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She is Bipolar depressed and I am Bipolar manic. I am prescribed Seroquel. She has been on Lithium most of her life so it is shutting down her kidneys and can no longer take it. However I know that we r at 2 opposite ends of the spectrum but she should not be given Seroquel. She says she feels worse and now I know why. She also has debilitating anxiety and the cut down her Klonopin and Trazadone. She is miserable and I thought with my poa and medical proxy that they needed my prior approval for a medication change. Am I wrong cuz we went through this once before and her Dr. always contacted me prior to a medication change.

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I see from your profile that you are your mother's health proxy. All the same, doctors have a duty to act in their patients' best interests, and it could easily be that in their qualified professional judgement the change of medication was essential. It's their signature on the prescription and their responsibility for what happens as a result, don't forget; and wouldn't you be much angrier if something went wrong and their excuse for not acting in time was that they hadn't been able to get your approval first?

But what happened, exactly, and what would you like to happen next?
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DawnPonticello1 Oct 2019
She is Bipolar. She had a mini stroke and I found out that they reduced her Klonopin 12 days prior & it explained why she keeps telling me she is getting worse. Because she is. They also put her on Seroquel. I know due to the fact that I am Bipolar as well that she needs other medication for this. I am Bipolar manic I am prescribed Seroquel. She is Bipolar depressed and anxiety that is debilitating. We r at the opposite sides. I take Seroquel and she is normally on lithium but she has kidney disease do to years of that med. She can not take it anymore but Seroquel is not the answer. She can't even stay awake. Thank u so much for your reply! Ok your turn again..lol
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Dawn, more than likely someone (including possibly you) had to sign a consent to treatment when initially seeing this particular doctor.   If you review it, you may find that the doctor has authority to manage medications, w/o having to consult with you first.

I wouldn't approach the doctor as if he/she had done something w/o your permission, but rather use this as an opportunity to establish a closer relationship with the doctor on medication management.   This will be very beneficial in the short and long run. 

If the doctor has a PA or NP, try to get information from that person first, indicating that you need to be fully informed as to  your mother's meds, and ask what steps can be taken to make this happen.

You can also ask about the specific med (after researching it online so you have some knowledge of its function) and how it relates to your mother's condition.

That'll demonstrate your interest in being up to date as well as in cooperating with the medical team.  

And BTW, what is this doctor's specialty?  Cardiac, pulmonary, PCP?   If the latter, I'd be more than a little bit leary; I haven't been impressed with PCPs' coordination with specialist doctors.
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DawnPonticello1 Oct 2019
She is Bipolar depressed and I am Bipolar manic. I am prescribed Seroquel. She has been on Lithium most of her life so it is shutting down her kidneys and can no longer take it. However I know that we r at 2 opposite ends of the spectrum but she should not be given Seroquel. She says she feels worse and now I know why. She also has debilitating anxiety and the cut down her Klonopin and Trazadone. She is miserable and I thought with my poa and medical proxy that they needed my prior approval for a medication change. Am I wrong cuz we went through this once before and her Dr. Always contacted me prior to a medication change. Thank u so much for replying. Ok your turn. Lol
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Dawn, what medication YOU need for the same condition, as you describe below, may not be the medication cocktail that works for MOM. Bipolar isn't something where specific drugs in specific amounts works. Each patient is as individual as a thumbprint, just as with a bad back, each patient's "what works" is as individual as a thumbprint. The doctor is "playing around" and if you are medical personnel they will admit that it is anything but an exact science. They have to find what works with you, what pills working in conjunction or alone and what amounts. It is experimentation, but it is all they have.
I think if you tell the doctor that, when medications are changed, you would like to be called and told what is changed and why and what they hope for with the change, that the doctor, if you are health care proxy will do this. I hope so anyway, as it is the responsible thing to do.
Good luck.
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Dawn, all I can say is *talk* to them. You're certainly entitled to ask for a detailed explanation of their reasoning about the changes to your mother's prescription - do the "informed consent" bit for her. And I'm sure that GA's and AlvaDeer's approaches are the right way to go about it.
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