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miss_lucy21Well, that was stressful. But hopefully successful.
The doctor agreed with me that I need something other than the Prozac on board, so we're trying combining the Prozac with Wellbutrin. Wellbutrin works on dopamine, not serotonin (which the Prozac works on), and since I have ADHD, we pretty much know my dopamine system is...not optimal. We're hoping that helping out my dopamine system might take enough pressure off my overstressed brain to even everything else out. It's a combination that's been used for quite awhile and it has a good track record, so it's a reasonable next step. If it doesn't work, however, I'm going to need to go psychiatrist shopping because my GP admits that she's going on her best guess and while she's comfortable with dealing with basic depression that responds to the older and well known antidepressants, ADHD is a complicating factor and it's not within her specialty. There's other meds that I could try, but she's just not comfortable with prescribing them to me because she just doesn't have the experience with how ADHD and depression interact. I can totally respect the fact that she knows where her limits are, and I really appreciate her admitting that I'm hitting the limits of her experience.
(She was like, "okay, just because I'm suggesting a psychiatrist doesn't mean I think you're "crazy" or something. So, please do not be insulted." I was like, uh, yeah, I'm aware I have mental health issues and that psychiatrists specialize in such things. Insurance covers you. It only has limited coverage for psych services, which is why I'm here bugging you about this. So that was...yeah)
We are also doing a whackload of blood tests because she wanted all the regular keeping tabs testing (diabetes and high cholesterol run in my family, so we check these every 6-12 months), plus thyroid testing and a rheumatoid arthritis test, more for my reassurance sake than anything else. I predict that I will not have lowered my cholesterol and I'll be on a statin after this test, because it's genetic and DNA will win out every time. She's only been hesitant on medicating the cholesterol in case I want to get pregnant, but it doesn't appear like that's happening anytime soon and she said that going off the meds if I did get pregnant would be fine, really. In which case, let's cross that bridge if it comes to it. I also predict that the thyroid will come back absolutely normal because it always comes back normal. The rest is a toss up.
And finally, I have a script for a mammogram, because my mom had breast cancer when she was 45 and I have been strongly recommended to get a mammogram when I hit 35. However, we don't know if the insurance will pay for it, or if it will even be readable, because breast tissue in people under the age of 40 doesn't always come clear on the scans. She said that if the insurance won't cover it, it's up to me how hard I want to push it or if I want to pay for it out of pocket. She believes it would be a good idea to get the mammogram, but she said if I was comfortable with the uncertainty at the moment, waiting until 40 would be safe as long as I kept up with the self exams (which I would do anyway, but honestly, Mom's cancer was caught on a mammogram before it would have been detectable in a self exam and it was in an area that would have been difficult to spot until it was very large, so I'm aware of the limitations of the self exams). But absolutely not to wait beyond 40. So I have to call the insurance company and see what they'll cover. There wasn't an absolute exclusion for people under 40 in the summary document, but it did say that coverage depended on age and other exclusions.
So, I go back in a month to evaluate how the Wellbutrin is working. Blood work will be back by then (I'll go tomorrow on the way to work. I'd had breakfast already this morning and it's a fasting test. And I'll remember to tell them I have to lay down this time), so we'll deal with that, too. But yeah, that was stressful.
The doctor agreed with me that I need something other than the Prozac on board, so we're trying combining the Prozac with Wellbutrin. Wellbutrin works on dopamine, not serotonin (which the Prozac works on), and since I have ADHD, we pretty much know my dopamine system is...not optimal. We're hoping that helping out my dopamine system might take enough pressure off my overstressed brain to even everything else out. It's a combination that's been used for quite awhile and it has a good track record, so it's a reasonable next step. If it doesn't work, however, I'm going to need to go psychiatrist shopping because my GP admits that she's going on her best guess and while she's comfortable with dealing with basic depression that responds to the older and well known antidepressants, ADHD is a complicating factor and it's not within her specialty. There's other meds that I could try, but she's just not comfortable with prescribing them to me because she just doesn't have the experience with how ADHD and depression interact. I can totally respect the fact that she knows where her limits are, and I really appreciate her admitting that I'm hitting the limits of her experience.
(She was like, "okay, just because I'm suggesting a psychiatrist doesn't mean I think you're "crazy" or something. So, please do not be insulted." I was like, uh, yeah, I'm aware I have mental health issues and that psychiatrists specialize in such things. Insurance covers you. It only has limited coverage for psych services, which is why I'm here bugging you about this. So that was...yeah)
We are also doing a whackload of blood tests because she wanted all the regular keeping tabs testing (diabetes and high cholesterol run in my family, so we check these every 6-12 months), plus thyroid testing and a rheumatoid arthritis test, more for my reassurance sake than anything else. I predict that I will not have lowered my cholesterol and I'll be on a statin after this test, because it's genetic and DNA will win out every time. She's only been hesitant on medicating the cholesterol in case I want to get pregnant, but it doesn't appear like that's happening anytime soon and she said that going off the meds if I did get pregnant would be fine, really. In which case, let's cross that bridge if it comes to it. I also predict that the thyroid will come back absolutely normal because it always comes back normal. The rest is a toss up.
And finally, I have a script for a mammogram, because my mom had breast cancer when she was 45 and I have been strongly recommended to get a mammogram when I hit 35. However, we don't know if the insurance will pay for it, or if it will even be readable, because breast tissue in people under the age of 40 doesn't always come clear on the scans. She said that if the insurance won't cover it, it's up to me how hard I want to push it or if I want to pay for it out of pocket. She believes it would be a good idea to get the mammogram, but she said if I was comfortable with the uncertainty at the moment, waiting until 40 would be safe as long as I kept up with the self exams (which I would do anyway, but honestly, Mom's cancer was caught on a mammogram before it would have been detectable in a self exam and it was in an area that would have been difficult to spot until it was very large, so I'm aware of the limitations of the self exams). But absolutely not to wait beyond 40. So I have to call the insurance company and see what they'll cover. There wasn't an absolute exclusion for people under 40 in the summary document, but it did say that coverage depended on age and other exclusions.
So, I go back in a month to evaluate how the Wellbutrin is working. Blood work will be back by then (I'll go tomorrow on the way to work. I'd had breakfast already this morning and it's a fasting test. And I'll remember to tell them I have to lay down this time), so we'll deal with that, too. But yeah, that was stressful.
no subject
Date: 2015-04-21 11:27 pm (UTC)no subject
Date: 2015-04-22 12:01 am (UTC)