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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 398 to 422 of 434. Go back in thread:
Posted by Elizabeth on October 11, 2001, at 11:09:26
In reply to Re: hanging in there » Elizabeth, posted by shelliR on October 10, 2001, at 16:21:02
> I think you misunderstood my statement. I meant that constipation is a problem with many medications ("has to be managed with so many medications.") Not that constipation itself requires many meds to deal with it.
You're right, I did misunderstand. Oops. :-} (It is a pretty difficult-to-manage side effect, though.)
> Elizabeth you must think I have a bird brain. I misread your statement. I thought that you were saying they are the same drug; of course I know that pharmacists can't substitute difference meds. ;-). Though at some point I might bring up the issue of morphine; right now I think he wants to see what happens if the nardil is increased.
MS Contin would be *much* cheaper than OxyContin is. You'd have to take a much higher dose, though (I don't know the relative potencies, exactly). I know of someone who's taking morphine (MSIR) for depression (and has been for some time without needing to increase the dose); he takes 150 mg/day (as 30 mg five times a day). (MS Contin is supposed to be taken twice a day.)
> > MAOIs do cause quite a bit of sleep disruption. I thought Ambien was pretty effective.
>
> I'm pretty sure I tried that in the past.And how did it go?
> I need to get my old records from my pdoc of 10 years--just keep forgetting to call before 4--her office closes early.
Being a control freak, I keep my own records. :-)
> I haven't a clue. But I do know that if it happens on 60mg, we'll have to figure out why. I had been on 45 mg for about a year when it started happening. Then I went down on nardil to 30mg with 45mg premenstrually, and it never happened again.
Hmm. I'm not sure if there's anything you can do about photosensitivity other than be careful and maybe wear sunglasses everywhere. :-) You have the weirdest drug reactions!
> I guess I get confused as to why you want to replace it. I thought I had read that several times in your posts that the despramine and buprehorphine was working, but that you'd rather find a replacement for the bupe?
Yes. The side effects are troublesome to manage, and I'd like to be able to take a pill or wear a patch instead of doing this weird ritual and fiddling with syringes and so forth.
> I have been dealing with all those concerns. The increased doses are pretty much to keep me alive until something else takes some of the workload.
Okay. I hope that you're able to find that "something else," because I think it would suck to be so dependent on a particular doctor, and even though he's well respected you might meet with some resistance if you tried to get a new doctor to prescribe it. I've had some troubles lately because I've had to move several times. I did manage to convince the new doctors to prescribe buprenorphine, of course, but you can't be certain that someone will be willing to do that. You might find that even if a new doctor is willing to prescribe it, they might pressure you to "detox."
> He has also given me on his prescription pad a list of all my meds, so if I had to be hospitalized in an emergency, I have the doses of all meds with his license number.)
That's pretty cool. I wish I'd had that when I was in the hospital back in February-March.
> Is desipramine the generic or brand name?
Generic. Brand name is Norpramin.
> I don't recall much about the tricylics. It was many years ago. Did the other tricyclics make you disoriented? That was the effect on me--total disorientaton.
No, but I had problems with constipation and appetite stimulation.
> yes. All my augmentations were with nardil. It's really the only AD I've ever been on, except for other trials.
So you're sticking with Nardil as your main AD, and experimenting with augmentations. Okay. What, if anything, did thyroid hormones do to you, BTW? I've been thinking about trying that, since it's something I haven't tried before.
> I did try furosemide (80mg), but I'm not sure that I actually followed through and took it for more than several days. And in several days it had little effect.
I don't know how fast those things are supposed to work or whether 80 mg is a reasonable dose. I find that I need higher doses of antihistamines for opioid-induced itching than I would for allergies, and I seem to need pretty high doses of bethanechol, too (the largest tablet size is 25 mg, and often that isn't enough).
> Well, thanks anyway, I think I've pretty much tried everything, except concerta, which is a likely possibility.
I would like to try it, if I had prescription insurance. (I think I'll ask for Adderall or Cylert instead.)
> Oh, and I did have pindolol on my list, but from everything I've read, it acts more to help ADs kick in faster than it does for poopout.
That's true; I've never heard of it being used for poop-out.
-elizabeth
Posted by Elizabeth on October 11, 2001, at 11:16:22
In reply to Hi Elizabeth, posted by judy1 on October 11, 2001, at 0:49:09
> By now I'm hoping you're feeling better.
? I've been doing well for quite a while. How are you?
> I found myself on the king/queen of narcotics- fentanyl which along with klonopin keeps me pretty even execept for those damn manic episodes where depakote marches in.
Depakote and fentanyl sounds like a fine mix for bipolar disorder. Were you using the fentanyl patch (Duragesic)? Fentanyl is good in that it has a favorable ratio of desired effects to adverse effects. You're right that it's one of the strongest legal opioids. Alpha-methylfentanyl (a longer-acting fentanyl analog) is sold on the street as "China white."
> It was a bear to get it- I have all sorts of nasty MRI's so I went to a pain clinic even though my shrink is supportive of the narcotic/benzo combo, he can't approach my tolerance.
I can imagine how hard it must have been to get it. I have a hard enough time convincing doctors to prescribe buprenorphine!
-elizabeth
Posted by Lorraine on October 11, 2001, at 11:36:11
In reply to Re: hanging in there » Lorraine, posted by shelliR on October 11, 2001, at 0:20:27
Shelli:
[re: the article: Drawing the Line Between Pain Management and Addiction:]
I thought the article was interesting b/c it did talk about how for some people the increased dosage was a "water seeks it's own level" and how the rate of actual addiction was quite low.Next post
> missed this post, I think.Glad you found it:-)
[re pushing away lovers] > why was the first one less threatening?My husband was such an "eligible bachelor"--you know, on the right track, heading for success, conventional, good provider, good gene pool for kids. All this "picture perfect" stuff scared the putty out of me b/c I was not very conventional and wasn't looking for an eligible bachelor. Plus, my husband wasn't needy. In my previous relationship (with a great guy who has remained a friend)I was a giver and everything was kind of messy--he had no "career" track (he's a janitor now) and he was kind of messed up in a fairly delightful way. When I got together with my husband, it was a big fork in the road for me--to follow my ambitions into law and be involved with someone who wasn't one of the "walking wounded" but was actually capable of giving back in a fairly powerful way. It meant giving up my image of being "f**** up" and becoming a highly functional competent human being. This notion, of sort of giving up my past and walking into the future, was very scarey to me. A life plays out and in retrospect either road may have been good. But taking the road I did required me to push all of my abilities to the limit and seize the day. So I'm not one of those people who has regrets about the things they haven't done, the opportunities that they let pass them by because they were too frightened to risk failure. I risked everything, but then again, to a certain extent I destroyed myself in the process, by pushing too hard, taking on too much stress and ultimately collapsing into a depression.
> > > > >Have you taken the Myer Briggs? I am a INTJ.
> > So am I and so is my husband.
>
> > > But I have never been attracted to an extraverted man. I do think it might be easier for me to get along with a INTP because I would think that our Js might clash a lot. Have you felt the tug I am talking about at all with your husband?I don't think my Js are very similar to my husband's Js. He is compulsive about time and things being in their proper place. His "schedule" of activities is a bit amazing. I'm more prone to be late and like having unscheduled time. The only time this conflicts is when he tries to fill up our "social" calendar or when we are on vacation and he want to "accomplish" the city we are visiting (hit all the museums etc). The way we have dealt with this is by recognizing that we are separate and don't have to do the same things even on vacations.
> >[re your therapist] > It's very complicated. She has been able to teach me to get myself back on track and that is very satisfying to me; going around in circles of course is very frustrating.It almost sounds a little cognitive therapy in approach, although I'm sure she delves into your past as well or maybe she's just organized in her approach.
> > > Actually, I think it is very special that you work so hard to have a good marriage, and the working seems to very much pay off.It's important to me and, you know, once a gulf begins between two people, it is easy for it to widen. Especially when you have kids that demand a lot of your time.
> >My pdoc wants me to do another QEEG and he may be right.
>
> I forget. What will a QEEG show?My brain wave activity--what affect the meds are having on my brain waves--for instance the spikey beta thing I have, is the anticonvulsant affecting that
> > > It knocks me out pretty well, with not much hangover. I do wake up slowly in the morning, but that seems more recent. I don't remember having an drowsiness before in the morning from it until this year. And as a bonus, I don't itch anymore from histamine problems.
Will the Atarax be enough to knock you out? Is your sleep difficulty just staying asleep? I know you are doing the valium--have you thought about Neurontin? I only need to add valium to my nighttime cocktail when I was on Parnate, which was much more activating than Nardil.
> > >[re showing side by side digital vs hand painted] (Plus I think it would be too defensive of an act).I think you're right.
> > >I may print up wallet size samples that I could send out, but it's been nice lately--I e-mail everything to people now (price list, directions)--no more snail mail.
This idea is actually a great way of doing it. "Let me send you out some samples of my recent work since I've switched to digital"
> > I rejoined my writing class. I think I shocked them a bit. The theme of my first poem was suicide. The second about being seduced by depressionl. Guy who runs it makes a big point about presentation. I wanted to sort of sink into the chair, but he made me move and talk about my kids and then read--which pretty much had me reduced to tears. Reading is such a vulnerable act, you know.
>
> So before you read, you talked about your family? It seems like a really interesting and personal class.It's a remarkably personal class and the people are very interesting. Some actors, a comedian, ---mainly though just good writers. A lot of the work brings me to tears, it is very deep. The guy who runs it is from the Second City comedy team. He really requires that you approach this stuff from a deep voice and if you are lucky enough to have written from that place, then he will require that you read it from that place. Sometimes when people read their work the start to cry and he says "it's ok to cry, just breath" and then at most maybe someone will extend a hand to touch the person's arm. I had forgotten how deep this class was. It's what I love about the NDMDA meetings I go to as well. It is life at a deeper level. Anyway, it's a big move for me to get myself back into writing. It requires the discipline of daily writing--let's see if I can do that. Plus, he has me writing from different voices--the child, the mother, the whore, the madonna, the hag, the crone. It's amazing how hard it was to write from the child.
Lorraine
Posted by judy1 on October 11, 2001, at 18:29:08
In reply to Re: Hi Judy, posted by shelliR on October 11, 2001, at 3:59:15
Hi Shelli,
Actually I'm doing a little too well according to my shrink, but I'm not complaining. Went to the pain clinic to be watched like the good girl I am and to be tapered when I have to. I did ask you about DID, didn't know if that was your diagnosis, mine is dissociative disorders NOS. I was curious if that is your diagnosis, how long did it take was it obvious, etc. If not just ignore the last couple of sentences and have a great day- Judy
Posted by judy1 on October 11, 2001, at 18:35:08
In reply to Hi Judy, posted by Elizabeth on October 11, 2001, at 11:16:22
I'm glad to see all my favorite posters. I use the patch- it feels very even to me, more so than ms contin (that I used a couple of years ago). I'm amazed at how ignorant some (most?) pdocs are when it comes to narcotics, I hope your buprenorphine is helping. Take care, Judy
Posted by Neal on October 11, 2001, at 23:52:41
In reply to Re: hanging in there » shelliR, posted by Elizabeth on October 11, 2001, at 11:09:26
> Yes. The side effects are troublesome to manage, and I'd like to be able to take a pill or wear a patch instead of doing this weird ritual and fiddling with syringes and so forth.Elizabeth
Another person on this board had her Bupe made into lozenges at a compounding pharmacy. That isn't an option for you?-Neal
Posted by Elizabeth on October 12, 2001, at 9:35:53
In reply to Re: Hi Judy » Elizabeth, posted by judy1 on October 11, 2001, at 18:35:08
> I'm glad to see all my favorite posters. I use the patch- it feels very even to me, more so than ms contin (that I used a couple of years ago).
Hi Judy. I think that Duragesic is probably one of the better formulations if you're taking opioids long-term. It's very smooth, and fentanyl is supposed to have fewer side effects than other opioids. How are you tolerating it -- any side effects? What dose are you on?
> I'm amazed at how ignorant some (most?) pdocs are when it comes to narcotics, I hope your buprenorphine is helping.
It certainly is, and I've been taking it on a regular basis for nearly a year now (I was using it intermittently before I started taking it daily).
I agree, pdocs sure aren't educated enough about opioids, which I think are a valuable tool for mood and anxiety disorders that haven't responded adequately to more conventional treatments.
What symptom(s) did you have that were only relieved by fentanyl?
> Take care, Judy
You too. :-)
-elizabeth
Posted by Elizabeth on October 12, 2001, at 9:41:04
In reply to Re: hanging in there » Elizabeth, posted by Neal on October 11, 2001, at 23:52:41
> Another person on this board had her Bupe made into lozenges at a compounding pharmacy. That isn't an option for you?
Yeah, I read those posts. I think that if you're taking it SL, the dose required is probably significantly higher -- I'd have to recalibrate, and I'm not sure that it's absorbed consistently through that route. And finally, compounded medications are *expensive*, and bupe is expensive enough in the regular formulation!
I would like to ask my pdoc if I can give myself intramuscular injections -- I think that would be less of a hassle -- but I'm kind of afraid of what his reaction would be. You know?
-elizabeth
Posted by judy1 on October 12, 2001, at 11:29:53
In reply to Judy, posted by Elizabeth on October 12, 2001, at 9:35:53
Hi Elizabeth,
I'm using a 50 ug? per hour and it works really well for depression which is my only alternative since I can't take AD's. I'll have to taper soon due to pregnancy, and because of problems in the past go right back on after delivery. I'm really really glad you're doing well- Judy
Posted by Elizabeth on October 13, 2001, at 16:45:06
In reply to Re: Judy » Elizabeth, posted by judy1 on October 12, 2001, at 11:29:53
> Hi Elizabeth,
> I'm using a 50 ug? per hour and it works really well for depression which is my only alternative since I can't take AD's.That's not an unreasonable dose (and yes, it is ug or mcg: micrograms) -- the lowest-dose patch is 25 mcg/h. How long have you been on it, and how often do you change the patches?
> I'll have to taper soon due to pregnancy, and because of problems in the past go right back on after delivery. I'm really really glad you're doing well- Judy
I'm glad you're doing well, too, and I hope your pregnancy is uneventful. :-)
-elizabeth
Posted by jojo on October 13, 2001, at 20:43:28
In reply to Re: Hypertensive crises, update » Lorraine, posted by Elizabeth on September 24, 2001, at 10:11:53
A few weeks ago, after taking 0.3 mg. of Bup and 10 mg. of Dexedrine, I foolishly decided, four hours later, and being out of town and low on Dexedrine, to substitute 2.6 mg. of Yohimbine for the Dexedrine. My bp went up to 185/107. Wishing to avoid the E.R., I smoked ½ of a joint of mj, took 10 mg of Valium, and about 30 mg. of Viagra. Within 15 minutes my bp was down to 135/87. I've got to believe that the reduction was due to the marijuana, as the pills would barely have had time to dissolve. If these results are typical, it would seem that smoked mj may be the fastest way to lower bp without an injected med.
Posted by Neal on October 13, 2001, at 23:02:45
In reply to Re: hanging in there » Neal, posted by Elizabeth on October 12, 2001, at 9:41:04
And finally, compounded medications are *expensive*, and bupe is expensive enough in the regular formulation!
How expensive is it.
Neal
Posted by Elizabeth on October 14, 2001, at 10:31:48
In reply to Re: Hypertensive crises, update » Elizabeth, posted by jojo on October 13, 2001, at 20:43:28
> A few weeks ago, after taking 0.3 mg. of Bup and 10 mg. of Dexedrine, I foolishly decided, four hours later, and being out of town and low on Dexedrine, to substitute 2.6 mg. of Yohimbine for the Dexedrine. My bp went up to 185/107.
Yohimbine is, I believe, a beta-adrenergic agonist. It can do that. I also find that my BP runs a little high on buprenorphine.
> Wishing to avoid the E.R., I smoked ½ of a joint of mj, took 10 mg of Valium, and about 30 mg. of Viagra. Within 15 minutes my bp was down to 135/87. I've got to believe that the reduction was due to the marijuana, as the pills would barely have had time to dissolve.
It might just have been due to the passage of time. Usually BP goes down pretty quickly in situations like that one. (Valium works fairly fast, and it might have played a role.)
> If these results are typical, it would seem that smoked mj may be the fastest way to lower bp without an injected med.
Maybe somebody can test this hypothesis by smoking a joint next time they find their blood pressure elevated. [in jest]
-eliz
Posted by Elizabeth on October 14, 2001, at 10:35:27
In reply to Re: how expensive » Elizabeth, posted by Neal on October 13, 2001, at 23:02:45
> How expensive is it.
Depends where you get it. I get 90 cartridges (of the Abbott generic, not Buprenex(R)) at a retail pharmacy for about $140. That's the lowest price I've gotten it for. I did get some Buprenex recently (pharmacy screwup), I'll dig up the receipt and see how much it was (same quantity, 90 ampuls).
-elizabeth
Posted by Lorraine on October 18, 2001, at 14:29:27
In reply to Re: hanging in there » Lorraine, posted by Elizabeth on October 10, 2001, at 13:28:50
Elizabeth:I thought you'd find this portion of an article of interest:
The FDA is preparing to approve a new medication for opiate addiction that won't be restricted this way. Buprenorphine is an unusual opiate - it has mixed effects on opioid receptors. At lower doses, it produces an opiate receptor-agonist effect like methadone; at high doses, it produces the opiate-blocking effects of naltrexone. Researchers say that at an agonist dose, most patients cannot distinguish it from methadone. (Interestingly, naltrexone is approved as a treatment for opiate addiction, but, because it doesn't provide the anxiety-reducing effects of opiate agonists, it is not as effective as methadone.)Congress has just passed legislation allowing any doctor with training in addictions to prescribe buprenorphine - addicts won't have to venture to ghetto areas or give up freedom to get it. And because it has antagonist effects if addicts try to take extra or use street drugs on top of it, it offers some satisfaction for those who want a drug to punish.
Here is the site:
http://news.bmn.com/hmsbeagle/91/notes/feature1
I just thought that it was interesting that at high doses bupe is an opiate blocker--I guess that is why my pdoc thought it was used with addicts.
Posted by shelliR on October 18, 2001, at 20:40:41
In reply to Re: Hi Judy » shelliR, posted by judy1 on October 11, 2001, at 18:29:08
> Hi Shelli,
> Actually I'm doing a little too well according to my shrink, but I'm not complaining. Went to the pain clinic to be watched like the good girl I am and to be tapered when I have to. I did ask you about DID, didn't know if that was your diagnosis, mine is dissociative disorders NOS. I was curious if that is your diagnosis, how long did it take was it obvious, etc. If not just ignore the last couple of sentences and have a great day- JudyHi Judy. I do have the same diagnosis as you. I have little kids inside but since I'm co-conscious with them, some therapists have put me in the DID category, others in DDNOS. I feel much more like DDNOS because there are so many ways that I don't have the same stresses as with MPD. My "kids" are always cooperative, don't come out unless they're allowed, and I don't find things that I don't know how they got in my house. In other words, the things that make DID so damn hard.
There was a long time that I knew there was one child inside, but all she would say is "I want my mommy". I don't remember exactly when that changed and she was a whole personality. I think the first time I was in the hospital. Then it was a big shock to have others inside--like how would I know who's talking to me, etc. But it all worked out, and the youngest have abreacted a lot of what happened to them. The eight year olds have not talked yet about what happened to them, except to say that it did happen. I don't focus on it a lot because I had a friend that only focused on memories and they never came to her--so I think when they're really they'll come out.
How did you come to diagnosed as DDNOS, instead of DID? Do you have different personalities inside? I guess you must have at least ego states, or you wouldn't be diagnosed.
I'm glad you are doing well. Is that why you went to the pain clinic--to be tapered down? Can they do that outpatient?
When are you due?Shelli
Posted by shelliR on October 18, 2001, at 21:11:05
In reply to Re: hanging in there » shelliR, posted by Lorraine on October 11, 2001, at 11:36:11
Lorraine
> My husband was such an "eligible bachelor"--you know, on the right track, heading for success, conventional, good provider, good gene pool for kids. All this "picture perfect" stuff scared the putty out of me b/c I was not very conventional and wasn't looking for an eligible bachelor. Plus, my husband wasn't needy. In my previous relationship (with a great guy who has remained a friend)I was a giver and everything was kind of messy--he had no "career" track (he's a janitor now) and he was kind of messed up in a fairly delightful way. When I got together with my husband, it was a big fork in the road for me--to follow my ambitions into law and be involved with someone who wasn't one of the "walking wounded" but was actually capable of giving back in a fairly powerful way. It meant giving up my image of being "f**** up" and becoming a highly functional competent human being. This notion, of sort of giving up my past and walking into the future, was very scarey to me. A life plays out and in retrospect either road may have been good. But taking the road I did required me to push all of my abilities to the limit and seize the day. So I'm not one of those people who has regrets about the things they haven't done, the opportunities that they let pass them by because they were too frightened to risk failure. I risked everything, but then again, to a certain extent I destroyed myself in the process, by pushing too hard, taking on too much stress and ultimately collapsing into a depression.
>
I didn't realize that you thought that you had pushed yourself into depression. I thought you thought it was more hormonal. Were you still working when the depression hit? Is that what you meant by pushing youself into depression?
> > > > > >Have you taken the Myer Briggs? I am a INTJ.
> > > So am I and so is my husband.
> > > > But I have never been attracted to an extraverted man. I do think it might be easier for me to get along with a INTP because I would think that our Js might clash a lot. Have you felt the tug I am talking about at all with your husband?
>
> I don't think my Js are very similar to my husband's Js. He is compulsive about time and things being in their proper place. His "schedule" of activities is a bit amazing. I'm more prone to be late and like having unscheduled time. The only time this conflicts is when he tries to fill up our "social" calendar or when we are on vacation and he want to "accomplish" the city we are visiting (hit all the museums etc). The way we have dealt with this is by recognizing that we are separate and don't have to do the same things even on vacations.So what is the "J" part of you? I always thought of Js as showing good taste and judgment, but also tending to be more critical. Where does your J come out? Does it have anything to do with pushing yourself. I know you are very picky about your house (colors, etc).
>
> > >[re your therapist] > It's very complicated. She has been able to teach me to get myself back on track and that is very satisfying to me; going around in circles of course is very frustrating.
> It almost sounds a little cognitive therapy in approach, although I'm sure she delves into your past as well or maybe she's just organized in her approach.Well, it gets very complicated because I don't remember much at all about the past, especially my family. Zero. No meals together, etc. Some bad memories, but not horrific. We've done some work with the kids, first with my last therapist and then some with this one. And the little ones are in a good place. I'm not so sure about the 8 to 10 year olds. They don't want to talk.
>
> > > > Actually, I think it is very special that you work so hard to have a good marriage, and the working seems to very much pay off.
> It's important to me and, you know, once a gulf begins between two people, it is easy for it to widen. Especially when you have kids that demand a lot of your time.It seems like kids both widen the gulf, but also bring parents together, because there is always that to share.
>>
> Will the Atarax be enough to knock you out? Is your sleep difficulty just staying asleep? I know you are doing the valium--have you thought about Neurontin? I only need to add valium to my nighttime cocktail when I was on Parnate, which was much more activating than Nardil.Well, it's about what Elizabeth talked about. It's not that it's so stimulating; it just disturbs sleep patterns, like my waking up after three hours. Aterex is pretty good; with neurotin I retained fluid in the same way as lamictal.
>> > > >I may print up wallet size samples that I could send out, but it's been nice lately--I e-mail everything to people now (price list, directions)--no more snail mail.
>
> This idea is actually a great way of doing it. "Let me send you out some samples of my recent work since I've switched to digital"I wish there was something else I could say besides digital. Writing it up was fairly easy, and I did use digital. ("are printed digitally using archival ink on heavy weight archival mat surface paper and Piezography™BW software.") Maybe I should leave the digatial out and just talk about archival paper and ink and Piezography BW software when people call?
> > > I rejoined my writing class. I think I shocked them a bit. The theme of my first poem was suicide. The second about being seduced by depressionl. Guy who runs it makes a big point about presentation. I wanted to sort of sink into the chair, but he made me move and talk about my kids and then read--which pretty much had me reduced to tears. Reading is such a vulnerable act, you know.How did you start with the writing class ? How many people are in it?
>
> It's a remarkably personal class and the people are very interesting. Some actors, a comedian, ---mainly though just good writers. A lot of the work brings me to tears, it is very deep. The guy who runs it is from the Second City comedy team. He really requires that you approach this stuff from a deep voice and if you are lucky enough to have written from that place, then he will require that you read it from that place. Sometimes when people read their work the start to cry and he says "it's ok to cry, just breath" and then at most maybe someone will extend a hand to touch the person's arm. I had forgotten how deep this class was. It's what I love about the NDMDA meetings I go to as well. It is life at a deeper level. Anyway, it's a big move for me to get myself back into writing. It requires the discipline of daily writing--let's see if I can do that. Plus, he has me writing from different voices--the child, the mother, the whore, the madonna, the hag, the crone. It's amazing how hard it was to write from the child.
Were those the voices he heard in your writing? Was the child so hard because of your burning? Were you a regular, normal kid before that?Shelli
p.s., my pdoc added concerta to my mixture. I got very spacy today, so he is cutting down both the nardil and wellbutrin. It is unusual for me to hear a pdoc say it sounds like toxcity and want to bring my meds down instead of insisting that I'll get used to them. I almost went into the hosptial to add the concerta; instead I am seeing him almost every day, outpatient.
Posted by Elizabeth on October 19, 2001, at 12:13:37
In reply to Re: hanging in there » Elizabeth, posted by Lorraine on October 18, 2001, at 14:29:27
Lorraine,
That's what a partial agonist is.
(I know about the legislation. It's going to take a while to get passed in the current climate -- Congress is much more concerned about getting anthrax in their mail than about helping addicts get better treatment.)
-elizabeth
Posted by judy1 on October 19, 2001, at 20:18:31
In reply to Re: Hi Judy » judy1, posted by shelliR on October 18, 2001, at 20:40:41
Moving to social side (thanks so much for the response)- Judy
Posted by Lorraine on October 22, 2001, at 9:20:40
In reply to Re: hanging in there » Lorraine, posted by shelliR on October 18, 2001, at 21:11:05
Shelli:
> > >I didn't realize that you thought that you had pushed yourself into depression. I thought you thought it was more hormonal. Were you still working when the depression hit? Is that what you meant by pushing youself into depression?
Yes--not just working, but working for an emotionally abusive man in an incredibly stessful job.
> > > So what is the "J" part of you? I always thought of Js as showing good taste and judgment, but also tending to be more critical. Where does your J come out? Does it have anything to do with pushing yourself. I know you are very picky about your house (colors, etc).Oh, yeah, I'm a perfectionist big time, just in a different way
> > > Well, it gets very complicated because I don't remember much at all about the past, especially my family. Zero. No meals together, etc. Some bad memories, but not horrific. We've done some work with the kids, first with my last therapist and then some with this one. And the little ones are in a good place. I'm not so sure about the 8 to 10 year olds. They don't want to talk.It must be hard to move forward when you don't know what you are up against--the 8-10 year old not talking
[re marraige and kids] > > It seems like kids both widen the gulf, but also bring parents together, because there is always that to share.
This is true. It's just easy to shift the focus to the kids and forget about maintaining the marriage.
> > > I wish there was something else I could say besides digital. Writing it up was fairly easy, and I did use digital. ("are printed digitally using archival ink on heavy weight archival mat surface paper and Piezography™BW software.")This sounds great. Will people--other than experts in your area know what Piezography BW software is?
> > >Maybe I should leave the digatial out and just talk about archival paper and ink and Piezography BW software when people call?
I think you will end up doing more explaining this way. Everyone knows what digital is--maybe "digitally enhanced"?
> > >Plus, he has me writing from different voices--the child, the mother, the whore, the madonna, the hag, the crone. It's amazing how hard it was to write from the child.
>
>
> Were those the voices he heard in your writing? Was the child so hard because of your burning? Were you a regular, normal kid before that?No, he does this with everyone. The child was hard because I didn't have much of a childhood to connect to. That is what was so enriching to me about having kids--that I got a chance through them to experience a good childhood. I have no idea who I was b/4 I was burned. My mom says I was like my daughter--who is actually quite outgoing, but I think it changed my brain chemistry.
> > > p.s., my pdoc added concerta to my mixture. I got very spacy today, so he is cutting down both the nardil and wellbutrin. It is unusual for me to hear a pdoc say it sounds like toxcity and want to bring my meds down instead of insisting that I'll get used to them. I almost went into the hosptial to add the concerta; instead I am seeing him almost every day, outpatient.How are you doing now? The Nardil is working I think, but I am struggling with some side effects--sexual dysfunction, sinus congestion (had this on Effexor also), afternoon sluggishnish, weight gain. I don't know which of these will resolve themselves or which I can handle by lifestyle changes. The anxiety seems to be abating. Afternoon sluggishnish is probably managable. Sinus congestion, I'll have to see. The most problematic are the weight gain and sexual dysfunction. I have authorization to add adderal to my mix--which I may do very carefully. I have moved all of my dosing to am today and am seeing how that goes.
Let me know how your cocktail is going.
Posted by Elizabeth on October 22, 2001, at 10:16:19
In reply to Re: hanging in there » shelliR, posted by Lorraine on October 22, 2001, at 9:20:40
> The Nardil is working I think, but I am struggling with some side effects--sexual dysfunction, sinus congestion (had this on Effexor also), afternoon sluggishnish, weight gain.
Hey, good to hear that it's doing something positive for you. I've been having some problems with congestion too. I think it's safe to use oxymetazoline nasal sprays (e.g., Afrin) with Nardil, though you might want to monitor your BP the first time to reassure yourself. (I've done it many times myself with Nardil, Marplan, and Parnate, and have never seen any evidence that it's a problem. I would not expect it to be a problem because it's a locally-acting drug, and even though there's a possibility that some could be absorbed into the bloodstream, the concentration would be too tiny to make any difference. Taking a pill like Sudafed with MAOIs, OTOH, is not safe.)
Watch out for the weight gain -- be mindful of what you're eating, and so on, that's pretty much all you can do. (FWIW, it's supposed to plateau at some point.)
The afternoon nod might be helped by good old-fashioned caffeine, and the anxiety should continue to dwindle.
> I have authorization to add adderal to my mix--which I may do very carefully.
That would be another thing that could help you to stay awake during the day (I found that Cylert helped me regularize my sleep-wake cycle and didn't interfere with sleep if I took it first thing in the AM). I would start off with no more than 2.5 mg, however.
HTH
-elizabeth
Posted by Lorraine on October 22, 2001, at 18:31:04
In reply to Re: hanging in there » Lorraine, posted by Elizabeth on October 19, 2001, at 12:13:37
Elizabeth:
The Nardil has kicked in. However, I am battling side effects including sexual dysfunciton, weight gain, insomnia (which Neurontin and Ambien handle), nasal congestion, afternoon drowsiness and some visual impairment. Given this I suspect I will be making adjustments. The anxiety seems to be lessening.
I'm wondering if you have read the immunology section of the book Treatment Resistent Mood Disorders by Jay D. Amsterdam, Mady Hornig (Editor), Andrew A. Nierenberg (Editor). It is pretty interesting in terms of the immune system connection with depression.
Lorraine
Posted by judy1 on October 24, 2001, at 10:09:03
In reply to Re: hanging in there » Elizabeth, posted by Lorraine on October 22, 2001, at 18:31:04
I was happy to read about your success with Nardil (although the side effects sound pretty awful). I'm not familiar with the book you posted and since Immunology is my field I was wondering if you could give a brief summary of the immune system- mood disorder relationship. I was under the impression that depression weakens the immune systen so that you're more susceptible to infections. Is this pretty much what the author(s) are saying? Curiously, when I am manic I am never physically ill and don't feel pain from injuries that I have incurred from car accidents. Thanks- Judy
Posted by judy1 on October 24, 2001, at 19:40:18
In reply to Elizabeth?, posted by judy1 on October 24, 2001, at 10:09:03
Posted by Lorraine on October 25, 2001, at 11:51:03
In reply to Whoops, sorry to Lorraine (nm), posted by judy1 on October 24, 2001, at 19:40:18
There is a correlation between depression and immune system inflammatory response. Part of the question is the chicken and egg that you always have with correlational analysis--namely is the depression causing the immune system impairment or is immune system impairment causing the depression or is some other factor causing both? Here is the summary of the chapter:
"There is considerable evidence that MDE in general and TRD in particular, may be accompanied by an immune-inflammatory response, as demonstrated by (i) an acute phase response (APR); (ii) an increased production of cytokines such as IL-6; and, (iii) activation of lymphocytes (T cells). The role of such immune activation in the pathophysiology of MDE and TRD remains to be determined. Clinical strategies that modulate immune function might be explored in TRD, including treatment with steroid antagonists, protein blockers and antibodies to IL-6 or sIL-1R. In this context, patients receiving anti-IL-6 antibody as a therapeutic adjuvant for TRD should show striking reductions in serum APP levels. Recent qantidepressant drug trials in MDE with several CNS peptide blockers that alter immunoendocrine function have been undertaken, and these studies suggest that the immunoendocrine laboratory findings since the 1980s will be the clinical treatment of the near future".
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