Pissed off at hospital doctor

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Unfortunately my 14 year old aspie daughter had another suicidal episode on last Thursday night. I was just telling her to turn her tv down, so I could head off to bed at 10:00 pm. I had had this horrid cold that I wanted to hopefully sleep off. And she started crying about how she was mad at me and "you know what you did." and finally she tells me that she is mad because I won't let her die and kill herself and how she is never happy and all that. How I couldn't watch her all the time and she was just going to slit her throat. Then she locked herself in her room and I had to get in there.

It was so unexpected again because we had had a good evening. She had called after school to say how she had had a good day and we had a nice dinner and watched a movie together and she went upstairs to watch South Park, her fave show. So before it got too dramatic and I had to call 911 again, we went off in a cab to the hospital because they had told me to bring her back if she got suicidal again. So we got there about 11:00 pm and we were left in the observation room for over two hours. They finally come in at 2:10 am to say she is fine and we can go home now. That I should have called the crisis line and not come to the emergency room, that they know how to deal with teenagers. But last time the crisis centre had told me to call 911. I said "What what I supposed to do? Just go to bed and say hope you feel better tomorrow morning?"

She says to me, well you have all the supports in place - Zoloft, aspergers program, on the waiting list list for a psychiatrist and a family doctor. It was like there was something wrong with our family because here we had all this in place and the nerve of my daughter to want to die.

I was so pissed off at the hospital, was ranting at home for hours pacing about how I try to get help for my daughter and then they act like I overacted, like she broke a nail or something. I guess next time her sister and I will have to deal with her because it is a complete waste of time and money to call for help. I had to pay about $35.00 in cabs and snacks last Thursday and then on the 27th, I will likely get a $240.00 bill for the ambulance because it wasn't a life threatening and necessary ride. If the police had brought her, it would have been free, but they chose to send her with the paramedics. I am so discouraged about it all and not too happy with Zoloft.

That seems really, really irresponsible of the doctor.

I have had that kind of doctor "eyeroll" response in the ER with my kid as well, it is very shaming and frustrating. My son used to have a GI issue that made him start vomiting until he dehydrated whenever he got sick. It was a condition a lot of doctors were unfamiliar with, and I would try to get him fluids *before* he got to the dehydration point and had to be admitted, but the ER docs sometimes responded to me like I was a panicky mom with a kid who had a "run of the mill" stomach virus and sent us home- only for him to return later and be admitted. I eventually worked out with his regular doctor, that any time I was headed to the ER with him for this issue, she would call the ER ahead of us and tell them the issue and how to treat it. I know you said you were on the waiting list for a Psychiatrist- but can you call their office, explain the issue and ask them to ask the doctor what protocol to follow if it happens again? Many specialists will be on call in an emergency, even if you are on the waiting list and haven't met in person yet. The Psychiatrist may be able to call the hospital ahead of your arrival and have them follow a different procedure.

So sorry for this.

Thanks Fitzi - I knew I couldn't be the only frustrated parent at the ER. I don't understand why this doctor made me feel so undeserving to be there - my daughter just started Zoloft 3 weeks ago and the main thing is to watch that your teen is not becoming suicidal and when she is and I am worried - I am considerred to be "overreacting". And if I ignored her words, would I not be a neglectful parent who didn't take her suicidal ideation seriously and get the help she needed?

That's ASININE.

I don't know how it is now, but 5 or 10 years ago there was a huge problem in the US with people "abusing" the ER for routine minor care (somehow, I was told, it gets written off faster if you cannot pay). I understand ER docs being frustrated with THAT, but you were doing what you were told and did, indeed, have a potentially life-threatening situation on your hands.

Not like me flipping out as a new mom and taking an 18-month-old to the ER over a stomach virus at 2 in the morning because I'd convinced myself she was the 0.0001% of kids who develop Reye's syndrome exposure to aspirin or something else crazy (and they definitely didn't pull that crap on me then, probably because the kid was little).

If you've got the nerve, I think I'd call/write and complain about that one. State, expressly, that you were following the instructions you were given.

And report the stated suicidality to the prescriber of the Zoloft. I know you've done this and so far they've dismissed you with "Wait and see for 6 weeks." Send thru proper channels, adamantly, and maybe something will get through their heads...

Hope something works out soon to improve the situation for both of you. *hugs* Wish I had more.

Yes ^^

I am really surprised (no matter how justified the doctor felt his/her response was) that a suicide threat was treated so lightly. I do think, if you are up to it, it would be good to report it to the hospital.

^^^This

I am just too speechless to add to what was said. I am sorry this doctor was such a tool.

Yes I think I should make some kind of formal complaint too - but now I feel just too tired with the situation that I don't even want to deal with it anymore. It just feels that no matter where you turn, there is no real help. I was so happy that I got my daughter into the aspergers program and I thought this would really help things and even they don't know how to help her. I know that any day now I will have the school wanting me to pick her up because she is freaking out and they don't know what to do with her. So they want me to leave work and get her, like bringing her home will fix it.

The Zoloft is certainly not doing the trick - her behaviours are awful on a daily basis and we will see our family doctor next week and he won't know what to do either. The school wants her doctor to do something and the doctor is asking me why the school isn't getting her help.

How many years of this do I have to go through?

I empathize.

Everyone wants to make it someone else's problem.

The school doesn't want to deal with it, so they blame the doc (like meds can fix everything---not) and then send her home so the rest of the day is not their issue, either.

I wish I knew something to tell you, but AS is AS, and she has been through a lot, to say the least, lately. If she handled it "well" it would have been surprising. Regular day to day things are hard enough without having an actual trauma that occur. An NT would not have necessarily handled it well, you know... What does anyone expect?

Have you discussed all this yet with the prescribing doctor? Please make sure he is fully updated, as he is the medical professional with the most information about your daughter, and is best positioned to adjust or clarify the advice he has given you - - as well as the medication, if necessary. Zoloft not only does not work for everyone, but can in some teens deepen the dark moods, so this is a tricky time that definitely DOES require monitoring, no matter how many idiots you end up dealing with.

It can take a while for Zoloft to start working, but what has happened is definitely troubling.

How do you feel her environment has been at school and elsewhere? Do you feel potential triggers and stress factors are being properly identified and mitigated? Everyone has to do their part, and while I wish there were short cuts, we all know there aren't any. Mold the environment, mitigate triggers. Look for the same things you would look for if you were trying to head off meltdowns; many older ASD individuals learn to internalize the negative energy instead of having a public meltdown, but while that makes them look more acceptable to society, it would seem logical that it might also increase suicide risk.

Don't let anyone stress you out about her age and where she needs to be in terms of progress; that all falls secondary to her mental health. She is going to have to develop and learn in her own time at her own pace.

I tend to be with the doctor on this one; the day to day help is extremely important. There is only so much that can be done with medication. Unfortunately, schools aren't usually equipped to deal with all the potential variables and nuances involved, either ... still, they are the ones who see the child daily and have the best opportunity to identify the issues, if they are able to observe carefully (which is much more difficult to do in a high school with 6-7 different teachers, than it would be in elementary). I can't recall all of your history; have you looked into other schooling options?

DW a mom - we have a follow up appointment with our family doctor on Monday. I was going to try to get her in this week, but this appointment works good for us because I can leave work early and get her from home and walk down, rather than having to bus to her school to get her there. I am hoping he has some good advice, but I feel telling him about the two times she felt suicidal is going to make him worry. He will probably want to consult with the hospital psychiatrist (that she has a year waiting list for one of them) before deciding what to do. We were supposed to try Zoloft for 30 days and then see how it went and decide whether to double her dosage. (she is currently on 25 mg which is the dose for 6 to 12 year olds.) He was too worried to prescribe her something before he spoke to the hospital doctor because he didn't want her to have bad side effects such as these.

The school is surprisingly being good this week and haven't called me. They know she is adjusting to the Zoloft (that they pushed for) and they seem to be dealing well with the consequences. They have been taking her out of class to play basketball when she is hyper and working with her outside of her classrooms, to get her work done.

She never slept last night (she ended up napping after school for two hours) and wanted to come home today and the school wanted to keep her there, which is good. I was expecting them to call to come get her. She already missed two days last week and exams are coming up, so I am glad they kept her there.

We all try to keep her triggers to a minimum - but sometimes nothing works. It doesn't help that she was sexually assaulted by that boy in her aspergers class a few months ago, so sometimes I think those memories put her in meltdown too.

This is definately the best schooling option for her, the aspergers program is not perfect, but she is definately doing better there than she would be in a regular high school program. She is able to attend 3 regular classes and then a learning support class and they have EAs in each of her classes and she can work outside of the classroom too.

Sometimes they feel that they have spent too much time with her with too many EAs helping her, but what do they expect?

It sounds like overall you have good plans in place, then, and it is mostly the process of sorting through the haystack while giving time for things to separate and play out as they will. And the one idiot doctor, of course.

Good luck with the Monday appointment. Hang in there. Effective processes take time and patience.

When doctors were worried about me they were able to make me see the therapist i was on the waiting list for before it was my turn on the waiting list.

He's the prescribing doctor -- he's responsible for her care and needs to be made aware of any sort of suicidal incident as quickly as possible when it occurs. He should have an answering service who can page him after hours -- the ER staff might have been less dismissive if you had called him while in the cab or the waiting room and he then called the ER to advise them that she was on Zoloft and this was a second incident. Sadly the same information carries more weight coming from a doctor than a parent.

This is also concerning -- be sure you tell the doctor about this when you see him on Monday. I think I recall from another thread that her father was bipolar? Some antidepressants, not sure if Zoloft is one of these or not, can sometimes trigger mania for people with bipolar. Not saying that's the case here, just make sure the doctor is aware of all the family history and current symptoms.

I am so sorry. I can only imagine how heartbreaking and frustrating this is. I have no advice to give other than what you have already received. I just wanted to send you some strength.