Posted by liliths on February 8, 2008, at 11:26:58
In reply to What a terrible situation » liliths, posted by Racer on February 7, 2008, at 13:05:40
hi racer... thanks for understanding.
unfortunately, I can't change pdocs without raising red flags with PRN (that's the 'governing agency' responsible for the monitoring). I'm stuck with him until I can get out of this contract or I just can't take it anymore and walk away from the profession (which I'm not earning anything from anyway but worked SO hard for)
I did think about having my primary prescribe my meds until I realized PRN probably wouldn't accept my not being 'monitored' by a psychiatrist and would most likely make me see one of theirs (at my own expense!) and who knows what kind of disaster that could yield, besides putting me deeper into debt
And I understand completely about what breaking a concerta pill does - that's one of the reasons I do it. I preferred focalin XR as it came on faster. Breaking one of the concertas helps with that. If I take 1- 1/2, I do have 1 concerta working properly
But the other reason I do it is that I have to 'stockpile' my meds as my insurance won't cover them all year. I have a limit of about $2400 per year. My new insurance, though much better for doctors, is worse for my meds - they charge MUCH more and I'll hit my ceiling much faster - am likely to barely make 6 months at this rate. With the other one I almost made 11 months before I had to pay 100% and that's simply not an option. I'd end up on nothing! This insurance doesn't cover focalin and is charging over $300 for each concerta script! Though my co-pay is only $30, they tally both costs in my 'covered' expenditure of $2400 . My other one only charged about $200 for either concerta or focalin and that co-pay was $25. All my other meds are much more expensive as well. My co-pays are higher (in most cases $0 is now $8) but 'their' costs are considerably higher than what the other insurance used. I think this one is charging my account what I would have to pay, whereas the other must have used their actual cost. I don't really know. But I probably should cut down to only 1 concerta per day within the next month or so if I'm to have enough for 12 months and may need to start cutting back on my others as well. My other option is to go onto something cheaper, like plain old ritalin. But I hated the ups and downs of ritalin and don't think those crashes would do me any good, particularly under the circumstances I'm stuck with
as for fighting, I fought a good long one and did look into legal representation. PRN makes almost 85% of it's revenue from the state... they're quite a big fish here. I did shell out $350 to a Health Law firm only to have them tell me that yes, what PRN was doing was illegal, but good luck trying to get anything done about it - and they were right, I couldn't find a lawyer (including them!) willing to even consider taking them on. I suppose if I were wealthy and could afford to pay, I 'might' be able to fight some sort of suit but even then..
the law is the law and unless that changes, the best I can hope for is an early release. You'd be surprised how apathetic people are to this kind of thing - unless it's hitting them directly, nobody really wants to get involved.now as for the therapist, that's just another chapter in this amazing unfortunate farce. I was with the same therapist for over 10 years and we had a great relationship. When this whole thing hit, I knew I needed to be back in therapy but it was around the same time as hurricane Katrina. My therapist literally disappeared on me and never really looked back. He became quite involved in Katrina and in fact, had I been licensed when I was supposed to, I had opportunities through him waiting for me in Louisiana as they have reciprocity with Florida. So as my therapist began spending a lot of time in LA, it never even occurred to him to refer me to someone and I was so nuts it never occurred to me to ask him to. I went through this entire ordeal with NO support beyond that of friends, family and this board. My therapist did write letters of recommendations etc, and I saw him a couple of times but as time passed he spent more and more time away till he was simply gone from my life. I must admit the betrayal I have felt as a result has been enormous and on top of many other experiences I've had, I've learned I simply can't trust therapists or pdocs not to betray me when I need them most
Now I don't have the strength, or the money to start over again... though I recognize I really should be seeing someone. But I'm totally and utterly broke. My old therapist was only charging me $10 a session by then - maybe that made it easier for him to walk away. I'll never know - my last attempts to reach him have gone unanswered. And like I said, we'd had a very close relationship over the years - the way he abandoned me was devastating.
PRN supposedly gave me a fairly lenient contract as compared to most. My therapist was also expected to 'have to' file quarterly reports. I explained I didn't see him on a regular basis anymore - that after all these years I only used him occasionally. They agreed to allow him to only file reports when I did see him and we did manage to file one... hopefully that will keep them off my backs. So not having a therapist anymore is just another secret I have to keep from them.
I try and tell myself to just hang in there until august, after 1 year of monitoring, when I feel I can reasonably ask for an early out of my contract. Right now, my contract reads I may be 'considered' after 3 years but I doubt I can do this that long.
anyway, as I initially wrote, I recognize that there's really nothing anyone can do for me so again, I thank you just for being here.
it was a futile post and I'm sorry if I wasted anyone's time
namaste,
lilith> That's terrible, and I'm very sorry you're struggling with all this. I well understand that limp feeling you're describing, as though a spring has snapped, and I certainly understand why you'd be feeling that way.
>
> I do have a few suggestions, none of which are likely to make you feel a whole lot better at this point, but most of which have a chance at helping down the line.
>
> First, that is *not* a description of a good fit with your psychiatrist. I strongly recommend that you consider interviewing some other pdocs, and maybe getting a second opinion or even third opinion. (I won't suggest you fire your current pdoc, but the thought certainly crossed my mind...) Alternately, if you have a good GP, maybe get your meds refilled there, since your pdoc won't change anything anyway?
>
> Also, Concerta's mechanism of release means that cutting it in half is a bad idea. In fact, it basically negates the whole slow-release thing. If you're finding the 108mg too high, maybe ask about dropping to the 36mg or even 18mg size, and combining two or three of them to get a good dose for you. Cutting the pills just isn't a good idea.
>
> As far as the licensing goes, my blood pressure went up when I read that. Aside from moving to a state without that sort of restriction, my knee jerk reaction is "VOTE!" Other than that, though, there are a few ideas floating in my brain about fighting it, but they'd all require you to be in fighting fit -- which means over this breakthrough depression.
>
> By the way, this sounds like a good situation for therapy -- just for the support and help learning to cope and with help brainstorming solutions. Have you got a good therapist? Or can you get in to see a therapist? I think it would help. (Although not as much as more reasonable licensing laws, perhaps, and more effective medication...)
>
> Good luck.
poster:liliths
thread:810489
URL: http://www.dr-bob.org/babble/20080207/msgs/811514.html