YES. I APPRECIATE YOUR OPINION.
PATENT AS OF TODAY
VALIUM 20-30 MG A DAY
LYRICA 300MG X2
WHO KNOWS WHAT ELSE ?
ARE YOU GOING TO ANSWER IN MORE DETAIL LATER OR IS THIS IT FOR TODAY?
GOOD MORNING DR, NATASHA.ONCE AGAIN I WOULD LIKE TO THANK YOU FOR YOU RESPONSE.
I HAVE BEEN CONSULTING WITH A FAMILY LAWYER,CPS, A CHILD CUSTODIAN. AND THE CASE IS BEFORE A FAMILY COURT JUDGE.
IN THE PATIENTS MEDICAL RECORD FROM PSYCHIATRIST#1 ,HE CLAIMS THAT HE HAD BEEN TREATING THE PARTY FOR 5 YEARS AND THAT HE IS BIPOLAR AMONGST HAVING OTHER ISSUES.WHEN HE WAS PAID TO TESTIFY IN COURT HE STATED THAT THE PATIENT IS NOT BIPOLAR.
PSYCHIATRIST # X : I REVIEWED HIS MEDICAL RECORDS AND FOUND HIS DIAGNOSIS TO REFLECT THAT THE PATIENT MAY BE BIPOLAR BUT BELIEVES THE PATIENT HAS CLUSTER PERSONALITY B.
THE PSYCHIATRIC HOSPITAL THAT HE CHECKED HIMSELF INTO AND WAS DISCHARGED FROM DIAGNOSED HIM AS BIPOLAR.
BOTH DOCTORS FEEL THAT THE PATIENT IS NOT A THREAT TO HIMSELF OR TO OTHERS, HOWEVER THEY FELT THAT IT WAS NECESSARY FOR HIM TO CHECK INTO A HOSPITAL. NEITHER DOCTOR SAW NOTES INDICATING THAT THE PATIENT WANTED TO HURT OR KILL HIMSELF BECAUSE THE PATIENT DIDN'T REPORT
IT TO THE DOCTORS. AS A MATTER OF FACT HE TOLD THE DOCTORS THAT HE WAS FINE AND NEVER FELT BETTER.
ON JUNE 27, 2013 ,DOCTOR # X RECEIVED A DRUG UTILIZATION REPORT FROM THE STATE, FOR A PERIOD OF 6 MONTHS.THE REPORT SHOWED THE FOLLOWING; DOCTOR # X PRESCRIBED 140 OXCODONE 5MG OVER A PERIOD OF 90 DAYS.
DOCTOR #1 PRESCRIBED 240 DIAZEPAN FROM JAN. TO JUNE- 30 MG EACH OR 3 A DAY.
DOCTOR # X PRESCRIBED 90 /30 MG DIAZEPAN AND
PREGABALIN 150MG 60 PILLS AND75 MG 14 FOR 7 DAYS.
ALL OF THESE ARE RESTRICTED DRUGS ,AS YOU KNOW.THE OTHER DRUGS WHICH I SENT THE LIST ON THE OTHER DAY, CAN CAUSE IMPAIRMENT AND ISSUES WITH DRIVING.
PSYCHIATRIST # X DISCHARGED THE PATIENT AND ASKED HIM TO FIND ANOTHER DOCTOR BECAUSE THE PATIENT WASN'T COMPLIANT WITH HIS MEDICATIONS AND WAS CYCLING TOO RAPIDLY WITH HIS PSYCH DISORDER.
THE COURT IS SWAYED BY THE DOCTORS TESTIMONY THAT THE PATIENT IN THEIR OPINION IS OK TO DRIVE.
THE CHILD COURT APPOINTED LAWYER ALSO FEELS THAT THE DOCTOR OPINION WILL DRIVE HIS DISSENSION TO ALLOW THE CHILD TO BE DRIVEN BY HIS FATHER.
CPS SEEMS TO SIDE WITH THE DOCTORS OPINION.
THE JUDGE WANTS ONLY THE DOCTORS REPORTS.
THE DUI ATTORNEY INDICATED THAT IN FACT A LAW DOES EXIST IN NEW YORK THAT PREVENTS ANY PERSON FROM OPERATING A VEHICLE WITH A CHILD WHILE THEIR ABILITY IS IMPAIRED BY DRUGS.AS YOU KNOW THERE IS NO DISTINCTION MADE BY THE LAW. DRIVING UNDER PRESCRIBED MEDICATION CAN AND IS STILL ILLEGAL IF YOU ARE DRIVING UNDER THE INFLUENCE IN NEW YORK STATE.WE ALL MAY AGREE THAT THE PRESCRIBED DRUGS AREN'T ILLEGAL BUT THE DRIVING CAN BE IF YOU CANT CONCENTRATE.
YOUR POINT ABOUT CUSTODY IS WELL TAKEN FOR NOW THE CHILD CAN SEE HIS DAD AT ANY TIME WITH SUPERVISION BUT CANT BE A PASSENGER IN A CAR IF HIS DAD IS DRIVING. THESE ARE TEMPORARY COURT ORDERS THAT THE JUDGE WILL BE RULING ON IN THE NEAR FUTURE.
THIS IS WHY I WANT AN OPINION ON THE CHILD'S SAFETY OF HIM BEING IN A VEHICLE WITH HIS DAD ON ALL OF THESE MEDICATIONS.
WAITING FOR YOUR OPINION
Good morning Dr. Natasha:
Thank you for your reply of last week. I would like to keep you up to date about the patient we were discussing. I just received a confidential Drug Utilization Report from the New York State Monitoring Program and found the patient is on 30 mg. of Diazepam a day and 600 mg. of Pregabalin. As well as these two drugs, he is also having prescriptions filled for Oxycodone 5 mg, 3 x a day. The other drugs he is on that are not monitored are Primidone 50 mg at bedtime, Lamictal 200 mg. a day, Viibryd 20 mg a day, Trazodone 100 mg at bedtime and Risperdal 2mg at bedtime. Naproxen 500 mg was also prescribed.
Needless to say, there might be other painkillers involved and I suspect this because he visited the Emergency Room this past week complaining about migraine headaches and I'm sure he received a prescription for some painkillers.
What I would really like you to do is seek the opinion of a colleague who is a Neuropsychiatrist to determine what effects these drugs have on the patient and whether or not he can safely drive a car. As I mentioned last week, the real danger comes from whether or not these drugs would interfere with his judgment. Please explain to your colleague that it is against the law to drive in New York State with a blood alcohol concentration level higher than 0.08 and according to the Substance Abuse and Mental Health Services Administration (SAMHSA) just 10 mg. of Valium can cause impairment similar to having a blood alcohol concentration of 0.1%
Knowing that the residual effects of sleeping pills and pain relievers can impair drivers, even in the morning, and may cause impairment similar to Codeine and Morphine, I am wondering if the Neuropsychiatrist can put an approximate reading of what the patient's blood alcohol concentration would be if he took the same dose of medications daily.
I am looking for a more specific answer that I received last week and know this is a difficult task, but I need it.