Wednesday, October 01, 2014

Ahhhhhhhh!!!!!!!! C'mon Dr. N., I need you on my side!!

...I say that with humor and a little frustration because you know when I got my chance yesterday I brought up the fact that Thomas will only shower every 4 days. Well...Dr. N. asked a few questions mostly about WHY Thomas doesn't shower but unlike Dr. K., he passed no judgment whatsoever leaving me hanging. At least Dr. K. made some offhand comment about it not being good that he doesn't shower very often which in the end didn't help but I figured if we could rack up a few respected people's opinions on the matter that it would help Thomas change his mind. Alas, no, nothing was said apart from trying to discover the why's of it all.

I have never been in on a full session with Dr. N. so I was surprised at how many questions he fired at Thomas. It sounded like a test to discover if someone has schizophrenia or not. A lot of the most basic questions that we all don't ask anymore because we know the answers well. But Dr. N. asked them all and it was interesting to sit in on it. The takeaway from all of that is that Thomas has zero delusions, no paranoia and no hallucinations. Go figure. I guess that is within the realm of possibility but after the last couple of weeks I don't know if I believe that or not. Certainly we're looking at a serious case of negative symptoms and drug side effects but at least for that session, Thomas is doing well in the positive symptoms department.

Then it happened. For the love of God I never understand the reasoning behind this but Dr. N. brought up reducing Thomas's meds. When he asked Thomas how he felt about doing that Thomas didn't miss a beat and looked straight at me. I'm not sure how I became "the decider" but it's a role I went ahead and took on because I have definite feelings on the matter. With the holidays coming and because for the last few years he has gotten worse in the fall and winter, I think it would be foolish to reduce meds now just as we are entering "the season". Dr. N. hasn't been in Thomas's life a full year yet so he's missed all of the "fun" of a full cycle of seasons. Needless to say, he won't be reducing meds and after I talked to him he understood why I feel like I do.

Then the akathesia came up. He backed up what the pharmacist told me and said that Cymbalta doesn't have akathesia as a side effect and that instead he felt it was the Latuda. This makes sense to me because my own med Risperdal will sometimes cause an evening here or there of intense akathesia. I think the antipsychotics are definitely known for this. The problem was, his solution to it is to reduce it. Back to that. So what do we do? Dr. N. decided that since the akathesia didn't stick around that we would wait it out a while longer. I hate the position these meds put our loved ones with schizophrenia in as well as ourselves as caregivers. There comes a point when you have to decide between the lesser to two evils. Not a fun place to be. Thomas seemed okay with waiting it out though so we kept everything the way it is.

All in all the session went well though not much was really accomplished. I had gone in there hoping he'd help me out with the showering thing but that is not to be. Now it'll be back in Dr. K.'s hands on Thursday. Let him have another go at it. For myself, I am out of ideas short of throwing down ultimatums which have never worked in all of Thomas's history. Here's hoping that it resolves itself soon.

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