ADHD friendly doctor in Indiana? [Archive] - ADD Forums - Attention Deficit Hyperactivity Disorder Support and Information Resources Community

zimmiegirl

03-03-08, 09:26 PM

Hi!

I was glad to see this thread (small as it is) asking about ADD docs in Indiana. I have had a "heck" of a time sinc moving here from the East Coast. If anyone else knows of other places or doctors, please jump in and tell us your secrets! Here's my long hyperfocused post of the evening.

I looked up Dr. Macari at CarmelClinic. Looks like she only takes regular insurance and cash. Any idea whether she accepts Medicare? Also, what type of treatment does she offer? Therapy, coaching, and meds -- or meds only? As for ADD meds, what is her drug of choice and dosage for Adders? I know that's a lot of brash nosiness, but I'm beyond the point where tact seems to make much difference. lol. (Is her husband also a doc or a therapist?) Her office is only blocks from where I live.

I don't know what part of Indiana each of you are located, but I will give you the names of a few mental health (that also are substance abuse facilities) with satellite offices in several cities. One is BehaviorCorp, main office is in Carmel, other offices in Noblesville, Lebanon, and Indianapolis. Maybe Frankfurt. Demand to see the psychiatrist rather than the NP, if you try it. Better yet, go to any of the offices other than the one in Carmel.

Indiana Health Group (Network?) is now headquartered in Carmel (right behind BehaviorCorp) and I believe it also has satellite offices. You will see a NP for meds. If you are lucky enough to be under 30, you might get an optimal dosage after a couple of trips about three weeks apart, unless you have paperwork from a recent doc who's been prescribing for you.

Midtown Mental Health has offices on the west side of Indy, near Speedway, but that's the satellite where the "really crazy people" go. ;)

Midtown also has an office at Community North Hospital, I think. No, sorry, I think it's a Gallahue Mental Health satelite at Community North. No matter, Community North's psych center has a decent reputation. I haven't been there, but I know more than a few folks who have been.

Gallahue Mental Health's other office covers the far east side of Indy and areas east or southeast beyond that.

I've heard that St. Vincent's Hospital has given up on mental health altogether and has closed its' crisis office. If anyone knows otherwise, please advise.

I have NO IDEA what Clarian/Methodist Hospital is offering in the way of ADD treatment. They are a big enough operation that they should have some sort of ADD program with coaches, therapists and doctors to prescribe.

Wishard Hospital has always been "THE inner city" hospital in Indianapolis -- and the only one you could walk into if in dire need of meds and usually get them on the same day, but only after an intake and a long wait. Midtown Mental Health most likely has its' main office located there, but I haven't had time to check.

Other than the Indianapolis and Indy North area, I don't know what the rest of the state offers. In Hendricks County, west of Marion, there is Cummins Mental Health, which I've heard some good things about, but you have to live in Hendricks to use it, I think. There is another center in Avon with a p-doc who supposedly "specializes" in ADHD or adult ADD (and many other disorders for which he writes prescriptions). Hendricks County encompasses Plainfield, Avon, Brownsburg, Danville and a few other little burgs.

So there's my "wealth" of knowledge, which isn't much.

As for BehaviorCorp and Indiana Health Group (or Network), you need to be on Medicaid, Medicare, insurance that covers some mental health treatment, or have a cash cow, because they want cash if you aren't on any of those, and if you are on one of them, they won't bill your provider for months, then all of a sudden you're staring at a whoppin' bill -- and if you want your prescriptions written, you'd better be able to pay it.

I've never (since I was in my 20s) had to have a psychiatrist or NP write my ADD meds.

Either an internal medicine doctor or neurologist wrote them. When I was much younger, family practice doctors wrote everything, even though most of it was wrong. ;)

Since moving to Indiana I've seen p-docs who've treated me only with lots of SSRIs (which certainly have never worked for me!), then I've been to three Mental Health Facilities where the psychiatrists are too busy to see patients, so they use Nurse Practitioners.

These were my first experience with NPs. The first was a v-e-r-y bad experience (at BehaviorCorp in Carmel), second one was mediocre ... no real help, and now I think the third one is the best I'm going to get, BUT I'm still not feeling confident about ADD treatment in this area. I've been seeing her for close to three months, but I've only "seen" her for less than an hour TOTAL. And she wants me in therapy and I cannot afford their rates, even with Medicare paying 50 percent. Most of the places that have NPs or even pyschiatrists here also have therapists or social workers and you are strongly encouraged to therapy.

Treatment becomes very expensive very quickly, unless you have extremely good insurance, are your parents' insurance or are on Medicaid. If you are on Medicare, like me, my co-pays are exorbitant. I cannot afford to pay them if I have to see a therapist weekly and the NP monthly. Medicare pays only 50 percent of mental health service charges.

Today, the trend (in the Midwest, at least) seems to be private corporate mental health facilities where, if you don't pay every single payment after each appointment, you will not be allowed to see your prescriber or therapist. The almighty dollar determines whether or not you will receive treatment, and even then, you certainly aren't guaranteed quality treatment.

My NP is allowed to see me for ONLY 15 minutes. We can't even discuss what my meds are doing, if anything, in that short amount of time. She just rewrites what she originally decided I needed during my initial appoinment and that's it -- sayonara!

I live in Hamilton County (Carmel) but am moving to Indianapolis (Marion County) within a month. So I'm already scouring the Internet looking for an ADD doc or mental health center in Marion County, which, since it's the capital of Indiana, one would think there would have a number of mental health services affiliated with the hospitals as well as county-funded.

But, it's not looking good. I've phoned a couple of centers that have been around for a long time. The director at one place told me that I wouldn't "fit in" there because her center was for "really mentally ill" people. DUH. When I called the second one, the nurse supervisor who answered the phone said, "You wouldn't want to come all the way over here. You should be able to find a place a lot closer." Then she referred me to the place where the "really mentally ill" people are. lol.

Another thing about Hoosierland that really addles me is when you ask for Dexedrine Spansules or tabs, which have been around forever and are proven to be much safer than many of the newer ADD meds, the p-docs raise their eyebrows as if you've asked them to write scripts for heroin. Yet they push Adderall XR and d-amp like there is no similarity in the world to them and Dex.

Of course, now they are pushing Focalin, which I will never take, as it's just another form of Ritalin. Same for Vyvanse. Lotsa money in ADD for the pharm companies.

Adderall XR is a rollercoaster ride for me everyday.

When the alarm goes off around 8:00 AM telling me to wake up, I feel like I've been run over by a truck, so I take an AddXR and a 10MG d-amp and it takes about 90 minutes before I feel anything. Around noon, it's at its peak. So, once I've taken the Adderall, my mornings are upbeat and somewhat productive.

This would be GREAT if only I could wake up earlier than 9:30 or 10:00 AM after being hyperfocused until 2:00 or 3:00 AM, thus getting only five hours sleep at the most. The mornings don't last long enough for me to get much more done after the meds kick in, then I fix something to eat, feed the cats, scoop litter boxes, check email -- and by then it's noon or later.

Usually I have some kind of appointment between 11:30 and 2:00, because I know I should be as good as I'm gonna get. By 2:00 -3:00 PM, Adderall XR's second wave hits and hangs in until late in the afternoon. During this time -- and for the rest of the night -- there is absolutely NO worthwhile productivity from me. I don't even notice that I'm hyperfocusing until I've been on the computer for seven or eight hours -- or doing something else completely contrary to that which I should be doing -- because my life has been crashing around me for the past nine months.

I can't afford to hyperfocus on anything but getting my house cleaned out, packing boxes, holding a garage sale, and making enough money to pay a moving company to move me from Carmel to Indy on April 1. I've told my NP this, and her answer is that I just have to "set aside" a special time each day to do housework, pack books, etc.

Sounds easy ... and surprisingly naive coming from a NP who specializes in ADD.

I never had that problem with Dex, although I do like reg Dex more than the Spansules. They don't last as long as the ADD XR, which is good in my opinion. And the honest to God truth is that Desoxyn has worked best of all for me in the past, but dare I tell that to my new NP?? I don't think so.

I am certainly no longer a kid, and have had ADHD since I was under 5 years old. My grandmother took me to her family doctor (the doctor who delivered me!) who determined that I had "hyperkenetic disorder." That was in the '50s. By the time I was 10 or so, he had added "conduct disorder" to my first diagnosis. At that time he was prescribing me Phenobarbital and Librium, a knock-out concoction of a barbituate and one of the first benzodiazepene meds. It made my ADD worse, made me have severe mood swings, and made me drive everyone crazy.

My aunt, seeing red flags, secretly took me to another family doctor when I was 11. He told her that I had "hyperactive disorder" with "severe lack of attention span" and agreed that I did indeed have a serious "conduct disorder" which he told her was usually only seen in boys. He took me off the other drugs and prescribed Dexedrine. What a wake-up call!

Within a week, my personality changed drastically for the better, although I was developing more impulsive behavior. Grades became better and I thought I would "grow out of it."

I had several cousins who also had these same diagnoses, which I really didn't think about much until adulthood. One of them has been institutionalized since she was 5 years old. Another died in a state institition when she was in her early 30s. She choked to death. The first cousin (who is still institutionalized) does NOT have ADHD, nor did she ever. She was/is severely mentally retarded with the mentality of no more than a 3 year old. Very sad.

The second cousin, who died, DID have ADHD/inattentive & hyperactive variety with severe conduct disorder as a child and early teens. But when she was in her later teens, she developed epilepsy. No one in the family ever talked about whether one was related to the other, so I was scared stiff that I too was going to have seizures like hers. Things got much worse for her.

By her mid-20s, she had been diagnosed as paranoid schizophrenic after trying to kill her dad while he slept. This was shortly after her mother died of breast cancer, she had been off all her ADD meds, and her dad remarried within less than a month. She was placed by her dad into a state institution where she used to phone relatives and carry on conversations as if she were just fine. Then she ran away with an orderly from the institution and became pregnant. Her dad, by then her legal guardian, had the fetus aborted and got the marriage annulled.

But her phone calls continued as usual with her always sounding slightly hyper and "giggly," but no more so than many so-called "normal" people I've known. So, there's ADHD and then there's myriad disorders that are misdiagnosed as ADD or overlooked completely.

My family moved from one place to another a lot, and because of the constant moving, I was out of meds for long periods of time. When that happened, I went back down into the rabbit hole or tore out of a phone booth in my Superman outfit ready to ....?????? Who knows?! In one of those no-meds periods, at 15, I ran away and married a 19 year old boy who trimmed my grandmother's shrubs.

Soon thereafter, knowing I'd made a huge mistake but not knowing exactly what to do about it, I went to an OB/GYN, as suggested by my mother who lived 800 miles away. He prescribed birth control pills and then asked me if I had ADHD. Filled him in on my history and he immediately prescribed Dexedrine (and took away the birth control pills, telling me to use birth control "foam" instread).

Shortly I became pregnant -- and so did my mother, who wanted me to come to Indiana to live at "home" and help take care of the new baby and help out with my other three sibs. I had practically raised the other three sibs since I was old enough to carry my first brother, and I knew that I didn't want to raise a child of my own and another sib who would be almost the same age. I also wanted out of the marriage BADLY, but felt like I had no option. (Abortions were still illegal at that time.)

I stayed in the marriage (if that's really what is was) and my son was born. I noticed almost immediately that he was very bright but very hyperactive -- way too much like I had been as a child. After he was born my OB/GYN put me on a higher dosage of Dexedrine and also on Obetrol, an amphetamine he said he was prescribing to help me take off the weight I'd gained when pregnant.

All of a sudden, life seemed wonderful!!! My moods stabilized again, I wasn't foggy brained, my concentration was great and I went back to school. The next time I saw the OB/GYN he prescribed more Obetrol to help maintain my weight loss and he noted that it "sure hadn't made my ADHD worse."

Today, I laugh when I remember him saying that because of all the hullaballoo about how unsafe this new ADHD drug Adderall was when it was introduced in the '90s. It was nothing new about it all except the packaging and manufacturer. Adderall is simply Obetrol repackaged with a different brand name. Absolutely the same drug as was being prescribed in the '60s for weight loss. By the '70s and on into the early '80s, Obetrol lost out in the "go" drug category, as well as the diet pill market, because of newer drugs like Biphetamine 20 which would allow you to stay up for days if you wanted.

When the '70s came around, I was doing well on Dexedrine, though at much higher doses than those now prescribed for adults with ADD. Today's six-year-olds have a better chance of getting an optimal dosage of Dex than do adults.

In the mid- to late-'70s, I had gone off my meds (I have no idea why) and my life really became a nightmare. Went to a neurophyschiatrist who tested me and started me on a cocktail of Desoxyn, Dexedrine, AND Biphetamine 20, by then the most popular amphetamine for both weight loss and partying.

Instead of exhibiting any worse ADD symptoms or behavioral problems, once again I settled down, was able to focus, began to read about 10 books a week, had no mind fog, was being nice to people, (and was doing well in my management job with AT&T).

The only problem that I couldn't elude is one that still remains: my severe impulsivity. And the ONLY drugs that ever helped with it were Dex at higher dosages than I'm likely to get from my current NP, and Desoxyn, which I'm sure I wouldn't get if I did ask for it.

If anyone knows of or hears of a doc or clinic where someone will dispense ADD meds to people who REALLY need them in the central Indiana area, please post it!

For now, Hi-ho! Cate