Private Health (S)Care?

So I read today that our country's first private health clinic has opened in British Columbia. Huzzah! (sarcasm) Yes, I am a strong supporter of our publicly funded health care system--even if it is in a bit of a shambles right now and sorely in need of some "rehabilitation" and healing in it's own right.

Still, privatization is not the answer. At least not in my opinion. And I think my opinion matters as a patient and health care consumer because in the end, it's us who always end up suffering the brunt of decisions made.

Some people who are onside with, not outright privatization (believe me, I don't think that will ever happen--over certain politician's dead bodies), but maintaining some sort of "two-tiered" approach, think that it will solve some of our current problems with backlogs. They think it will allow for people to seek non-vital services faster. Uh huh. Ah, yes. You have the money, you get to move to the head of the line. But will such "queue jumping" really improve our backlogs? The system is not clogged simply with non-vital services. Oh, take a stroll through the emergency rooms. The "vital" services are looking pretty grim, also.

So here we have this new private clinic that has opened up that treats "vital" or as they say "urgent" services. But wait. According to the article, some vital services are paid for under the public system. This would make the clinic in violation under the Canada Health Act. The doctors there are also working in both systems--private and public so hmmm...dual practice? Conflict of interest? Don't like how slowly things are going at the hospital, well...why don't you come over to the clinic...for a few dollars, we can get you out a lot faster!

So this is that latest in healthcare from our Federal Government. They'll sit and watch this sort of behaviour go on, keep an eye on it and yet they won't actually invest in fixing the problems.

I don't want to be all "Chicken Little" but you know what they say: "Give them an inch..." If one or a few of these start popping up it will turn viral. Maybe the rich don't mind (you'd think they would!) but there are a lot of people that need publicly funded healthcare. We've got a great system. It works. It's just been neglected for way too long by a government that doesn't seem to care.

A Lazy Weekend

Well, most of my weekends are pretty lazy. They're my time to decompress from work, all things schedule-oriented (although I need schedule to function) and just relax. Except it's also time to do household tasks. And in this weekend's case, I'm still trying to beat this infection.

I watched the Liberal Leadership Convention on television all day yesterday. Yeah, I know. I can hear the multiple comments you must be making. They vary from to "Uber Geek!" to "Are you kidding me...BORING!" to maybe a couple of people saying, "Oh, I didn't know she was into politics."

Well, I'm not really but someone has to do something about our current Prime Minister "Bush Lite." And don't worry, this isn't going to turn into some crazy political rant or (heaven forbid!) blog because I'm really not that passionate about politics. If I was, I would be more crazy than I already am and probably need to be permanently institutionalized.

It (the Convention) was mildly interesting--when I wasn't nodding off or channel switching in between updates. But man, was it long! The problem was, we had so many candidates (a few dropped out and backed others before the final voting) so they had to do four votes. And there's all of this switching to others' camps in between and for the most part, the commentary was gruelling. I mean, think of your favourite sport and how annoying that is. Now magnify it by about 20.

So now we finally have a new Leader of the Opposition in Parliament so we'll see if anything exciting happens. Doubtful.

Finding A New Doctor

In some previous posts I have referred to my "ex-doctor" or my "ex-GP." In life I have also referred to him as "Ding Dong," "Dr. Asshole" and other unflattering terms. Why did I stay with this man for app. six years?

Well, I have "white coat syndrome" for one. I have a strange fear of the Doctor as Authority Figure. I just gave it that name as I don't believe it's really a classified "Capital-S Syndrome." Also, I always likened us to an old married couple. We would argue over my treatment and it was kind of funny. Or not. I mean, it actually bordered on a co-dependent relationship, looking back. But I got away with a lot because I was smart (he bestowed three Ph.D.s on me in our time together) so I could usually get what I wanted out of him.

But he would do a lot of other, what I feel, unprofessional things. He would huff and puff and complain about how busy he was and tell me of his troubles. Um, excuse me, but is this not my appointment for my troubles? Good thing I'm not in the U.S. and I wasn't paying for this! And he would pull this, kind of, passive-aggressive bullshit where he'd get all uppity about something and then say things like, "Oh, you didn't think I'd do that (for you) did you?" or "Oh, you don't think I care, do you?"

I would have to fight a lot to get things done. Like referrals. Sometimes I'd "win," sometimes, I'd lose. This was not about me being a demanding patient. Remember, this was the same man who did not believe I was having seizures. Upon finally seeing a neurologist, the neuro said to me my brain was "screaming" for an EEG and MRI. He wanted to know why on earth I'd never had them done before. I didn't answer.

No, this was because this GP wanted to treat everything himself and things he couldn't treat simply did not exist. Or they were "stress." And because I was too afraid to leave, I just sat there and took it.

Well, over the last few months, it became unbearable that by appointment times, I was either so anxious I could barely stand it and would burst into tears or feel like I was going to ex/implode or I was so angry I wanted to punch him. And I'm pretty passive and non-violent!

Time to find a new doctor?

So off I went. And I wanted a woman haha! I'd only ever seen men and they'd all proven to be trouble. Sorry all you male GPs out there, I don't like to make blanket statements but I've just had no luck with you! I'm sure women physicians can be jerks too but I thought that maybe, just maybe, I'd have better luck with another gal.

Everyone out there, I recommend you interview your prospective GPs! I'd never done it before and boy, did I feel like an ass (I was SO nervous!) but it really makes a difference. These people are responsible for your health! Here is a list of questions that I came up with. Maybe you can think of others that would apply to your situation. I kept these pretty broad:

1. How long have you been in practice?

2. How do you see the role of the patient in your practice?

3. Do you value a collaborative relationship with your patients (eg. valuing my opinions, open to hearing about research/treatments I am interested in?)

4. How would you feel if I brought medical research/information obtained from the internet to an appointment for discussion?

5. What made you want to become a GP?

6. What do you think the role of a GP is?

7. Do you have any personal philosophies concerning treatment?

8. How do you keep abreast of the latest in medical research/trends?

9. What are your feelings about antibiotics? Do you have any other feelings regarding the prescription of any other medications?

10. How would you feel if I did not wish to take a certain medication prescribed?

11. Do you have a specialty?

12. What is your affiliated hospital?

13. Can you refer patients to other practitioners outside of your affiliated hospital?

14. What is your policy/are your feelings about giving referrals?

15. What is your availability, appointment wait times and what is your current patient load?

16. How long do you usually spend with a patient?

17. What is your policy with telephone calls, urgent issues/questions if they arise (i.e. will you speak to me over the telephone, call me back if I leave a message or by appt. only?)

18. Who handles your practice during vacations, leaves of absences etc…?

19. What are your office hours? Is this your only location?

20. How do you handle after hours needs?

21. If lab work needs to be done, where are the tests conducted? How quickly are results usually obtained and how will I be notified?

How did I make out? Well, after almost giving myself an aneurysm (hehe, I know you can't really "do" that to yourself but it sounds fun to say) I finally found someone who I think is good. She seems certainly proficient although a bit distant but we're just getting to know each other. (I talk way too much and I've even prepared long "notes" in Excel/Word for our appointments so maybe she hates me already!) I already have a therapist--it's not like I need her to be my shoulder to cry on. But some level of "humanity" would be good. I don't want to feel like I'm talking to a robot.

Anyway, she's setting up the referrals that I need and we're taking things from there.

Bye bye Dr. Ding Dong Asshole!

Blogger Is Sucking...

Alright. No more fucking with fonts in posts. I can't seem to change them back. Is it a Blogger beta thing? Is it a browser thing? In Firefox, I've still got my quick edits but in IE they seem to have disappeared. And "server down" messages abound!

*rethinks scrapping this because it's early and moving to WordPress*

Ah well...

Medroll, Please!

I'm going to kill blogger. For the third time I am re-writing this. It keeps eating my posts. Anyway!

For those who like to keep score, here are all of the meds that I have been on. They've invariably caused me some sort of wacky/ugly side effect and some have not even bothered to work at all. As always, I welcome any questions and if you don't recognize a med here, just ask!

- Oxazepam/Serax
- Diazepam/Valium (just a few days but what the hey)
- Sertraline/Zoloft
- Lorazepam/Ativan
- Venlafaxine/Effexor
- Buproprion/Wellbutrin
- Clonazepam/Klonopin
- Zopiclone/Imovane
- Liothyronine Sodium/Cytomel (I know this looks funny on a head med list but it was used as an adjunct to Effexor)
- Mirtazapine/Remeron
- Moclobemide/Manerix
- Nefazodone/Serzone
- Temazepam/Restoril
- Fluoxetine/Prozac
- Carbamazepine/Tegretol
- Citalopram/Celexa
- Lamotrigine/Lamictal
- Divalproex Sodium/Depakote (eh, three days in-patient but again, why not?)
- Topiramate/Topamax
- Rizatriptan/Maxalt
- Olanzapine/Zyprexa
- Clobazam/Frisium
- Atomoxetine/Strattera

I am currently taking 200mg Topiramate, 10mg Clobazam, 7.5mg Imovane and 10mg Rizatriptan prn. Oh, and 40mg Esomeprazole/Nexium but that's a Proton Pump Inhibitor--for my stomach not my head haha. And it's not really working but that's another post!

So, I guess that pretty much covers every class except the tricyclics, the "old school" or "typical" APs and the stimulants.

I have an appt. with a new psychiatrist (scary!) in March and I really want to discuss stims with him as Strattera was a disaster. It's kind of my own "fault" as I completely forgot that it's basically an antidepressant--an NRI (norepinephrine reuptake inhibitor.) I can not even be in the same room with an AD! Okay, it's not that bad but they make me go positively nuts. In 13 days, Strattera reduced me to a quivering, mumbling, mixed-state, ultradian cycling pile of rubble. Hey, at least I gave the drug 13 days. And the physical side effects were hell too. A gastronomic disaster and waking up at the crack of dawn just for the fun of it, basically.

Yep, developed in Sweden as an AD with disastrous (or simply null?) results and now it's an ADD med! I wonder if it actually helps ADD folks. No really. I'm not being snarky. I do wonder. Show me some studies.

Don't get me wrong. I would never discourage someone from trying a med based solely on my experience! That would be silly. We are all neurochemically diverse and unique.

Sick Today...

Crap. Why do some infections just sneak up behind you and hit you over the head with a shovel? I'm at home today and thought I'd just whine. I should be in bed but I've pretty much been up since 0500hrs. When I get sick it really fucks with my insomnia--despite the fact that I'm already on sleep meds!

I just got back from a Walk-In Clinic as there was no way in hell I'd get an appt. with my regular doc. It was interesting. I got a script for Azythromycin when all I really wanted was one for my magic elixir Benzydamine (aka Tantum.) Man, if you have a sore throat, this stuff is good.

I'm always confused by the whole "antibiotic thing." It's either, "Here you go!" or "Nope, it's a virus." (Usually the latter in my case.) I know there are certain indicators, sputum colour etc... that can assist in the diagnosis but otherwise, it can be pretty hard to distinguish a lot of the bugs flying around out there, correct?

Anyway, this guy handed over the broad spectrum tabs quite easily based upon the fact that I smoke (yeah...a little...), my chest is killing me and he was concerned about encroaching bronchitis.

Hmmm.

Ah well, time for some soup, Zithro, Buckley's, Tantum and bed in that order.

All About My Seizures

A lot of the time when people think about seizures, they get this mental image of someone dropping to the floor and flailing around like a fish out of water. I blame television and the movies for dramatic effect. Not that this can't happen with a tonic-clonic seizure but seizures come in many flavours. They're wild and wacky and I find them just fascinating! Yes, I want to be a neurologist when I grow up. But for some, they can be really debilitating and that's not good. For me, I've never really had any problems.

Simple partial seizures happen while you are still conscious (or you might lose just a wee bit of your awareness.) They are also called "auras" as they can lead to seizures where you do lose consciousness. Therefore, they really should be investigated even if you don't think you have a problem. I am generally aware enough to tell you that I am having one and can speak to you but I have difficulty keeping track of time in order to figure out how long the seizure is lasting--if that gives you an idea of how impaired I can become. And a lot of the time, my seizures have just made me feel really tripped out or kind of stoned so I haven't really minded them haha!

As a child, I experienced the following:

1. Muffled ambient sound (kind of a whooshing sound, like being underwater that would go back and forth from side to side)
2. Deja vu
3. Rapid changes in my heartbeat for no reason
4. Trunk spasms
5. Visual illusions in the form of scintillations or "seeing stars"
6. A weird sensation of "brain tingling" (I know, it sounds weird but I could *feel* my brain)

As I grew older, a lot of these issues just sort of seemed to resolve themselves. They just went away and I guess I "forgot." But when the bipolar started to hit in my early 20s, some of them started to come back a little bit. I find this very interesting due to the fact that bipolar disorder is treated with the very same drugs used to treat epilepsy. Now of course, not every person with bipolar has a comorbid seizure disorder but with some trigger and rapidly misfiring neurons, had this awakened my sleeping seizures?

Also, with the beginning of anticonvulsant treatment, my seizures were definitely affected. This is not unheard of as with new treatment or a change/titration of a med, your brain can get hit in an affected area and it just might take a bit of time to adjust. Theoretically, if it's the right med, things should even out.

As an adult, now with bipolar, all of the above came back, pretty much minus the trunk spasms and not so many scintillations but also:

• Depersonalization/Derealization (Woo Hoo! I'm floating away!)
• Body Image Disturbances (more specifically called micro/macrosomatognosia--aka, my hands/feet are too small or too big!)
• Jamais vu (that's my stuff but it doesn't look like my stuff and just where the fuck am I even though I know this is my desk...)
• Micropsia (why does my keyboard look so small--great when in conjunction with macrosomatognosia!)
• Epigastric rising
• Rapid eye blinking
• And my all time favourite, gelastic seizures

Now a bit of explanation about what the hell these things are. And no, you don't turn into a big rubber band or a gymnast. Gelastic seizures are rapid rushes of emotion (any kind!) out of nowhere. With me (luckily) it was humour. I've only ever had two but they were hilarious--literally. I would get all spaced out with some DP/DR and then, just start laughing uproariously out of nowhere and nothing was funny. I mean, nothing.was.funny. And wow, I was doubled over, uncontrollably laughing, busting a gut, drooling and then, *snap!* I was back to "normal," straight faced, like nothing had ever happened. Spooky, huh?

Now, there was one other rather "exotic" occurrence that befell me but it's unconfirmed. I'll add it anyway because hell, it's a great story and I believe that it really was "epilepsia partialis continua." You can read about it
here. Now, not to worry, I have neither any lesions nor Rasmussen syndrome haha. But the introduction pretty much lays out what I went through and if you scroll down to how it presents, that's a match too. This was, I believe, in large part due to my old arch-enemy Effexor and probably its partner in crime Wellbutrin. I was on them at the time plus a sub-therapeutic dose of Lamotrigine.

So, I'm on my way to work and the eyes start flickering. Okay. Is this going to turn into a "big deal" or will it just resolve itself? By the time I get into the building things have rapidly progressed (about 5 minutes) to my jaw thrusting and jerking. Soon, my neck joins this to make a trio. I begin to call my doctor but by the time I grasp the phone, my tongue starts drooping out of my mouth and I can't speak and I'm drooling like crazy. I'm not aphasic, mind you--I just physically can't speak because I'm twitching and jerking uncontrollably and my tongue is literally falling out of my face. Then the jerking starts to move down my right shoulder/arm and my hand starts to twitch.

At the time, the GP I was seeing was a mere couple of blocks away so I walked to his office and boy did I make quite a stir! I tried to write "Tardive Dyskinesia" with my left hand (I'm right handed haha) because no one could get a word out of me and this was prior to my whole seizure diagnosis--not to mention that I had been arguing with this doofus about whether or not I even had been having seizures. He did not believe me and said they were merely manifestations of "stress." Yeah. He was just about to reach for the Cogentin but then decided to send me to the hospital instead. I rotted away in the ER for hours when someone finally looked at me. By then (about 6 hours later) things had settle down a fair bit and I didn't appear in such dire straits. They made me walk a straight line and push/pull against the doc's hands and pronounced me "fine" and said "go home." I collapsed in a heap of post-ictal exhaustion and just slept. I can't even try to recreate what I looked like. It was seriously like being possessed like a demon. And it hurt! I was in so much pain! I didn't know your body could do that against your will! It's no wonder people feel like such utter shit after tonic-clonics!

I said TD because in post marketing, some stuff came back about Effexor even though Wyeth doesn't want to tie it to the drug. Yeah, no doubt. It's in the PI sheet (or at least one I read) and on RxList. And Wellbutrin? I don't think it's got the greatest track record and supposedly can "unmask TD."

I'm not sure about any other stuff Effexor did to me but when I drank on it the myoclonus sure got worse, I fell down a lot and even got a concussion once. And I would frequently wake up in a puddle of urine--a sure sign of nocturnal seizures. No neurologists were in bed with me *snicker* so no one can be sure, however. Still, I've never been so drunk in my life I haven't been able to make it to the bathroom so I'm pretty sure I was seizing then too.

Okay, guess that's it from seizure central.