The Squeaky Wheel
By Pamela D. Wilson, CSA, MS, BS/BA, CG
You know yourself and perhaps the family member you care for better than anyone else. Where there are instances where health just doesn’t seem to be improving or something just doesn’t seem right, sometimes you must be the “squeaky wheel” and learn to advocate.
Terry was having bouts of sleeplessness, anxiety, poor appetite and just didn’t want to participate in the usual activities. After several calls to her physician by her son, the physician said it was probably just her Alzheimer’s going into a different stage. The doctor prescribed a new medication for memory and hoped the symptoms would improve. After two weeks of no improvement and escalated feelings of panic, Terry was sent to a psychiatric hospital for review.
On the first day at the psychiatric hospital, she left a group session, went back to her room and proceeded to drink two bottles of shampoo and eat a tube of toothpaste. After this incident Terry regretted what happened and said she just wanted to get better. The psychiatric hospital released Terry a few days later with a change in medication only for sleep.
Several days later all of the previous issues returned. The son initiated four appointments in the span of one day with two doctors, a nurse and a crises team. As the result of the son’s persistence in knowing something “just wasn’t right”, Terry was placed on medication for severe depression and anxiety. One would think that the stay at the psychiatric hospital would have resulted in this action. However, Terry, when receiving attention is a different person and could seriously convince the Eskimos to buy ice from her. It was difficult for many of Terry’s physicians to see the “real” Terry, the Terry her son and others saw daily.
Still surprising is that none of the psychiatrists or physicians considered ordering neuropsychological or related testing. This type of testing has the ability to identify issues with cognition, patterns of behavior and other helpful information to support appropriate diagnoses and the prescription of medication.
In situations where something just doesn’t seem right, the family have a responsibility to speak up for the person in need. You must give physicians and other health professionals exact descriptions and information about the health of the person including discussing contradictory behavior. You must stand up for the person for whom you provide care even if you must disagree with how that person “sees” themselves.
If concerns exist with information, I recommend seeking a second opinion. In the case of a client of mine who was having unexplained health issues that even her primary care physician failed to immediately diagnose, a second opinion was invaluable. This woman was diagnosed with a “too fast” thyroid condition. The first endocrinologist recommended immediately radiating (killing) the thyroid which would have resulted in my client having to take medication for the remainder of her life. A second opinion with a more experienced and a bit more cautious endocrinologist resulted in the prescription of medication for a period of time. In the case of my client, her thyroid condition resolved. She no longer takes medication and her thyroid remains where God placed it – in her body. Know that there is significant benefit to requesting a second opinion. If your primary doctor questions or becomes angry at your request it may be time to consider if you have the right primary care doctor.
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