Med involvement and also ozempic questions

[Jkc]

Dd18, massive struggle over the last six months, in and out of our household (crashes with friends).

Hasn't been able to maintain a job. Hopefully one tomorrow she can stick but it's been constant turnover and derailing.

We support her financially trying not to enable but also doesn't seem to have anything*click in her brain with consequences. (We pulled the car at one point so she just quit school, rotted with friends went low contact with us and made an attempt and ended up in hospital).

We are a bit more involved and she is home a bit more but frequently really mad full of conflict etc.

Questions:

She pulled me off everything medical. We however pay for everything including insurance and bills.

She's on a lot of meds  I'm concerned that they are not effective currently ( hyper focus, poor judgement, no impulse control, huge volatility/low emotional regulation, fixation, low or ineffective motivation, etc).... And these aren't new problems but they have been substantially better in the past....

Do I risk pissing her off more and reach out to her Dr and give my insight? I don't feel like they are getting more than 25% of her reality?

Her judgement is concerning-- she's so desperate to get away from us and so reactive to anything I say that she's not rational -- example - she's convinced someone is going to pay her $60/hr to nanny... I'm like that is not real. That is a scam. But she's still chasing it and that is scary.... But also reflective of her mind state.

Second... She really wants on ozempic.

Our pediatrician gave her prescription (!!!) when she went for follow up on chronic uticaria rash (previous history of that and it came back... After she tried metformin and it kinda triggered this whole downward spiral this fall) (missed work from hives, ended up quitting before getting fired but didn't try to just work with them etc ) I pushed back and also read insurance might not cover in the future so she didn't start it. I have massive concerns. And we are moving to individual insurance after being on cobra and it's going to be very expensive and triple the deductible... But as evidenced by something clearly black and white like the scammy too good to be true nanny thing... I can't even really have good conversations with something slightly more grey like this medicine.

Advice or experiences with these kind of situations??

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Sancho]

Can I ask if DD diabetic - or wanting ozempic for weight loss? You mentioned she had been on metformin so just wondering?

Gosh DD is on a lot of stuff so thought I would clarify the ozempic mention first.

[Sancho]

Also can I ask when DD was diagnosed with ADHD and ASD? Has she been on ADHD meds for quite a while and did you notice that they were helpful? Are they regularly reviewed?

Sorry for all the questions!

[Jkc]

Years ago on ADHD and meds help

Not diabetic. Leans overweight because genetics and lifestyle but ambilify definitely is z factor

[Sancho]

Hi Jkc
I would try to find a way to clarify what medicines DD is on and why she is on them.

This is what I gather from your post:
DD is on antidepressants, mood stabilizer and meds for ADHD (is abilify the mood stabilizer?)
DD is not diabetic. Both Ozempic and metformin appear to be meds to treat type 2 diabetes.
The paediatrician prescribed Ozempic because DD developed uticaria (a skin rash) as a result of using metformin. Both metformin and Ozempic seem to be linked to weight loss, but where I come from they don’t seem to be approved for this purpose – I might be wrong on this.

There does seem to be some confusion both in what DD is formally diagnosed with – and what meds are being prescribed to treat these conditions and you have noticed that her symptoms seem to have worsened.

DD is only 18 and I know that is legal age, but it is still very young to be negotiating a way through complex medical matters.

The only interaction I had with paediatric psychiatrists was when my DD was a teenager, and he was most reluctant to prescribe any medication because of DD’s age. Of course one can’t compare but everything I have read about your DD’s behaviour lines up with my DD’s behaviour due to BPD.

I have been trying to think what I would do in your situation. I think I would write the list of meds on a bit of paper and talk to a pharmacist. Make a list of questions eg Do these meds go well together; are there any worrying side effects of any of them if they are used long term; how often should they be re-evaluated; are younger people such as teenagers more likely to get side effects from taking these meds together.

We have care packages here and one option is a chat to a pharmacist. They can be immensely helpful. I found out stuff that no doctor had told me.

I would also contact DD’s GP – I suppose you would just get to talk to a receptionist – but I would say something like  ‘I know I can’t discuss my DD’s medical status with her doctor, but I would like him/her to know that I am concerned that DD is worse than she was a few months ago. I am also concerned that she is on some serious medication, and the number she is on makes it hard to really observe the effect of each one and also possible side effects.

I have done this in the past ie told someone’s GP that I knew he couldn’t talk or comment or discuss, but I wanted him to know xxxxxxxxxxxx

It worked well.

Sorry I can’t be more helpful.

Ps my DD put on an enormous amount of weight when she was prescribed a mood stabilizer. This very fact of course made her even more dissatisfied with herself!

[ForeverDad]

Here's my understanding of how it goes when contacting professionals such as doctors.

HIPAA privacy laws (in US) require that doctors not divulge patient information without the patient's authorization.  But it probably doesn't limit what observations and insights you can share with the doctor.  Just be aware that you may not get responses.  And yes, your D may get upset if you share info, weigh the different pros and cons.