Tuesday, July 19, 2011

End of an Era

After spending my entire life with PPO insurance and medical teams, I said goodbye to my endocrinologist today.  Starting next month I venture into the HMO frontier.  The good news is I can see an endocrinologist in my own city.  Not that 17 miles away is far to see an endo.  But given the fact that those 17 miles are most easily traveled via freeway and I hate the freeway . . . my own backyard will be a welcome change! 

It was a strange last meeting with my endo today.  I was crazy nervous and I have no idea why.  I couldn’t sleep last night and when I did fall asleep it wasn’t long before I was awake again tossing and turning.  My heart was pounding in my throat all morning and I took deep breath after deep breath in failed attempts to calm myself. 

My mind was torn between nerves and jealousy.  The jealousy was of a family member who was put on medication sometime after I was.  This person was diagnosed with a less common form of obsessive compulsive disorder.  It was explained to me but I don’t remember the name nor do I remember the particulars.  It’s not the typical germiphobic OCD, it’s more emotional or mental or something.  I should stop typing about it since I’m probably butchering what it is.  What makes me jealous is how every time I talk to other family members they tell me this person is completely different on meds.  The happiness has returned and this person is doing a million times better on meds.  So what’s up with me? 

I went on Zoloft sometime in January I think.  I finally got my endo to stop increasing the dosage so I could avoid new side effects every month and see if it’s really working.  All I want to do is stop taking it altogether.  I would almost rather go back to the constant racing heart than be the “new me.”  My legs ache and twitch at night as if I have restless leg syndrome and my chest feels like it’s constricted under pressure.  This is almost every night.  I watch TV until I start to fall asleep but pushing the power button on the remote wakes me up and I get to deal with the aforementioned nightly panic attack.  Irritating doesn’t even begin to describe it. 

The agoraphobia seemed to be lessening on Zoloft but over the last couple months it seems to be increasing again.  Last night Heath offered to go to Costco on his way home from work.  I told him no since I hadn’t been out of the house all day.  Costco seems to be the best measuring stick of my agoraphobic anxiety.  Since I still can’t handle Costco my meds are not working.  Every time I go I try so hard not to be bothered by the cars or the streets we drive on.  I try so hard not to be bothered by every sound my kids make convinced everything they do is amplified and bugging the snot out of perfect strangers around us.  Soon my head starts to swirl with thoughts and feelings.  I am overwhelmed and overstimulated and I cannot wait until it’s all over.  It’s ridiculous! 

Did I tell my endo that when he asked how the Zoloft was doing?  No.  Not a chance.  I was terrified he might change my dosage.  So I lied.  Big fat opened my mouth and in as few words as possible led him to believe I was fine.  I’m breaking out like a teenager with constant PMS.  Every subtle sign of stress I have ever had in my life is happening now only magnified 10 times.  I have maintained a 5 lb. weight gain, my blood sugars are still all over the map.  My A1C is still heading north.  Why?Why?Why?  But did I tell my endo any of this?  No.  Because what would be the point?  New insurance starts August 1.  I have to start over then. 

Heath has been on HMO insurance before.  He said he liked it.  Friends have shared their experiences with us with Kaiser.  One friend told me that Kaiser is really good at maintaining health but you have to get diagnosed by an out of network provider and only then will Kaiser look into your complaints.  She said, “But you already know your issues so you should be fine.”  That does not make me feel any better.  What if something else happens to me?  And what if, heaven forbid, something happens to my kids?  What if one of them develops diabetes?  Do I have to always fight the system to get my needs met?  My endo told me that Kaiser is a good group but I will have to be very vocal about the things I need.  I’m exhausted already just thinking about it.  My endo and I have just started to make breakthroughs with our communication with one another in only the last 5 or 6 months.  After nearly 3 years of working together! 

I mourn the loss of Dr. G, my internist in Salt Lake, who was the best doctor I have ever had.  He wouldn’t put up with my crap until I finally pulled my diabetes act together.  I feel like I’ve been dealing with everything alone ever since I moved.  One endo was too lax, the next was hard to communicate with, what will the next one be like?  A friend says he hates the endo I would be seeing here because he (my friend) isn’t compliant.  This gives me hope that the new endo will be more like Dr. G.  My hope is that with a managed health system I will be referred to a mental health professional and the Zoloft/anxiety issue will be better addressed.  I also hope I will be referred to a nutritionist and other diabetes health team members who will work with me in handling all the variables of diabetes.  Obviously what I’m doing is not working.  I would even be willing to use my CGM (continuous glucose monitor) if an endo or someone can actually help me understand the data.  I am not happy my A1C is 7.9.  That totally sucks. 

Time to reign in the fear of the unknown.  Time to sit in my gazebo and drink the rest of the Diet Coke if I have to.  Big exhale and move on. 

2 thoughts:

Grandma W said...

Good time to start on a new "right foot" and open up and communicate with the endo. I hate going to the endo myself and don't envy you the change but it may be the best thing to happen to you. We used an HMO for years and I had no complaints. We only switched because of one of the PAs they had here was a REAL jerk and we almost came to blows. I actually called Barry from the nurses’ station one day and told him he needed to get over to the office ASAP because one of us was going out the 5th story window but I couldn’t decide if it was me or PA Smith. Needless to say I got right in to the shrinks office that day. Oh, and the PA got a formal reprimand. The best thing for you to do is open up and tell it all right from the start. Remember, I have years of experience. How is that for unsolicited advice? You can always call for more ‘casue you know I love you.

The Piquant Storyteller said...

Thanks Dawn. I have learned that the older I get the more ok I am with being who I am. Much to everyone's dismay I don't suppress emotions much anymore. Your son, who you raised so well, gives me the best reason to get out of bed every day and keep trying to be a better me. I've finally accepted my anxiety for what it is and am open to doing what I can to fix it.

You're right, this change may be the best thing to happen to me because I'm finally ready to walk into a doctor's office and be honest. "Hey doc, this is me. I come with all sorts of baggage. Let's work on it together."

I meant to post something to that effect but what came out was emotional purging. It felt good to just write and not worry about what anyone thought. These anxiety posts will show me how far I've come and I'm thinking of publishing a book about my anxiety when I get to the other side.

p.s. did you see the gazebo post? That was not embellished. It's that awesome! Well worth the 4 or so hours to set up to be reminded how wonderful my life really is!