:o Hi everyone. Well here is a big vent about Megan's 2nd appointment with the psychatrist. During the 1st appointment he told me he was considering a bipolar comorbid with ADHD diagnosis for Megan. Because she is on antidepressants and stratterra, he wanted us to come back in two weeks (which was yesterday) to see how she was doing and talk some more about all this. So...DH takes a half day off to go with us, thinking we are going to talk about diagnosis and we get there (wait an hour because he is behind). He does not even know why we are there! Says he is not feeling well. He has us scheduled for a 15 minute appointment. I had to remind him why we were here. So he then pulls out her file and kind of describes the difference between ADHD and bipolar to DH who is having a hard time with all this. DH is really aggravated with him. He says after a short time that he can't really get into this now and has to end the session. I finally say that he wanted me to tell him how Megan was doing on the med. combo she is on. He says do I want to wait another 2 weeks to get a mood stablizer or get a presc. now!!!! :mad: I said I would wait, knowing I am done with this guy. I am going to get a second opinion. I am going to go to someone that just treats children. Tell me is it just me!?If you are seeking a diagnosis shouldn't you give someone more than 15 minutes!? Especially a child, who can't tell you exactly what is going on. It is going to take more time than that. So DH and I are determined to see just a child psychiatrist even if it is not totally covered. That will be hard too, because Megan has so many medical bills now that we are struggling. On the bright side, Megan started counseling and the counselor is great. She would not see the Dr. alone, so I had to stay with her. I got to hear her talk and I was glad she was talking about it. So one down, one to go. Thanks for listening...
Laurie

I'm a DH as well. Are you a FLYlady? We're going through similiar struggles as you are. My son has also been diagnosed with bipolar. As I understand it, the meds are very different for bipolar than ADD. We took our son off the effexor he was on as it may have been contributing to his difficulties. A 15 minute appointment is for med management, not diagnosis. That takes 45 minutes to an hour. Our doctor won't even do 15 minute appts. We stay there for 45 minutes whether we need to time or not. We're trying mood stabilizers now, seroquel and rispidal. The rispidal has been a lifesaver as our son has gotten increasingly combustible.

I'm a DH as well. Are you a FLYlady

What is DH and FLYlady mean

http://www.addforums.com/forums/showthread.php?s=&threadid=1324&highlight=true+hope

Check this link regarding BI Polar

DH stands for "dear husband" at a website called flylady.com. FLY stands for "finally loving yourself". It's one of the few websites my wife frequents.

There are at least a few Forum members here that are Fly ladies (www.flylady.com). I myself am a DH :)

Roger, I am not a fly lady (first I ever heard of this). The DH term is something I just always use on all the forums I have been involved with. Regarding your son...do you see a ped. psyc. for him or do you use someone who treats kids and adults? I am just wondering if the pediatric psys. would give us a little more time? Thanks,
Laurie

Laurie,

Personally, I think you are doing the right thing, by being a strong child advocate, and watching out for the possibility of careless medicine.

medications for bipolar can be more complicated and in some cases, require blood level checks periodically, and lithium can cause stress or damage to internal organs over time if not managed properly. My brother had kidney damage, went comatose for a week from poor management of lithium, and he acquired diabetes as a result of that episode. The management of bipolar is changing and improving as new medications are coming out all the time. However, if the dr is not showing professionalism and attentiveness, I wouldn't depend on him for delivery of such critical services nor depend soley on that diagnosis. I might start fresh with 2 more opinions, from 2 well respected child psychiatrists. Call psychiatrists and psychologists around your area, and ask who they would send their child to...

In my opinion, any serious medical diagnosis should be checked out with second opinions. Doctors are fallable, can disagree with each other, and medicine is an art.

GL

Jon

Thanks, Jon. I discussed all this with our pediatrician and he is giving us a referral to Children's Hospital. He knows everyone there and I trust his opinion. I did not go there 1st because our insurance will only cover 40%. It will be hard for us, but we want the best for Megan. She is going to have a complete neuro-psych. evaluation. I am waiting to hear when it will be. What do they do with this kind of evaluation? I am sure it it more intense than the one they did at school. In the meantime...she is really moody. We went on vacation last week and the transition was really hard. She was really impulsive, anxious, and angry. She is at the max with her Stratterra and I do not want to do anything more with the Prozac as it may be making the bipolar worse if she has bipolar. Our ped. was reluctant to take her off the Prozac, so I am waiting to see if she gets any worse. I also need to have a meeting with the IEP team to set up Megan's first IEP for next year. I am really hoping to get all this in place before the end of August.
Thanks,
Laurie

We're seeing a med doc who treats adults and children. We haven't decided if we're going to seek a 2nd opinion from a child specialist. Our son has been doing much better. The risperdal has been particularly effective. He went away for camp for the first time in his life this last week. They haven't called asking us to come pick him up! It was very strange to not have him around. Even though the relative calm and quiet is welcome, I realize we're geared up to his level of energy.

:o Well, I found out that there is an 8 month wait to get Megan in to see the Dr. our pediatrician wanted her to see. So I made an appointment to see the psychiatrist that I really do not like as a back up. I will call around this week to see if anyone else will see her for a second opinion (who treats children). I know she needs a med change. Her psychologist's colleage, is going to do an evaluation for us as he is the one who does the testing. I must admit, I am still baffled as to who makes the diagnosis...a psychologist or a psychiatrist? I know the psychiatrist does the meds and took a history, offering a diagnosis, but can the psychologist make a diagnosis too?
Laurie

Yes, the psychologist can make diagnosis. So can the psychiatrist. Personally, I have had positive and negative results with both, so it really comes down to the ability of the practicioner. Psychology and psychiatry are both an art, and a science, but still a large component of art. I have had better results when testing was involved, but that is not a fail-safe avenue either. With my child, things went very well with testing and diagnosis. As an adult, not the same luck. Psychologists will tend to consider non-medication interventions in addition to the medication interventions. Psychiatrists tend to look at medication interventions alone, but there are those who are going to break the mold and look at all possible interventions. It is more likely to get a behavior modification bprogram from a psychologist than a psychiatrist. They usually refer out for interventions other than medication. Psychologist is more likely to send forms to school for teachers to fill out, as a diagnostic tool, or to counsel the whole family, or to look at family dynamics as it relates to your child's behaviro patterns. for me, the appt at the psychiatrist is the easy one, just a couple changes here and there in the medications strategy. The psychologist appointment is the one that requires more thinking, and for me, gets results that are just as important as the results from a medication check.

For my child, the medication and the 4 times/yr appts with the developmental pediatrician is enough. She has seen a psychologist on occassion as a safety backup system, in order to be sure stressful situations of life were being dealt with in a healthy manner, and that she is developing well emotionally. Other than the testing from school psychologist in private practice, the other psychologist appointments have been helpful for our peace of mind, so we can hear the psychologist say she is doing well and we are providing the support she needs, doing well as parents in her life.

I hope that helps. I know the system is still intolerably confusing. GL with your child and be persistent.

Jonathan

we had a simialr exp. when b was just ending 1st grade. i took her to an adult psych. that was treating children. Well in the 1st visit, about 15 min. into the visit she gets up and hands me a sample pack of seroquel and a sample pack of Remeron. Does not tell me what kind of meds there were, or really even what they were for. She just says give these a try and will see you back in 2 weeks!! I go home give B the meds and I have a complete zombie for a child. so I called up the family practice doc and she has a fit and takes her off of the meds. Then sends us to another psych. I am learning as we go what questions to ask and to not be so trusting. If I have not been told what the med is, what it is for, what it will do, side effects, and confirmed dosage with the psych, I will not give it!! I also have acquired a rather large library of med books and adhd books, which i research the med the best I can before I give it.Just as in any profession there are some woo hoo's out there and you must becareful!!

phew - can't stress this enough: do your "homework", people!!!"

being diagnosed as an adult, i can't imagine (well, actually i *can*, but...;-) what it must feel/be like to be a parent of a child with (neuro)psychiatric "issues", but i *do* know that it pays to be well-read on any subject, and *this* subject (or *any* medical subject, really) in particular...

i've met some pretty weird/plain stupid people/doctors/shrinks along the way, and i have come close to giving up *"everything"* (which i almost managed to do in december last year, when i tried to commit suicide) a couple of times, but *thank God* i now have a *wonderful* doctor/psychiatrist, who - although she's not an adhd/add specialist (she's an expert on bipolar disorder and schizophrenia) - is willing to learn (from *me* and others), and is *very* empathic (is that a word???) and *really* great!