Nurse Practitioner’s Appt This Afternoon

I had a brief meeting with my nurse practitioner this afternoon. Even though it was only half an hour, we discussed a lot of things. First we made concrete plans for me to start the topiramate. Like I said before, I would need to be on the injectible birth control for two weeks before I could start it. That would be next Thursday, but I proposed I won’t start with the topiramate until the Sunday after that, July 4. That way, I won’t be just starting out when I go to Lobith on July 3. This was okay with my nurse practitioner and he’d make sure the pharmacy would get it ready on time.

Next, we discussed my bloodwork results. In the part that measures metabolic health, nothing worrisome was found. I asked about my kidney function and first my nurse practitioner said that unless your estimated GFR is below 60, it’s no reason to worry yet. Mine was 81. He checked my previous lab results. My estimated GFR was 71 in 2019 and 82 in 2020, so there’s not a clear decrease either.

He also complimented me on my cholesterol level, which was completely normal. Of course, there is only so much you can do about high cholesterol, but apparently I’m doing what I need to. It probably helps that I don’t drink and try to eat a relatively healthy diet.

Then the other page showed my blood level for my antipsychotic aripiprazole and its active metabolite. These were quite high. This means that side effects may outweigh the effectivness of the medication. While I don’t experience any major side effects, we will try to lower my aripiprazole dose in the not-too-distant future. That’s been a long-time wish for me anyway.

Then we got to discuss my crisis last week and my conversations with my husband. My husband had suggested I might have dependent personality disorder and I eventually thought he was right. Of course, in my mind, this led to all kinds of additional conclusions that my husband hadn’t mentioned, like my not having trauma-related issues and my not even being autistic and my being one giant manipulator.

My nurse practitioner said that DPD rarely if ever goes alone and that he wonders whether it even is a valid diagnosis. It is according to DSM-5, of course. He added that this is one of the most negative diagnoses to give someone. My nurse practitioner obviously didn’t mean my husband, as he didn’t really try to diagnose me at all, just wanted to give me food for thought. We will further discuss my issues with dependency in the future.

Overall, it was a good appt. As my nurse practitioner hadn’t read the E-mails we (meaning my inner people) had sent him over the weekend, we didn’t go into those specifically. Those E-mails had included a lot of self-loathing and self-doubt, including about our possible DID. I did explain about the dependency issue, like I said above. He also made sure I’m no longer in actual crisis. I confirmed this. This means I no longer need more frequent contact with the mental health team than I normally have.

10 thoughts on “Nurse Practitioner’s Appt This Afternoon

    1. Thank you! I am still a little worried about being diagnosed with DPD eventually and then losing my long-term care. I know that even if I do have DPD, it won’t be the only thing and I likely won’t lose my care, but still.

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        1. Thanks so much for reassuring me. It’s a big trigger because back in 2016 our DPD diagnosis was used against us to kick us out of the mental hospital.

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  1. That really sounds like a fairly good appt. 🙂 I’m glad you could go through all that stuff and hope the Topiramate will help once you start taking it. 🙂 As for the DPD thing, I think it would be very not okay if they just kicked you out of long-term care even if you did have it and got diagnosed. I mean, being diagnosed with DPD doesn’t really say anything about you other than that you’d have DPD, you are still multiply disabled and need care like you did before. Even if they would decide that you don’t need quite as much of it and that it’s better for you to live independently so that your dependence isn’t further reinforced, you would still need adequate support to succeed in independent living, as well as healing from the potential DPD, which can’t happen on its own once you’d be kicked out and have no one to depend on. That’is at least how I understand it anyway, and it doesn’t make sense to me to diagnose someone with DPD just to get rid of them and it sounds very cruel. Besides DPD doesn’t happen from nowhere and there may also be trauma involved, so even if you do have it, that doesn’t have to mean that you don’t have trauma-related issues or autism. I can imagine it must be very triggering for you given your previous experience with being accused of having DPD. That’s why I have to say I’m a bit surprised that your husband decided to tell you such a thing, because even though it was very well-intentioned and I guess meant to somehow motivate you or something, if he knows your story it would be quite clear that saying such a thing could trigger you big time. Actually, I suppose telling anyone that they might have dependent personality disorder would make them jump to further conclusions, I guess. Or maybe it’s just me.
    Hugs to your inner people. 🙂

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    1. Thank you so very much for supporting me/us! I thankfully got my long-term care funding based on blindness, with the reasoning that if I weren’t blind, treatment for autism etcn would have been easier. This was in 2019, when psychiatric diagnoses including autism were still exempt from qualifying you for long-term care. This being the case, you’re probably right that I wouldn’t lose mylong-term care even if I did have DPD.

      As for my husband, he can be pretty blunt and upfront with his opinion. When I was originally diagnosed with DPD, he also said he thought I may indeed have it. He probably didn’t realize this would trigger me to the point that it did.

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