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Bipolar Bureaucratic Blues



I’m still waiting for a referral from the agency that handles outside referrals for the VA to see a psychiatric or psychological professional because my VA psychiatrist said she can no longer see me long-term, per VA directive. The agency that sets up appointments called me before Thanksgiving to say they would find someone (probably an ARNP) to handle my case. They said that I would be authorized to see that person for only four visits. The interesting thing about this is that I’ve been seeing my VA psychiatrist once every six months, but the agency that does the outside referrals only authorizes visits to occur in a four-month period. So, the outside provider will have to send in a document that is called an SAR to request additional visits after the four-month limit has expired.


I’ve dealt with this before with my outside dermatologist who sent in the required SAR, except that agency sent me a letter stating I was not eligible to see an outside dermatologist. I had to send my Primary an e-mail requesting she initiate a referral to the Dermatology Clinic at the Seattle VA Medical Center for another total body scan because I have had two cancerous lesions removed already by the outside provider I’ve been seeing. Now, the Dermatology Clinic at the Seattle VA Medical Center has a process called nurse triage of referrals and this process takes a minimum of 30 days. Then their representative calls and says they will not be able to see me for three to four more months, but would I like to see an outside provider; to which I say “Yes.” Then they notify the agency that handles outside referrals that I need to see an outside dermatologist. A week later, a representative calls me to say that they have received a referral from the Dermatology Department at the Seattle Medical Center stating that I am eligible to see an outside provider. They ask if I have a specific provider in mind and I state that it would be nice if I could see the provider that I have been seeing for the past two years. They take the information and inform me that another representative of their agency will call me with appointment details in five to seven days. They, also, ask if it would be alright to leave a detailed message on my voice mail.


In my current situation, with a referral to an outside psychiatric/psychological professional it’s been more than five to seven days waiting for the agency to contact me. I suppose sometime next week I will have to call them, again, and ask if they’ve found an outside psychiatric/psychological professional to treat me, since the VA refuses to treatment on a long-term basis. I do not expect a positive answer when I call because the people you call are not the people who make the appointments. They have filter people to sort out the real crazy Vets who attempt to placate them with meaningless drivel.


It’s been a week since I completely stopped taking Depakote to maintain my sanity and completely relying on Seroquel (an atypical antipsychotic) to take up the slack. Quite frankly, I think I’m going a bit wonky, but I think I’ll have to do a bit of self-monitoring to make sure. That’s interesting isn’t it, the VA hasn’t provided an outside psychiatric/psychological professional to treat me, so I have to rely on self-cognitive therapies. No worry because I’ve been through extensive cognitive behavioral therapy in the past, so I should no how to treat myself. First Rule: Do Not Stop Taking the Medicine That Isn’t Working Because It Will Only Make You Worse. Second Rule: Call Your Psychiatrist ASAP To Get Permission to Go Back on the Mood Stabilizer. Yes, I think I’m going wonky.

On the other hand, I’ve been making great progress with the new book. I’ve already come up with a suitable title for it and I’ve pulled in a character from 319. Actually, I think I’m going to have fun with this because it deals with a lot of psychological issues I’ve had to deal with myself. I think I’m going to have fun with one character who is gay and the other who might not be, but who may feel a responsibility to provide sexual services to the other if only to ensure their continuing friendship. I know this is rather vague, but at least I don’t think anyone is going to die in this story. Honest, I don’t like killing of characters, but sometimes there is no other choice.


Yes, there’s no doubt about this, I’m definitely going wonky. Trust me, it’s not fun being nutso. At least I’m not suicidal; that’s a definite bummer. No, it’s definitely wonky time here.

Nana is stretched out across the sofa and I’m listening to the George Harrison song “Wah-Wah” sung by Eric Clapton, et. al., on the “Concert for George Harrison” album.

Yes, I’m definitely going wonky.



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Yeah, I agree, it sounds frustrating. Have you ever tried Latuda? I take it, and it seems to help with my mood. It definitely helps for the psychosis. 

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