The Last Visit

Well, the long-dreaded parting with my psychiatrist has finally happened: thanks to my insurance, which will only pay for care received in my county of residence, yesterday was my last visit with Dr. Awesomesauce. And all I can say is I’m thankful I’m not in crisis at this point, because I’m not fond of the idea of getting my mental health care through the county clinic. Dr. A says he’s going to do everything he can to keep me on as a patient, but there’s not a lot he can do and frankly, it would take a miracle to persuade Medicaid to allow me to continue with him. That’s just the reality I have to deal with, and it sucks.

He didn’t just cast me adrift, however. He is willing to prescribe for me for as long as I need it (it may be awhile till I can get in to see someone) and gave me a list of resources in the local area, as well as some names of doctors NOT to see. I’ll probably have to find a therapist as well because most psychiatrists and psychiatric nurse practitioners aren’t like Dr. A, they only prescribe and don’t do therapy. I was lucky to have the luxury of “one-stop shopping”, as it were, and that’s probably not going to happen again.

What I fear is getting lost in a sea of other mentally ill poor folks in the clinic setting. Maybe I don’t deserve any better—I did let my bipolar get out of control and pretty much ruin my life, which is why I’m in this predicament—and I’m certainly nobody special in the great scheme of things. But with Dr. A, I’m an individual in whom he’s invested a lot of time and care; there, I’ll be just another psych patient. Which is something I’ll get used to, because I have no choice…I’ll have to be under somebody’s care for the rest of my life.

This is more than a little scary. I don’t want anyone messing with my meds—they are almost perfect just the way they are and even Dr. A is adamant that we don’t change anything. It took three years to get to this level of stability and I’m terrified a doctor or NP is going to think I’m on too much medication, or on the wrong kinds, and screw it all up for me. I know people who’ve had this happen to them and it took what seemed like forever to get back on track. And I’ve been really high-maintenance during most of the past four years…who will be there for me when the next bipolar shitstorm occurs?

But what grieves me the most is the loss of the relationship I’ve had with Dr. A. I’ve never known anyone quite like him, and I’m going to miss him sorely. How many doctors do you know who served in the Iraq War, have traveled the world, pray for their patients and do their own home canning?  Not only that, but he knows things about me that even my own family doesn’t know, things I’m not proud of and would never share with anyone else, and yet he’s never looked down on me. Unfailingly supportive, kind, funny, smart…that’s what he’s been, and I can’t imagine how anyone else will ever fill his shoes. In fact, I almost feel sorry for my next psychiatrist, because Dr. A is the standard by which all future mental health care providers will be judged.

So I’ll call the mental health clinic on Monday and do whatever I have to do to get on board with them. As sad and disappointed as I am, life must go on and I need to get on their radar so I have somewhere to go when the fecal material collides with the oscillatory ventilating system. Because it will, as Dr. A reminded me yesterday; after all, bipolar is the gift that keeps on giving, though it’s been pretty easy over the past eight months or so to forget that I even have it.

I’ve had the feeling this was coming for some time. I was even prepared for it, which is why I’m not panicking. But it’s still a blow, and I am most unhappy about it.

And so it goes.







Published by bpnurse

I'm a retired registered nurse and writer who also happens to be street-rat crazy, if the DSM-IV.....oops, 5---is to be believed. I was diagnosed with bipolar I disorder at the age of 55, and am still sorting through the ashes of the flaming garbage pile that my life had become. Here, I'll share the lumps and bumps of a late-life journey toward sanity.... along with some rants, gripes, sour grapes and good old-fashioned whining from time to time. It's not easy being bipolar in a unipolar world; let's figure it out together.

6 thoughts on “The Last Visit

  1. Nowhere near as severe, I had to let go of a psychiatrist a couple years ago whom I’d had for 10 years (he took a job w/ the hospital). He was not amazing, he had not given so many details of his personal life, but still – having someone be able to remember your history, your weaknesses, your hopes and dreams, the moment they saw your face, yeah, that alone is invaluable. Add the other elements of Dr A and I understand, this is a major loss. Grieve it as you might any other significant relationship and don’t minimize that. Meanwhile, you know the qualities you expect AT MINIMUM. Go for them! Love you deah

    Liked by 2 people

  2. First of all – you do deserve better!

    That being said if Dr. A can give you some trusted resources or even perhaps a referral/introduction, then you have a good chance of being able to continue to find a beneficial professional/medical relationship.

    Good luck in your “quest” and best wishes always!

    Liked by 1 person

  3. First of all I really feel your pain. I had a therapist of 20 years who died in an accident. But I actually found someone who is excellent…it worked out other than my grieving for my therapist.
    My psychiatrist is 70 some years old. I have seriously been seeing him for 27 years. I know he will retire soon. But what can you do? Just move ahead I guess.
    As far as the “poor” clinic…I used to go to a bipolar support group located in a clinic for those on state aid. It was weird, because even though I had private insurance, they still got all of these services denied to me. All kinds of support services, transportation here and there, therapeutic activities, places to go and do activities, hot meals…etc. Just a clump of services. Maybe there are some things you can benefit from. All of our people also had an advocate. And got free meds. You just never know.

    Liked by 1 person

  4. I send my condolences, but want to remind you that what Dr. A offered will remain with you. You have developed insights and coping skills. You have found a medication combination that works. You are a nurse. Advocate on your own behalf. Do not assume that the county clinic will consider you “just another psych patient.” Mental health care professionals, most at least, entered their vocation because they care. You are now an informed patient/client/consumer. Each therapist I’ve had over the years has had something different to give. Consider this an opportunity. I wish you the best. I will keep you in my thoughts and prayers.

    Liked by 1 person

  5. I bet you’ll find a good Dr./therapist. Probably not in the same person like you had, my first Dr. also did therapy and it was great, but when she moved to another state, I couldn’t find anyone else who did that. I had found a good nurse practitioner and therapist, but now she’s cutting her hours and I’ve been in crisis, so the Mental Health Center has been shuffling me between three other Dr.s, two of whom only passed their boards (or whatever the term is) last week! They’d been working as psychiatrists before they were licensed! (they were M.D.s) Hmmm… I started out trying to reassure you! I’m sure it will work out well for both of us in the end though….

    Liked by 1 person

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