me with like 9 other meds. I am 24 I shouldnt have a med list like I do

Expert:  Dr. Chip replied 11 months ago.
Yes on both the lorazepam and the sertarline. I also told you about the miralax and the amitriptylene. Not sure about the Reglan and the Zantac--that depends on what is finally decided about the cause of the GI problem
Customer: replied 11 months ago.

When I talked to my regular GI dr yesterday he said he isnt too sure that Mayo will be able to give me a diagnosis

Expert:  Dr. Chip replied 11 months ago.
They will--the workup isn't over with as yet
Customer: replied 11 months ago.

why does it seem like this is taking forever wiht Mayo?

Expert:  Dr. Chip replied 11 months ago.
Not really that long--it just seems that way to you
Customer: replied 11 months ago.

It's going to be a long 3 months.


 


 


I have a question. My 20 year old sister is on fluoxetine 60 mg every day. She just out of the blue stops taking it. She says when she is not taking it she hears voices tell her to "come to the dark side" What do you think is going on with her?


 

Expert:  Dr. Chip replied 11 months ago.
Why exactly was she on it? How long has she been off it?
Customer: replied 11 months ago.

shes on it for depression. She periodically stops taking it. and usually i can tell when she is off the med for like a week because all she does it cry. She says within days of stopping it the voices come back. I made her start it again. i just dont like the whole hearing voices thing


 

Expert:  Dr. Chip replied 11 months ago.
If she really is hearing voices then that sounds like schizophrenia and not just depression
Customer: replied 11 months ago.

that is kind of what I was thinking but I dont want it to be. She doesnt have any other symptoms of schizophrenia

Expert:  Dr. Chip replied 11 months ago.
Of course, and I can't possibly know, she may just be saying that when it really isn't the case. I don't see how fluoxetine alone would suppress auditory hallucinations
Customer: replied 11 months ago.

this isnt the first time shes said this. She told me this last summer too and the summer before that. Im kind of at a loss of what to do. Im bringing her to see her dr this afternoon but since she is now 20 I cant really tell the dr. And i dont know that she will.

Expert:  Dr. Chip replied 11 months ago.
You can tell the doctor and I think you should because if she is having negative hallucinations it could get out of hand one day
Customer: replied 11 months ago.
Shes already tried to kill
Herself once
Expert:  Dr. Chip replied 11 months ago.
Then by all means you need to tell the doctor that she stops the medicine from time to time and has hallucinations when she does
Customer: replied 11 months ago.
What are they going to do then? I cant make her take her meds. I dont think the fluoxetine is working anyways
Expert:  Dr. Chip replied 11 months ago.
Not sure what he'll do then but he needs to know
Customer: replied 11 months ago.
Do you think ot
Schizoprenia? Does she need to be on a different med?
Expert:  Dr. Chip replied 11 months ago.
Auditory hallucinations are by definition either from schizophrenia or psychosis or both. An SSRI wouldn't be sufficient for either of those
Customer: replied 11 months ago.

But she is only 20. I dont want her to have either diagnoses for the rest of her life

Expert:  Dr. Chip replied 11 months ago.
Up to you but hallucinations like that can drive the patient to doing harm either to themselves or to others
Customer: replied 11 months ago.

I dont really need this extra stress in my life right now.

Expert:  Dr. Chip replied 11 months ago.
Up to you--just telling you what would be best
Customer: replied 11 months ago.

I know what I have to do, it just sucks.

Expert:  Dr. Chip replied 11 months ago.
Best for her
Customer: replied 11 months ago.
I cant
Take care of her forever
Expert:  Dr. Chip replied 11 months ago.
Of course not
Customer: replied 11 months ago.
So I have an appt to establish care with the NP. Should
I rethink it
Expert:  Dr. Chip replied 11 months ago.
Not sure what that is?
Customer: replied 11 months ago.
To establish care means that she would be my new pcp
Expert:  Dr. Chip replied 11 months ago.
So you're switching NP's?
Customer: replied 11 months ago.
No i dont have a pcp right now. Today is my Drs last day. So i need to find a new pcp.
Expert:  Dr. Chip replied 11 months ago.
Why rethink seeing her?
Customer: replied 11 months ago.
Idont know if shes the right one.
Expert:  Dr. Chip replied 11 months ago.
Right how and if you've never met her why?
Customer: replied 11 months ago.
I have met her. Shes the one i saw
Monday for the pee issue. I think maybe shes too new.
Expert:  Dr. Chip replied 11 months ago.
Well, maybe since she really didn't follow up on the bladder problem properly
Customer: replied 11 months ago.
Do you think i should
Pick someone else was a pcp
Expert:  Dr. Chip replied 11 months ago.
I think you need to see an actual MD first
Customer: replied 11 months ago.
What do you mean first?
Expert:  Dr. Chip replied 11 months ago.
If you're going to reestablish with a new practitioner it should be the MD and not his NP first
Customer: replied 11 months ago.
She sees her own patients. But if she has questions she runs it by one of our internal med drs since shes an internal med NPs. But she doesnt work under a specific dr
Expert:  Dr. Chip replied 11 months ago.
She has to have a supervising MD. I guess if that MD is one of your clinic doctors it's OK but you should see a real MD anyway
Customer: replied 11 months ago.
How come? Maybe i shouldnt see an internal med dr but stick to a family practice dr
Expert:  Dr. Chip replied 11 months ago.
You've got the kind of problems that needs an MD seeing you at least once in a while.
Customer: replied 11 months ago.
Do you have a preference of internal med or family practice? What kind of problems do i have that requires an md to see me every once in a while versus once
A year
Customer: replied 11 months ago.
Did i make you mad?
Expert:  Dr. Chip replied 11 months ago.
Sorry--had to be off. Again why do you think I'd be mad?
Customer: replied 11 months ago.
I dont know Do you have a preference of internal med or family practice? What kind of problems do i have that requires an md to see me every once in a while versus once
A year
Expert:  Dr. Chip replied 11 months ago.
Well for now you need an internist just to be overseeing your GI and your urinary problems as well as the possible tachycardia problem.
Customer: replied 11 months ago.
Whats the difference between thr two
Expert:  Dr. Chip replied 11 months ago.
Not all that much but you have a complicated medical history so I'd go with the internist
Customer: replied 11 months ago.
There has
To be a reason why
Expert:  Dr. Chip replied 11 months ago.
A reason why what?
Customer: replied 11 months ago.
You reccomend an internist. I dont think i have a complicated medical history
Expert:  Dr. Chip replied 11 months ago.
You have to different medical problems--the GI and the urinary--requiring two different specialties. For that reason alone an internist is better suited to be your primary care doctor but a family doctor would probably do OK--just giving you my opinion so let's not quibble about it
Customer: replied 11 months ago.
I dont have a diagnosed urinary issue. But i do have complicated gi issues. Ok im done quibbling.
Expert:  Dr. Chip replied 11 months ago.
Anything else?
Customer: replied 11 months ago.
I just dont know
Who to choose to be my pcp
Expert:  Dr. Chip replied 11 months ago.
I already told you I'd pick an internist but that a FP would be OK--there's isn't some sort of previsit check list to help someone make that decision
Customer: replied 11 months ago.
Maybe i just wont have a pcp. Ill just aee whos on call the day im sick and see them
Expert:  Dr. Chip replied 11 months ago.
OK--anything else?
Customer: replied 11 months ago.
The dr put her on zoloft
Expert:  Dr. Chip replied 11 months ago.
And did you tell him about what was going on?
Customer: replied 11 months ago.
I did. She said all my sister told her is how shed kill herself if she was going to
Expert:  Dr. Chip replied 11 months ago.
This is a psychiatrist?
Customer: replied 11 months ago.
No its her pcp. My sister refuses to seea therapust or psychiatrist
Expert:  Dr. Chip replied 11 months ago.
Well, let's finish the page and this last topic here. Her telling him how she would do it is more than sufficient grounds for her to be Baker acted and committed for at least three days so I don't know where the PCP's mind was. Maybe if she only has the hallucinations off the SSRI nothing more than that will ever happen.
Customer: replied 11 months ago.
Idk why her dr didnt do anything. I dont know what to do about this
Expert:  Dr. Chip replied 11 months ago.
There really isn't anything you can do since to tell anyone else is really hearsay and not enough to get her committed. For now just try to keep her taking her medicine.
Customer: replied 11 months ago.
What the hell i going to do if she takes her whole bottle of pills
Expert:  Dr. Chip replied 11 months ago.
Again, what if's aren't usually helpful. Listen I'm out the door and won't be back for at least three hours so let's close this page and we can talk tomorrow
Customer: replied 11 months ago.
Whatever
Expert:  Dr. Chip replied 11 months ago.
Talk to you later on a new page
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 22099
Experience: Over 20 yrs of Family Practice
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