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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 32224
Experience:  Over 20 yrs of Family Practice
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How do i tell the new guy everything

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How do i tell the new guy everything
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 4 years ago.
Indont care if i think i did a good job. I just want to go in there and say everything
Then start with what I just said and let the guy respond and then you can add the details
Customer: replied 4 years ago.
Is it ABSOLUTELY necessary to add all the details
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 4 years ago.
i can keep secret everything my dad did and not tell him the details besides my dad molested me
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 4 years ago.
If you promise
I do
Customer: replied 4 years ago.
What else
That's the basics--nothing more to say about that
Customer: replied 4 years ago.
Ok. Am ever going to be able to be off all my meds
Which ones?
Customer: replied 4 years ago.
All of them
I think with therapy you can get off all the psych meds. Hard to say about the GI meds
Customer: replied 4 years 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

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 4 years 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

They will--the workup isn't over with as yet
Customer: replied 4 years ago.

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

Not really that long--it just seems that way to you
Customer: replied 4 years 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?

Why exactly was she on it? How long has she been off it?
Customer: replied 4 years 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

If she really is hearing voices then that sounds like schizophrenia and not just depression
Customer: replied 4 years ago.

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

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 4 years 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.

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 4 years ago.
Shes already tried to kill
Herself once
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 4 years ago.
What are they going to do then? I cant make her take her meds. I dont think the fluoxetine is working anyways
Not sure what he'll do then but he needs to know
Customer: replied 4 years ago.
Do you think ot
Schizoprenia? Does she need to be on a different med?
Auditory hallucinations are by definition either from schizophrenia or psychosis or both. An SSRI wouldn't be sufficient for either of those
Customer: replied 4 years ago.

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

Up to you but hallucinations like that can drive the patient to doing harm either to themselves or to others
Customer: replied 4 years ago.

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

Up to you--just telling you what would be best
Customer: replied 4 years ago.

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

Best for her
Customer: replied 4 years ago.
I cant
Take care of her forever
Of course not
Customer: replied 4 years ago.
I have an appt to establish care with the NP. Should
I rethink it
Not sure what that is?
Customer: replied 4 years ago.
To establish care means that she would be my new pcp
you're switching NP's?
Customer: replied 4 years ago.
No i dont have a pcp right now. Today is my Drs last day. So i need to find a new pcp.
Why rethink seeing her?
Customer: replied 4 years ago.
Idont know if shes the right one.
Right how and if you've never met her why?
Customer: replied 4 years ago.
I have met her. Shes the one i saw
Monday for the pee issue. I think maybe shes too new.
Well, maybe since she really didn't follow up on the bladder problem properly
Customer: replied 4 years ago.
Do you think i should
Pick someone else was a pcp
I think you need to see an actual MD first
Customer: replied 4 years ago.
What do you mean first?
If you're going to reestablish with a new practitioner it should be the MD and not his NP first
Customer: replied 4 years 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
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 4 years ago.
How come? Maybe i shouldnt see an internal med dr but stick to a family practice dr
You've got the kind of problems that needs an MD seeing you at least once in a while.
Customer: replied 4 years 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 4 years ago.
Did i make you mad?
Sorry--had to be off. Again why do you think I'd be mad?
Customer: replied 4 years 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
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 4 years ago.
Whats the difference between thr two
Not all that much but you have a complicated medical history so I'd go with the internist
Customer: replied 4 years ago.
There has
To be a reason why
A reason why what?
Customer: replied 4 years ago.
You reccomend an internist. I dont think i have a complicated medical history
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 4 years ago.
I dont have a diagnosed urinary issue. But i do have complicated gi issues. Ok im done quibbling.
Anything else?
Customer: replied 4 years ago.
I just dont know
Who to choose to be my pcp
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 4 years ago.
Maybe i just wont have a pcp. Ill just aee whos on call the day im sick and see them
OK--anything else?
Customer: replied 4 years ago.
The dr put her on zoloft
did you tell him about what was going on?
Customer: replied 4 years ago.
I did. She said all my sister told her is how shed kill herself if she was going to
This is a psychiatrist?
Customer: replied 4 years ago.
No its her pcp. My sister refuses to seea therapust or psychiatrist
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 4 years ago.
Idk why her dr didnt do anything. I dont know what to do about this
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 4 years ago.
What the hell i going to do if she takes her whole bottle of pills
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 4 years ago.
Talk to you later on a new page
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