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Wednesday, January 25, 2012

Next Up - Psychiatrist Appointment

Every two months I have an appointment with my psychiatrist for "medication management."  That's what they call the 20 minutes I have to meet, discuss, and make any changes to my medications.

I met with Dr. G on Friday.  It was in the morning so I was sure to be groggy and miss some something.

We talked about the usual stuff: sleep, meds compliance, exercise, diet, and medication effectiveness.  However, we spent most of the time going over my disability retirement application.

Disability Retirement

The disability retirement program is for federal service, not social security disability.  However, as a condition of the federal program I also have to apply for social security disability.  I did this last month.  I am doubtful they will approve my application.

Social security disability has a higher bar or threshold for acceptance than the federal disability retirement.  They require that you must not be able to perform any gainful work due to a medical condition that will last at least 12 months.  However, for the federal system the applicant need only be unable to work in their current job because of a medical condition.

Anyway, Dr. G and I spent a lot of the appointment discussing how my bipolar impacts my ability to do my work.  For example, during a bipolar depression I struggle with concentration and memory problems.  This makes it difficult for me to effectively read and analyze technical reports, which is an essential function of my job.

Dr. G typed what we came up with in her notes.  The notes will be used to document how the illness impacted my ability to do my job.  When the notes are typed up in the required format along with some additional information it is called the Physician's Statement.


Dr. G and I discussed possible changes to my medications.  She mentioned Seroquel and Remeron.  I am reluctant to start another mood stabilizer at this point.

I am trying to reduce my psych meds.  I recently got of Abilify and now I am considering stopping Cymbalta.  I don't think it is doing much anymore.

However, I do want to try the supplement N-Acetyl-L-Cysteine or NAC.  I recently did some research into NAC and it seems worth trying.  So we agreed that I'll try the NAC and see how things go.  In the meantime I will research Seroquel and Remeron although I'm not very excited about either of them.

That's about it.  Won't be writing about Dr. G for a while since my next appointment isn't until May.  She's overbooked.


  1. Hi :). I had seroquel and remeron. Seroquel get weight for me and I was guite sleepy all the time. (or I had seroquel prolong). And remeron was toxic to me. I was in hospital many weeks because I had bad problems to breath. In Finland remeron was firstly very popular medication but then there started to found so much problems that doctors are not using it so much anymore. But remeron is ok because then you don´t usually need sleeping pills. I meet my therapeut once a week and a doctor once a month. I think it´s nesessary for me and good way to control my medication. In finland treatment is free (doesn´t pay anything) so it´s possible to use services so much you need. T: Päivi

    1. Päivi - Good to hear from you. Hope things are well. Thanks for sharing your experiences with Remeron and Seroquel. I've heard similar things, but I've heard good things as well. I need to do more research I think.

  2. I hope I can get my comment to share. I think it's great Jeff that you are researching your mess and that your doctor is open. I like that you are I. The drivers seat with regard to your treatment. I hope you feel some empowerment and peace that you are in charge of your life. I'm impressed with the leaps you've made in your life. I like hearing from you all the time. Love, your sister Su

    1. Yep, your comments made it! Thanks for the support Sis. I'm not sure I would call them "leaps." Blips maybe.