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Preview: Comments on Shrink Rap: My Three Shrinks Podcast 7: Fireside Chat

Comments on Shrink Rap: My Three Shrinks Podcast 7: Fireside Chat

Updated: 2018-04-20T07:01:29.662-04:00


Roy - Nurse you knew giving you a shot in the butt...


Roy - Nurse you knew giving you a shot in the butt - how about a male cardiac tech about my age giving me an EKG daily for 12 days? haha.... I still see him all the time in the hospital as I work 2 floors below the cardiac unit where I was a patient and also a nursing student in my tele rotation. I've had friends of mine show up to take care of me when I was in the OR and recovery. I've had people in the ER that I used to work with knowing my entire health history because I have to be registered when I come in and then have to give my brief medical history to those who work in the ER and are involved in my care. Fortunately, the times I had to be cathed, it was when I had my bilat knee surgery, which was out at Penn Presbyterian, and not where I work! Thank goodness! But at any rate - if I can go through all that (and I haven't even gotten into the part where I was in the tele ICU and had to ring for someone to shut the door so I could use the bedside commode and also they then had to empty it - and I was very sick due to total electrolyte depletion from lasix) and STILL go to the hospital where I work when I need hospitalization, then....that's saying a lot about my hospital - I guess I like it a lot! LOL...

Take care,
Carrie :)

Fire Corner, by King Stitt?


Fire Corner, by King Stitt?

Wow, lots of discussion here (some more than other...


Wow, lots of discussion here (some more than others, lol).

Thank you all for the great comments on the podcast. I've inserted our Fireplace Chat picture at the bottom of the post (I admit, the fire is "enhanced", as the pic I took showed mostly glowing embers... thank you, Photoshop Elements... our feet, of course, look exactly as they do in the real world ;-)

As for the whole going-to-the-hospital discussion, I have been admitted thrice to the hospital as an adult. The first was at the hospital where I was a med student... mostly because the chair of the department specialized in the type of ear surgery I needed. I'll never forget my roomate, who was going through DT's, engaging my father in an intense discussion about the kangaroo outside the window. I recall ringing for the nurse to get him some Ativan.

The other two were at a hospital where I worked. I chose it mostly because I knew the docs and felt comfortable with their skills. My confidence in their abilities outweighed any privacy concerns (despite the fact that a nurse I knew had to give me Dilaudid shots in the butt).

Last chance on the song snippet. I'll reveal it in tomorrow's show notes. (Hint: keyword = "fire")

Nice feet! Toasty toes.Mine are freezing every da...


Nice feet! Toasty toes.

Mine are freezing every day! (my computer is three feet in front of the front door; even w/draft stopper, the 10 degree cold just seeps in anyway!)

Brr! (btw, had a dream about y'all last night! You three were teachers in some sort of a giant high school. Highly paid psychiatrists doing some teaching work too. And I was in your class, of course (all 3 of you taught the same class at once.) You all seemed very nice, altho at one point I was carrying around Dinah's talking mannequin-like head . . . hee hee!)

I liked this podcast the best. I think that the m...


I liked this podcast the best. I think that the more in-depth discussion of fewer issues works well in this format.

You should do a question and answer podcast! It could be fun. Or, I guess, it could also be a disaster.

I'm going to step back from the content and commen...


I'm going to step back from the content and comment on the form of this podcast. This has got to be the best 'cast yet: purposeful, lively and direct. I think that to justify creating a podcast requires that its special potentials be utilized, that the substance and style of the material go beyond what could be
expressed in a regular blog entry. I think you achieved that here.

Yeah I see the negatives of going to my own hospit...


Yeah I see the negatives of going to my own hospital....I could list them, but I don't feel like it. However, my own hospital has the only multidisciplinary headache center in the city of Philadelphia. There is just one other semi-large headache center, and it does not have the availability to do inpatient or infusion therapies for headache. During a time when I needed a break from the center where I go, I went to that other headache center, but ultimately went back to the mothership because the other center did not have the same resources and wasn't as on the cutting edge as the center at my hospital. Because I have not one, but TWO very rare headache types, I need somewhere on the cutting edge. I need the best of the best. And our center has the big names in the field - the innovators.And then there's the fact that because I'm a hospital employee, my insurance has one other stipulation. I am actually insured by the same plan (#2 PPO in the nation or something like that...BCBS PC) that I was covered by when I was covered under my mom's insurance, but when I was on my mom's plan, I could go to a wider variety of doctors and hospitals. We have a further restriction (except they present it as a benefit) that we have to go to hospitals in our hospital system. The only doctors that I have outside my hospital's health system are ones that I do'nt expect to need hospitalization with. I have a $20 copay to see specialists in my health system, but I pay $25 for those that are outside of it...even though they are still covered under the BCBS plan. If I were to be hospitalized or seek emergency treatment at another hospital outside my hospital's system, then I would have a $2000 deductible and would have to pay 20% of all remaining bills. So most people would think that you'd be okay after meeeting the deductible, and for some - $2000 wouldn't be the worst thing in the world... But think about this - I've had hospital stays cost $100,000 (this is when I get the insurance statements...I see that's how much it costs!!)... So that means that after my $2000 deductible, I'd owe an additional $20,000!!! Bigger deal than it originally looks!My orthopedic who did my bilateral knee surgery is phenomenal. He is the #1 doc recommended in the Philadelphia area (and a broader area than this actually!) for avascular necrosis of the knees and hips. Hopkins is actually the only other major AVN subspecialty center besides Penn. My core decompression will not be the last surgery I will ever have to have for AVN - but now I can't go to my surgeon anymore because there's no way I could afford the bills if I had it done at the hospital I went to before. I was covered equally as long as the doc and hospital took the BCBS plan when I had my mom's insurance - I could go to whatever hospital I wanted, as long as it was on the plan. That's why I was glad I had my surgery while still on her insurance!! I know there are doctors at my hospital who can do the surgery (afterall, the hospital I work at basically has the #1 orthopedic center in the country), but nobody here specializes in AVN - and AVN is a very scary and badass bone disease. Frankly, I want surgery done by someone who specializes in it! So that's the only thing that truly sucks about my plan. Otherwise, I have chosen an excellent team of doctors within my hospital system because it saves me money!! Only my rheumatologist, psychiatrist, and OB/Gyn are outside my hospital system - and when it comes time for me to get pregnant someday, I'll switch to an OB/Gyn within our system since that will ultimately lead to a hopefully short and uncomplicated hospital stay at some point, someday in the future....I hope. ;)I will say that I chose my hospital way before I worked at it...and I went to nursing school at this university because of how happy I was with the nursing care I had received. I wanted to go to medical sc[...]

Oh my gosh, you are so wrong here. You don't pick...


Oh my gosh, you are so wrong here. You don't pick a hospital based on closeness. I will never be your roommate with thinking like this.

I have had the privlege of studying at the best of institutions, and I'm grateful for my education. Working in even a great institution lends you to see it's faults and so here are my thoughts on where I would be hospitalized:

I would not go to my own hospital (and I'll leave it nameless) because I don't want everyone I know having access to my medical records through the electronic records. I also don't want to be treated by residents because I am a medical snob (there, I've admitted it).

I wouldn't be admitted to a hospital except in dire circumstances because I hate being out of control, and hospitals kill people. Not intentionally, but the micro-organisms they have in hospitals are not good for sick people and there is a lot of room for errors. I've been responsible for some (none of any great medical consequence, but still, it's humbling) and I know they are made. Sort of like all my spelling errors.

If I had anything weird or rare or not obviously curable instantly, I'd go to Hopkins and anything else I was concerned about, I'd get over.

Otherwise, I'd find some hospital I've never worked at so I wouldn't know the shortcomings. Baltimore has no shortage of hospitals.

Sheesh - it took me so long to type that comment a...


Sheesh - it took me so long to type that comment and then re-read it and edit a few things that my very first sentence no longer really fits. When I was saying that that last bit was very funny, I was referring to the duck comment! That was the last comment when I started typing mine!! haha.... ;)

Clink - I think the only reason it sounded like you were saying anxiety wasn't a real problem had something to do with maybe the wording you were using not so much in the retreat post itself - but in the podcast - I can't even remember what it was right now - but obviously both Sara and I misinterpreted something to sort of sound like you were questioning the seriousness (not necessarily the validity, but rather the seriousness) of anxiety disorders. I need to go back to listen to it to find exactly what triggered me to think that way, at least!!

And for the record, I didn't personally think that you really felt that way. When I took that out of whatever you said in the podcast, I thought maybe you just weren't coming across as meaning what it really sounded like you were saying. I didn't think that you thought anxiety disorders were no big deal, but I did think that's how some comment (which I can't recall at the moment without re-listening) made it sound.

Take care!
Carrie :)

Haha I like that last comment there...very funny :...


Haha I like that last comment there...very funny :)Now - me? Issues? Nah... LOL ;)I've thought about this a few times today. I have a couple of different thoughts as of late, and I suppose some of them are relevant! When I think about what Clink had to say with regards to those who come in to talk about day-to events and how they don't deserve reimbursement, I feel like I personally can interpret it two different ways. And if I can interpret it two different ways, then I bet other people can interpret it in other ways, too. Guess that means that it's not so much about what we really meant, but rather what people perceive we mean. There is the part of me that jumps to the gut reaction that I automatically fall into the category of one who shouldn't be reimbursed because of the fact that I do not have an extremely severe mental illness that serves as the focus of each and every appt I have - in a life or death kind of way.But - there is another part of me that looks at Clink's comment about Dinah's patient who continues to see her, despite having her axis 1 under control but still having a lot of stressors and sees that this isn't a contradiction of Clink's point on the issue. Rather it is a clarification, and if we take time to examine it, it shows a bit of a deeper meaning. If I'm interpreting this correctly, then Clink isn't saying that this patient or Sara or myself or any of the rest of us who fall into the category of talking about day-to-day issues but are working in therapy to achieve some goal and maintain control of our psychiatric ailments are the ones that do not deserve reimbursement. I think instead she could be referring to those who, let me choose some random example, go through a rough period - say they go through a bad divorce. Say this person needs some help, possibly even medication, while going through this divorce. While they are having this very rough time, it is very imperitive that they see a shrink and of course they should be reimbursed. This period may even last for quite a long time - some people move through major life stressors at a faster or slower clip than others. But let's go on to say that this person, months down the line, is over the divorce. In fact, maybe she's happy with her life - dating again, doing well at work, or whatever. But yet - she still hangs onto that therapy appointment, and at that appointment, she recounts the events of her day or discusses how she feels about the war in Iraq or whatever.... My gut feeling about that comment makes me think that Clink is referring more to these types of people when she says they shouldn't be reimbursed - not so much people like me or Sara or others who do have diagnoses and, even if we may be in a "remission" period or stable or whatever at a particular time, still go to therapy to work on a lot of issues. Those issues may not be something as serious as constantly talking about hearing voices or paranoia or seeing things that aren't really there or other things like that. I, myself, am actually pretty high functioning - I still go to work - which means that I'm not completely disabled by my own illness. But I somehow don't think that Clink would discount my reasons for going to therapy or even say that I should not be reimbursed by my insurance company if I continue to go when I don't feel suicidal or I'm not as depressed and not on meds for depression or whatever.But still - even if I view it that way (which is the view I have chosen to stick with in my mind!), where does one draw the line? Even a practitioner is subjective - and if that weren't the case, then concepts like counter-transference wouldn't even exist! It is very much like the pain analogy that Roy brought up. And that makes a lot of sense to me because I can put it in terms of headaches. In my own headache[...]

Aack, I never questioned the validity of treating ...


Aack, I never questioned the validity of treating anxiety disorders. My post was intended to comment on the service, not the patients. Oy. I may need to blog to clarify my blog. I have a headache.

I need to clarify I would not go to Hopkins because of distance, not quality. If I were sick enough to go to the hospital (and I've had reason to think about this lately) I'd go to the nearest, not necessarily the best. And I wouldn't care if I was sharing my room with the Internet or Bobo the Dancing Clown (as long as she kept her floppy shoes on her side of the room). Actually I'd prefer Dinah for a hospital roommate except I wouldn't wish a disease on her for that.

And who's telling poor sweet Roy to shut up? I'll moida da bum!

And where's the new pic of our feet?

Ok...I vote for no more "fireside" chats. I jumpe...


Ok...I vote for no more "fireside" chats. I jumped every single time there was a pop. I wish you guys got all our snow and ice on Sunday (2 inches this time). Can't stand the stuff!

What the heck is that song???

play nice.


play nice.

Shut up.


Shut up.




Thanks Dinah. Sometimes you two sound alike, anyw...


Thanks Dinah. Sometimes you two sound alike, anyway, hee hee hee!

Maybe CLINK is beneath the floorboard today, whee!

Anyway, I also mean and use my experiences, to illustrate my point of view, and opinion(s) on what you say here, and in the 'casts. So it's not just about me saying HEY, I have THIS experience, so this means I am justifiably suffering/being treated, etc. I mean it also to illustrate part of WHY I think things about the issues, regarding mental health in general, and people who seek care, fighting stigma, or whatever other issue is up for discussion.

Anyway, my personal examples are both about me, and about the larger issue (not always about the larger issue, but I try to write so that what I'm saying, pertains to the larger picture, or the larger picture of a specific portion of what is being discussed.)

Make sense? Anyway, I don't mean any offense, just clarifying! Saying I'm fully participating in the discussions and debates that go on, and not just being a mental patient that comments on various blogs, including mental health ones.

And I think Carrie would say the same (but I sound NOTHING like her, hee hee! And can't speak for her anyway.)

Next, we'll have Roy speaking for the Duck. And Clink, speaking for, hrm. Max? hee hee.

Where are our new feet pic??For the record: ClinkS...


Where are our new feet pic??

For the record: ClinkShrink is the only psychiatrist in the world who would question the validity of treating Anxiety Disorders (and I have a feeling even she didn't mean it).

I'm still stewing about the question of who warrants care and what it's valid to talk about with whom and why. Another post coming soon I think.

Neonursechic & Sarebear: no one begrudges the fact that you seek psychiatric care, you both have plenty to say and to process. Maybe I shouldn't speak for Clink...

Haha with regards to the anxiety topic - now that ...


Haha with regards to the anxiety topic - now that Sara brought it up. I'm the child of a mom who is the picture of GAD, although undiagnosed, and a dad with a panic disorder diagnosed within the last year and a half. His was actually diagnosed because he had a massive panic attack and collapsed in the driveway and was nonverbal for like 5 hours - and they treated him for a suspected heart attack until they ruled out cardiac causes. (Although I saw such a ton of PVCs and PACs on the monitor in the ER...) I think they just never found out exactly what happened, but we're pretty sure now that it is the panic disorder. He went off his meds once (he's on wellbutrin and then xanax prn) and then had another major attack. He's just really high strung, but he's not a worrier - just has a short fuse more than anything. And my mom is a worrier...

And I am their firstborn. LOL And the only girl. I used to have really bad anxiety attacks in high school complete with palpitations and just racing thoughts and shaking hands, etc. I still think that anxiety plays a part in my headaches because when my heart starts pounding and racing, it really kills my head, too.

So - I definitely think there's some legitimacy to anxiety disorders! One of the things that has affected me most the past few years is more of a social anxiety thing. I didn't always have this, but I do now. I cannot be in large hoardes of people without really having some issues. I don't like anyone in my space, and I avoid going out and doing things if I don't know exactly how things work. For example, I didn't go to the gym for 6 months because I just didn't know how things worked with going to the lockers and the pool, etc. So even though I no longer really have anxiety attacks like I did in high school, I still definitely have some impairment due to anxiety. Working on it - but I'm also quite high strung - kinda a mix between parents!! I don't think I'm quite as much of a worrier as my mom is - and I'm also a procrastinator, and that makes things harder for me. I am my own worst enemy! lol

Anyway - gotta get ready for work. I'm so incredibly exhausted from not sleeping yesterday and not sleeping well last night. I'm definitely DVR'ing any new shows on tonight and totally crashing for most of tomorrow, except for my appt in the late afternoon.

Take care!
Carrie :)

Oh, and I'm not finishing later cause it's too lon...


Oh, and I'm not finishing later cause it's too long; same thing as Carrie, I can't sleep lately.

But I'm going to take a stab at it in a minute (well, if I do that the raised aerobed in the livingroom will deflate!). Think sleepy thoughts for me.

Lately I'm only getting sleep every other night, out of sheer exhaustion from bein gup 40 hours or whatever.

I don't have an iatrist yet, and I can't call my GP (commented on THAT in a recent comment at Dr. A's.) So I have nowhere to turn medically, or for anything to fix this, or the fact that I'm doing half doses of pills to stretch the meds. I s'pose I could crash pretty badly w/all this stuff happening at once. When ya got nowhere to turn, it sucks. My ologist left on vacation for three weeks, he forgot to tell me until right before leaving. So I'm figuring the best I can.

Woops, sorry to go on so long, there.

Woohoo! Fresh 'cast!I just started it, and as you...


Woohoo! Fresh 'cast!I just started it, and as you said what was on Clink's shirt and Roy's 'puter, I then thought, and what, Dinah has one on her head? And where's William Tell when you need him . . . hee hee!Thanks, Clink, for the color. Great image in my head!!! NOT. hee hee.on with the cast . . . ooo, just looked at the length. Nice long 'cast this time!(listens s'more; oh hey, maybe that fire is making me hungry for s'mores, can you make me some next time? thanks!) . . . .Ha!! Dinah! You said, "These are either mentally ill rich people, or the CHILDREN of mentally ill rich people." What, the kids need to get a break from their ill parents? Hee hee.Clink, you SEEEM to be implying, after saying that Mood Disorders obviously are serious illnesses, that anxiety disorders are not, or something.I LIVE IN FEAR EVERY MOMENT OF EVERY DAY, PRACTICALLY. IT SUCKS. The fears are a maze that I work through and combat and use tremendous energy and effort to get past, and frequently fail, or frequently use myself up so much that after a while, I collapse in mental exhaustion in this maze, and it overtakes and assaults me even more, ala the hostile maze in Harry Potter and the Goblet of Fire.Um. Lemme back off a bit. I don't think you were trying to insult me, so let me say that I realize I'm personalizing this too much. . . .whew . . . ok, though just wondering what's up with your perspective on this, exactly what IS your perspective on this, and perhaps, again, it's partly a function of the population you are exposed to daily in your occupation, vs. free society.It's just . . . like having a ball and chain clamped on my leg, except instead of the "standard issue" ball and chain (if there is such!!), it's more the Christmas Carol Bob Marley (Ok I'm probably getting his name wrong!) all covered in chains, version, that I'm dragging around with me. Crippling. Actually, I'm walking around in and with my own prison, and the layers of bars and bars and gates and checkpoints and doors is exhaustive and exhausting.Ok, enough about that. Mebbe I'll find out more about your perspective if I PUSH THE DANG PLAY BUTTON AND LISTEN FURTHER, hee hee! (caps for funny effect, not for being mad or anything effect.)Ok. The weeks to months time frame for that stuff seems long! Although . . . if someone really wants to make some good progress on some of this stuff, and not string things out on a once a week therapy appt on stuff, because, heck, they've got the money to access this sort of more intensive and also sushi environment . . . I think that'd be cool.I can see your point about the jarring juxtaposition of oh, hey, I'm worried about x, y, z, let's go inpatient for ar coupla months. I see that.Clink, you wouldn't go to Hopkins . . . would you go to Roy's hospital? Hrm, that brings up an interesting question. About mental health professionals, who are probably known by others in same or related professions in their area . . . where do you go, and what happens if a shrink you know who has a grudge against you or you sent their underwear up the flagpole in college, walks in and is the shrink for your case in the hospital? These are hypotheticals. Just wonderin!!(listening more . . .)Healthcare may be a right . . . but it's a privilege, in practical terms, quite often. And that is BEYOND sad. Mental Healthcare seems to be seen as "optional" by many of the ins. co's, and that's beyond sad too.listening moreNope, NO idea on the music!EXACTLY, Dinah! I talk about and work on relationship stuff, talk about stuff from [...]

Great podcast. I think I like this one the best y...


Great podcast. I think I like this one the best yet because you all had very strong opinions about the topics that you discussed, and you stuck to your guns! I really enjoyed listening to the discussions and viewpoints.Favorite line has to be: "You don't really have headaches..." hehe We don't have to wait for a national health system to hear that line - there are plenty of ER docs (not every ER doc - just certain ones!!) and primary care docs (again - only a select few) who are willing to toss that phrase around just because they are frustrated that they can't get rid of somebody's headache - so therefore it must not be real. I'll never forget (and I know the PA-C's name still) being in the ER 8 days into my constant headache (which has now been here for 6 years as of last Thursday) and the ER PA announced to the entire ER that I had a headache for attention since it didn't resolve with her chosen treatment of dumping 3 different mega painkillers in me in a period of just a few hours - so then I had to be admitted for intractible vomiting. Once I had to be admitted, she also threatened that they were going to have to put an NG tube in because of how much I'd been throwing up - which was not true...I hadn't thrown up at all before coming to the hospital and had only thrown up a few times as a direct result of the pain medication. What a .... you know ;)But anyway - I have so much I want to say on this topic, but want to say it quickly or maybe just a few quick things because even though I'm commenting at about 5 minutes till 4am, I actually am sleeping better tonight. And the improvement is solely that I'm sleeping at all. I've still been waking up about every 30-45 minutes for some nutty reason.With respect to the NHS and private health insurance - some companies in England do actually offer private health insurance as part of the benefits package. It's just that that isn't going to be the one thing that makes or breaks somebody's life because if they do not chose to opt into that (and having to pay some part of their salary towards the premium), then they always have the NHS to just go ahead and lean on. When I told my friend Helen (who I was visiting in England) about how much Dr. Crippen and SHP hate the NHS, she was shocked. She said that for the most part, patients absolutely love the system. It has a few snafus that she has run into on occasion, but she is thrilled to be provided with health insurance, no matter what. Nobody in England is going bankrupt over medical care. (And I should state here that Helen is not someone who has minimal contact with the system - she has had MAJOR health problems and just got out of quite a lengthy hospital stay for new issues... So with her history, she was bound to experience the whole speectrum of what the system is like from the patient's perspective...)Now - one issue we have seen amongst cluster headache patients (and possibly some migraine patients, but more often clusters) is this issue with rationing of prescriptions. Each physician in the NHS is given an allotted budget, and I cannot remember if this budget is solely for prescriptions or if it is the entire allotted budget and prescriptions make up a part of it. At any rate - triptans are expensive. For many cluster patients, the only thing that aborts their headaches are imigran (sumatriptan) injections...or jabs as they call them! I have another friend over there whose GP will only give him 2 injections at a time and forces him to come back in any time he needs mor[...]