I've GAINED 1.3 pounds in the last three days! Weighed in on the 23rd, then just a few hours ago, today, the 26th.
Since I had recently been getting very bored of one type of item in my diet, I'd been seeking a change, and been changing some things up the last few days, which led to a variety of other items.
I don't think that those items were necessarily more calories than what I had been tiring of, but . . . . it's one possible factor. It's also potentially the fact that the TYPES and VARIETY . . . . .
It's a good thing I've been keeping a food diary, so I can see the difference between the last three days, and the previous 7-8 days, back to when I had started tracking the food; I can use the differences to mix-and-match some of the different types of stuff from the last few days that weren't in the previous 8 day stretch, and try to come up with a combination that still has me losing weight, but at a modest rate.
There'll likely be ups and downs, but I now don't feel as panicked that things will plummet in a free fall. Still, to do what I've done the last couple of days, is still a pretty big conscious effort to make sure I'm eating as soon as I feel like I've had just enough of a rest from the last meal or mini-meal. Ie, I'm not CONSTANTLY eating, but I can't go longer than 2 hours without trying to figure out what to fix so I get enough either. Depending on the WHAT, as far as content of everything I'm eating (granted, there's been two pieces of cake in the last three days, not huge though) and depending on when I add using the exercise bike to a DAILY regimen instead of it just being every OTHER day (with this walking on my knee, without a cane, AT HOME, being a new stress on the leg, I'm concerned about adding too much, especially since, after 6 days of it, it still doesn't feel stronger, and I get wobbly partway through the day still), adding in that daily exercise bike, will burn more daily calories.
I had REALLY been concerned about adding that daily biking, when I thought I had no way of controlling the rate of weight loss. With that fear beginning to be alleviated, that also alleviates the fear that I won't get the benefit to my leg that doing daily exercise biking will add to it. I'm just not quite sure when to add it. It doesn't really hurt, it's just I wish I felt even a slight difference after almost a week of walking on the leg at home . . . . .
Even with knocking physical therapy down to two days this week, since we have a total gym and the bike (the only other machine used at physical therapy is the knee bender, NOT an aerobic exercise, but painful; extension work is done on a table, and, again, not a calorie burner), I did my squats on the home TG and then used the home exercise bike on Wednesday, since this week we started with the reduced schedule of twice a week physical therapy on Monday and Friday. So I still got the "big" exercises in, although I suppose all the "extra" effort of getting out and going to the physical location would not have been there, taking some calories burned out of the equation, but not a zillion. Still a factor, though.
On another note, I think perhaps that, since I've been living with my bipolar and other mental health diagnoses for so long, that I've forgotten the potential impact that they can have on others, the potential judgment/stigma etc. that they can produce, the potential for a reaction of, "I'm not going near THAT with a ten foot pole . . . ."
Some might say, well, if someone would be like that, you're better off, but . . . it's not that simple. I just forgot myself and rattled off that hey, here's where I blog, to someone from my past, and now I'm worried that, well . . . .
Especially since it's been some time since I used the blog effectively for mental health advocacy, fighting stigma and fostering understanding and hopefully acceptance by showing what MY struggles and experience are like, with my illnesses, tough and harsh though they are at times, especially in the blacker storms, as well as it having been some time since I've used the blog effectively to show WHO I AM, beyond illnesses both physical and mental, although those are both aspects of my life experience, especially recently, in the surgical situation.
Jeez, if that wasn't a run-on paragraph, I don't know WHAT is. I am not doing very well at focusing lately, even ON my medication for that. STILL trying to get the appeal for the MRI claim written, as well as the financial papers for special small payments that are usually unacceptable for such a large balance, for the institution that performed the MRI's, finished and mailed off with associated financial papers. MUST be mailed tomorrow. Even so I don't know how we're gonna scrape up another $50 a month even if they DO accept it . . . . and we have to work out that much of a payment on another medical bill now, too, so . . . blimey.
Friday, February 26, 2010
Friday, February 19, 2010
A Nice Gesture In the Search For a New Psychiatrist
On Tuesday 'round 5pm, I was making a few more calls on psychiatrists. I had started at about quarter 'till . . . why is it I wait until the end of the business day? I'm sure these offices must love this, but apparently at least one clinician takes appointments after five . . . .
One guy, his non-hospital phone number mailbox was full. That doesn't bode well, and I'd guess his practice is full. Upon calling his hospital number, I did get transferred to the floor where he practices and sees patients, but he only sees people ages 55+. I am not sure if that applies to his hospital practice, or to his other address down the street 5 blocks as well . . . .
So my third call, though technically only to the second psychiatrist of the day, was to a man's office - I've never been aware of a woman named "Frederick", although it could happen, I suppose - "Freddie?" anyone? Or perhaps as had happened early in seeing my first psychiatrist, he was either suspended (as in that case) and needed a substitute, or perhaps just on vacation, but . . .
So. I call this Frederick's office, and a nice woman answers the phone. It just seems one of those things that was meant to happen, because no one else was around, and she usually wouldn't have picked it up, because she was in with a patient. I had started to talk before I knew that, but I did not start out with, "Are you accepting new patients?" I had settled, instinctively, on a different approach, which, with the few people I had talked to at the hospital, about the other guy, before I found out about the age thing, it seemed to strike a chord, and even then, they tried to put me through to his hospital voice mail, since they didn't know what kind of patients he saw at the other address.
This approach being, a pretty brief, but emotional, without crying or fakeness, but without hopefully too much desperation, but there's obviously some in my voice, because I don't want to go through 6 months again of a search, . . . I would say something like,
It's just, from what I can remember of the last search, if you can get a bit of YOU across to the other person, they are much more likely to want to help you, especially if you aren't wasting their time. Especially if you can show that you really are a person in NEED, which I think my little speech shows .
The lady at this Dr. Frederick's ***** office answered the phone, and was apparently in with a patient as I think I may have said, and DID indeed make that sound or word of assent when I got to the part about fearing they were closed to new patients. I went on with the gist of what I had to say, with a little give and take from her, learning she was with someone, not all of what I said above said in that block, and perhaps a little more was said, but I refined it just a little above. She was VERY kind, and sincere in her desire to help. For the second time, she reiterated she was with someone, but that she had two numbers/psychiatrists to refer me to, although she couldn't know if they took my insurance. As she was pulling up the numbers, she encouraged me and said, that if they, too, were closed to new patients, to ask these psychiatrists for referrals, and to keep on going, and to not give up. Some of this was said AFTER she gave me the numbers, as the numbers came up partway through her encouraging me.
She gave me the names and numbers, spelling them out for me as one is an ethnic name, not spelling like it sounded, and then she finished her quick but professional and definitely not brushed off advice about keeping on going - she had learned from me about how it had taken me 6 months last time to find a psychiatrist. We said our final niceties and parted ways, hanging up.
That was the NICEST, most GO OUT OF YOUR WAY for a patient you aren't going to take on, interaction that I've EVER had with a doctor's office of any kind, let alone a psychiatrist's. Based on that alone, I'd recommend, should they ever open up to accepting new patients, this lady highly to anyone. Her manner, and the way she handled things, reminds me of the way that Dinah over at Shrink Rap says she handles things . . . . just the POISE of the lady on the other end, and that little extra something. The whole call was under 3 minutes, and I'm sure she did her best by the patient she had with her. She wasn't even sure why she had picked up the phone . . . . so I'm not sure if it was one of those, "meant to be" kind of things.
I then went on to call and leave a message for the one name of the two she gave me, that is on the list I printed out from my insurance company. I even had it include everybody within 50 miles, although this name isn't that far, it's not as close as I'd hoped; still, doctors tend to refer to those that they've recently known to be accepting patients, although they also know that this status can change.
Or at least I HOPE they refer to those who they know that hey, at Christmas, they told me they were still accepting new patients . . . .
Crossing Fingers! Even if it is an 18 mile drive into the middle of Salt Lake. 7 miles farther than the last one, but beggars can't be choosers. It'd be something, though, if I found one so soon, now, wouldn't it?
Addition before post goes to press, a day after post was written:
Said psychiatrist I was referred to, her office called me back, and she IS taking new patients! Woohoo!!!! They need me to come in to fill out the New Patient Information packet, and copy my Insurance card, and from there they'll make the initial appointment. At first I thought, okay, I think I can get in there in about a week to do that, and told them so. After a few minutes of thought, though, considering that she's currently scheduling appointments into the beginning of March, and I'm not sure what the surgeon is going to recommend (given my recent other health issues I suspect he'd maybe hold off on surgery, even if he ignores the knee degrees), so I thought I'd better try to get in as soon as possible.
First, I called my Mother-in-Law, to see if she could pick me & dd up and head right down there, to arrive when they get back from their lunch break. It's further away than I'd wish, but it beats the pants off of a 6 month search, and it's a sparse market for psychiatrists if you are looking for one that takes insurance, especially YOUR insurance. Psychiatry is one specialty where they tend, apparently, to sometimes or even often practice without taking any insurance at all! Because it's hard to find one, or find one that fits you well, sometimes people DO have to go out of network to find one that works for them, and/or go with one that doesn't take insurance at all and go through a hassle to get some pittance of reimbursement later from their insurance company. I'm glad that it seems I won't have to think about that road, because after having to have probably crossed out a huge chunk of providers that would see my huge MRI bill on their computers and not want to take me on, potentially, and cross off the next biggest block of psychiatrists listed that is apparently a Child & Adolescent practice, and then hitting one who is a Geriatric specialty . . . . aside from the couple of, closed to new patients . . . . well pickings on my 50 mile distance list were looking slim (although the ones over 40 miles I crossed out as too far, anyway; the choices for distance were 25, then 50, so if I wanted to include 30 miles I had to go out to 50 miles).
Not that this prospect is 30 miles out, although round trip is more than, I'll say that much.
My Mother-in-law was free that day to be able to take me and my daughter there at that time, which I am grateful for - I'll have had time to have iced my knee a bit after physical therapy, although my knee is NOT looking forward to the car ride . . . . it's a gonna hurt!!!.
I'm going to attempt to have my list of past psych meds and when and by whom prescribed, typed up - and why they didn't work out, if they didn't . . . . so I can have that handy.
Maybe surgeries too, for the medical history, as a reminder to me. Don't want to get TOO obsessive.
One guy, his non-hospital phone number mailbox was full. That doesn't bode well, and I'd guess his practice is full. Upon calling his hospital number, I did get transferred to the floor where he practices and sees patients, but he only sees people ages 55+. I am not sure if that applies to his hospital practice, or to his other address down the street 5 blocks as well . . . .
So my third call, though technically only to the second psychiatrist of the day, was to a man's office - I've never been aware of a woman named "Frederick", although it could happen, I suppose - "Freddie?" anyone? Or perhaps as had happened early in seeing my first psychiatrist, he was either suspended (as in that case) and needed a substitute, or perhaps just on vacation, but . . .
So. I call this Frederick's office, and a nice woman answers the phone. It just seems one of those things that was meant to happen, because no one else was around, and she usually wouldn't have picked it up, because she was in with a patient. I had started to talk before I knew that, but I did not start out with, "Are you accepting new patients?" I had settled, instinctively, on a different approach, which, with the few people I had talked to at the hospital, about the other guy, before I found out about the age thing, it seemed to strike a chord, and even then, they tried to put me through to his hospital voice mail, since they didn't know what kind of patients he saw at the other address.
This approach being, a pretty brief, but emotional, without crying or fakeness, but without hopefully too much desperation, but there's obviously some in my voice, because I don't want to go through 6 months again of a search, . . . I would say something like,
"Well, I'm Sara XYZABCD, and I'm looking for a new psychiatrist. Now, I'm afraid (or, "I fear") you are about to say you aren't taking any (at which point a sound of assent/agreement is usually what I hear), but I will just say that I see a psychologist for therapy, am 37, 8 weeks out from a total knee replacement, have recently lost 13 pounds in 13 days from anxiety, depression, & other reasons and really do not want my physical condition to continue to deteriorate this way, especially after such a major surgery. I see a psychologist for therapy, but my last psychiatrist never called me back when I called him about a potentially life-threatening reaction to a medication. This is also why I am not on an anti-depressant at the moment; too tricky of an issue for my GP.Now, that right there LOOKS like it takes MUCH longer to say than it actually does. It's pretty quick to say, and even for those who are closed to new patients, they get the gist that I really do need a new psychiatrist, what some of the issues are, it's not assuming failure right off the start like a straight out, "Are you taking new patients?", even though that's sort of in the second phrase of my first sentence in a different form . . .
It's just, from what I can remember of the last search, if you can get a bit of YOU across to the other person, they are much more likely to want to help you, especially if you aren't wasting their time. Especially if you can show that you really are a person in NEED, which I think my little speech shows .
The lady at this Dr. Frederick's ***** office answered the phone, and was apparently in with a patient as I think I may have said, and DID indeed make that sound or word of assent when I got to the part about fearing they were closed to new patients. I went on with the gist of what I had to say, with a little give and take from her, learning she was with someone, not all of what I said above said in that block, and perhaps a little more was said, but I refined it just a little above. She was VERY kind, and sincere in her desire to help. For the second time, she reiterated she was with someone, but that she had two numbers/psychiatrists to refer me to, although she couldn't know if they took my insurance. As she was pulling up the numbers, she encouraged me and said, that if they, too, were closed to new patients, to ask these psychiatrists for referrals, and to keep on going, and to not give up. Some of this was said AFTER she gave me the numbers, as the numbers came up partway through her encouraging me.
She gave me the names and numbers, spelling them out for me as one is an ethnic name, not spelling like it sounded, and then she finished her quick but professional and definitely not brushed off advice about keeping on going - she had learned from me about how it had taken me 6 months last time to find a psychiatrist. We said our final niceties and parted ways, hanging up.
That was the NICEST, most GO OUT OF YOUR WAY for a patient you aren't going to take on, interaction that I've EVER had with a doctor's office of any kind, let alone a psychiatrist's. Based on that alone, I'd recommend, should they ever open up to accepting new patients, this lady highly to anyone. Her manner, and the way she handled things, reminds me of the way that Dinah over at Shrink Rap says she handles things . . . . just the POISE of the lady on the other end, and that little extra something. The whole call was under 3 minutes, and I'm sure she did her best by the patient she had with her. She wasn't even sure why she had picked up the phone . . . . so I'm not sure if it was one of those, "meant to be" kind of things.
I then went on to call and leave a message for the one name of the two she gave me, that is on the list I printed out from my insurance company. I even had it include everybody within 50 miles, although this name isn't that far, it's not as close as I'd hoped; still, doctors tend to refer to those that they've recently known to be accepting patients, although they also know that this status can change.
Or at least I HOPE they refer to those who they know that hey, at Christmas, they told me they were still accepting new patients . . . .
Crossing Fingers! Even if it is an 18 mile drive into the middle of Salt Lake. 7 miles farther than the last one, but beggars can't be choosers. It'd be something, though, if I found one so soon, now, wouldn't it?
Addition before post goes to press, a day after post was written:
Said psychiatrist I was referred to, her office called me back, and she IS taking new patients! Woohoo!!!! They need me to come in to fill out the New Patient Information packet, and copy my Insurance card, and from there they'll make the initial appointment. At first I thought, okay, I think I can get in there in about a week to do that, and told them so. After a few minutes of thought, though, considering that she's currently scheduling appointments into the beginning of March, and I'm not sure what the surgeon is going to recommend (given my recent other health issues I suspect he'd maybe hold off on surgery, even if he ignores the knee degrees), so I thought I'd better try to get in as soon as possible.
First, I called my Mother-in-Law, to see if she could pick me & dd up and head right down there, to arrive when they get back from their lunch break. It's further away than I'd wish, but it beats the pants off of a 6 month search, and it's a sparse market for psychiatrists if you are looking for one that takes insurance, especially YOUR insurance. Psychiatry is one specialty where they tend, apparently, to sometimes or even often practice without taking any insurance at all! Because it's hard to find one, or find one that fits you well, sometimes people DO have to go out of network to find one that works for them, and/or go with one that doesn't take insurance at all and go through a hassle to get some pittance of reimbursement later from their insurance company. I'm glad that it seems I won't have to think about that road, because after having to have probably crossed out a huge chunk of providers that would see my huge MRI bill on their computers and not want to take me on, potentially, and cross off the next biggest block of psychiatrists listed that is apparently a Child & Adolescent practice, and then hitting one who is a Geriatric specialty . . . . aside from the couple of, closed to new patients . . . . well pickings on my 50 mile distance list were looking slim (although the ones over 40 miles I crossed out as too far, anyway; the choices for distance were 25, then 50, so if I wanted to include 30 miles I had to go out to 50 miles).
Not that this prospect is 30 miles out, although round trip is more than, I'll say that much.
My Mother-in-law was free that day to be able to take me and my daughter there at that time, which I am grateful for - I'll have had time to have iced my knee a bit after physical therapy, although my knee is NOT looking forward to the car ride . . . . it's a gonna hurt!!!.
I'm going to attempt to have my list of past psych meds and when and by whom prescribed, typed up - and why they didn't work out, if they didn't . . . . so I can have that handy.
Maybe surgeries too, for the medical history, as a reminder to me. Don't want to get TOO obsessive.
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