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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by lepus on July 3, 2011, at 19:30:08
In reply to Re: Encouragement - Emsam » lepus, posted by floatingbridge on July 3, 2011, at 18:57:57
I think the psychological response to knowing the patch is off might be enough to calm frayed nerves. Well, at least for me. I really don't know anymore how much of my reactions are actually reactions or are me being a Nervous Nelly.
I do sunbathe since I have low Vit D levels. I hope that won't be a problem. I don't do it in excessive heat but I do get right in the light.
With most drugs you know their half life, how long they take to kick in, how long they'll be in your system, etc. I don't see any of that info for Emsam? Does anyone else? Scott?
Posted by lepus on July 3, 2011, at 19:37:52
In reply to Re: Encouragement - Emsam, posted by lepus on July 3, 2011, at 19:30:08
Found the half life. It is about 18 to 25 hours. Long...
Posted by Phillipa on July 3, 2011, at 20:49:40
In reply to Re: Encouragement - Emsam, posted by lepus on July 3, 2011, at 19:37:52
I feel as you that it's comforting to know you can see the actual patch gone and know that slowly the med is leaving your system. And that it does bypass gastrointestional system and hepatic first pass. Phillipa
Posted by lepus on July 3, 2011, at 22:51:40
In reply to Re: Encouragement - Emsam » lepus, posted by Phillipa on July 3, 2011, at 20:49:40
> I feel as you that it's comforting to know you can see the actual patch gone and know that slowly the med is leaving your system. And that it does bypass gastrointestional system and hepatic first pass. Phillipa
Right. Even though I know it isn't going to leave my system immediately should I have an issue, there is a certain psychological comfort in tearing off the patch and pitching it.
I have not ripped it off though. Today has gone fairly smoothly, but then I'm on a baby amount. I hope dosage increases go smoothly as well. :fingers crossed:
Posted by Phillipa on July 4, 2011, at 0:26:36
In reply to Re: Encouragement - Emsam, posted by lepus on July 3, 2011, at 22:51:40
I feel that means a lot as once was going to try it and that was so comforting. Have a scientific mind and have to see to believe. Don't forget toe crossing also!!!! Phillipa
Posted by Lepus on July 4, 2011, at 4:06:07
In reply to Re: Encouragement - Emsam » lepus, posted by Phillipa on July 4, 2011, at 0:26:36
Think I might need to cross a few more things in the hopes this will work. Woke up to a nocturnal panic attack tonight. Not sure if it is due to the EMSAM or not. I have been having more of them lately.
Not happy. I feel like I'm being tortured lately. I just want it to end. Please.
Posted by floatingbridge on July 4, 2011, at 7:26:06
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 4:06:07
Lepus,
The nocturnal attacks appeared before emsam?
Do you ever write stuff down? Like took what when and symptoms like panic episodes? You probably do. It's a good tool and frees up my mind.
> Think I might need to cross a few more things in the hopes this will work. Woke up to a nocturnal panic attack tonight. Not sure if it is due to the EMSAM or not. I have been having more of them lately.
>
> Not happy. I feel like I'm being tortured lately. I just want it to end. Please.
Posted by Lepus on July 4, 2011, at 7:26:32
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 4:06:07
Patch is off. I just woke up again to ridiculous anxiety.
I don't understand. I was only on 1/4th of a patch. But this has to be more than mere coincidence now, surely? I'm a nervous wreck!
Now what...
Posted by floatingbridge on July 4, 2011, at 7:40:37
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 7:26:32
> Patch is off. I just woke up again to ridiculous anxiety.
>
> I don't understand. I was only on 1/4th of a patch. But this has to be more than mere coincidence now, surely? I'm a nervous wreck!
>
> Now what...Lepus, I'm sorry. Did you ever look at any of my multiple emsam threads? My patch was off and on countless times
:- / I know I drove everyone nuts. I felt nuts starting up.I don't want to tell you what to do. That wouldn't be right. Keep me posted if you will. I'll be here no matter what you decide.
Myself, I still wake early from some intense dream, but my sleep time is lengthening a bit. Today was 4:30 am. That's good for me.
Hang in there whatever you decide.
Posted by Lepus on July 4, 2011, at 8:01:51
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 7:40:37
I do recall several of your start up threads. I thought the anxiety was mostly your thyroid though?
I don't think I can handle waking up every night to that kind of anxiety. I woke up twice in a panic!
I don't understand. I feel doomed now. I don't know what is left for me to try.
Posted by Lepus on July 4, 2011, at 8:12:35
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 7:26:06
The nocturnal panic attacks were there before the EMSAM. I had an incident on Thursday when I was in the hospital. This attack felt different though. More difficulty breathing.
I am not a journaler and I regret it, especially since all my previous doctors seem to have retired or they won't release my records no matter how many times I request them and fill out the necessary forms. Seems they just don't even have them anymore. I don't know.
> Lepus,
> Z
> The nocturnal attacks appeared before emsam?
>
> Do you ever write stuff down? Like took what when and symptoms like panic episodes? You probably do. It's a good tool and frees up my mind.
>
>
> > Think I might need to cross a few more things in the hopes this will work. Woke up to a nocturnal panic attack tonight. Not sure if it is due to the EMSAM or not. I have been having more of them lately.
> >
> > Not happy. I feel like I'm being tortured lately. I just want it to end. Please.
>
>
Posted by floatingbridge on July 4, 2011, at 8:14:37
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 8:01:51
What kind of panic (symptoms) you experiencing?
And I'm curious when you started emsam. Yesterday (Sat) or Friday?
I was told I could take my patch off about an hour before bed.
I hope you don't feel pushed here. I'm just trying to listen and be steady.
Posted by floatingbridge on July 4, 2011, at 8:28:52
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 8:12:35
If it might help, you could start with the hospital and go forward. Maybe not a journal; more like an outline. Very dry. Likes 7/3 removed 1/4 patch emsam. Anxiety episode nocturnal, then note qualities physical and cognitive (I thought________. ) I feel better myself having a written record, because when I panic, my thinking brain goes tilt. It shuts down. So I can't recall with reliability when I did what or took what :-/
I don't know. It helps when talking to a doctor, too. I had to go to the urgent care on Friday, and I wrote a very short list of dates down just in case he asked (he didn't ). When I look at the list, or even write stuff, I can sometimes feel more steady. It's as close to 'facts' as I can get.
Please try not to despair. Anxiety is awful. It is hell. But you sound lucid. That's big imo.
> The nocturnal panic attacks were there before the EMSAM. I had an incident on Thursday when I was in the hospital. This attack felt different though. More difficulty breathing.
>
> I am not a journaler and I regret it, especially since all my previous doctors seem to have retired or they won't release my records no matter how many times I request them and fill out the necessary forms. Seems they just don't even have them anymore. I don't know.
>
> > Lepus,
> > Z
> > The nocturnal attacks appeared before emsam?
> >
> > Do you ever write stuff down? Like took what when and symptoms like panic episodes? You probably do. It's a good tool and frees up my mind.
> >
> >
> > > Think I might need to cross a few more things in the hopes this will work. Woke up to a nocturnal panic attack tonight. Not sure if it is due to the EMSAM or not. I have been having more of them lately.
> > >
> > > Not happy. I feel like I'm being tortured lately. I just want it to end. Please.
> >
> >
>
>
Posted by Lepus on July 4, 2011, at 12:37:53
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 8:14:37
I started EMSAM yesterday, which was Sunday. I started it around 3pm. The anxiety hit me about 3:30am I think? Maybe 2:30am. I can't quite remember. I had the typical panic attack. Heart was racing, trouble breathing, sweaty, feeling unreal, etc. For me it feels like I have an angry hornet's nest inside my chest after the initial attack leaves. That is how I feel now. I'm not necessarily panicking anymore but I am anxious.
But when I woke up to panic, I got some ice water and took a Klonopin, then waited it out. I got to sleep around 5am. Then I woke up again to panic and ripped the patch off. Then after I ripped the patch off I woke up again panicking. That time it felt like I woke up because I wasn't breathing. I really gasped when I awoke.
That's about it. I have no idea what is up. The Klonopin doesn't really seem to help very much. I have Ativan but frankly I think the Klonopin works better. Ativan seems to leave me tired and still panicky.
I'm so screwed.
Posted by Lepus on July 4, 2011, at 12:40:43
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 8:28:52
I guess I've never been much of a journaler because I usually remember everything. So before major appointments or times when I might have to remember specifics under pressure, I make notes for myself.
Posted by floatingbridge on July 4, 2011, at 13:31:27
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 12:40:43
> I guess I've never been much of a journaler because I usually remember everything. So before major appointments or times when I might have to remember specifics under pressure, I make notes for myself.
Well that's great you can keep it all in your head :-)I had a very bad episode on Friday. I was already not doing well, and was forced to leave the house on an errand (w/o my child, so no worries there.) My fright was so extreme that I kept forgetting the address and place where I had been before. I live in a small town, like one main street, so, you can see how bad that was.
My husband gave me an emergency xanax the next day. I was then able to go to the urgent care and request a stop gap of xanax. In order to calm myself-
-you know, in the examine room where you wait after the waiting room--I forced myself to write a list of stop and start dates for meds. Holy cr*p. It felt like a month had gone by, but only two weeks since my last benzodiazapine (?). It had been Ativan, and my memory of Ativan was that it did not really hit that panic spot. The urgent care doctor gave me a little xanax. It was so bad though, I couldn't look at him. I was stuttering and petrified but much better than the non-stop Friday event. I found myself
covering my eyes while I was talking to him. I know I am just blabbing on here.
But I could barely talk or look at him or any stranger. I knew enough to apologize. The doc was like, that's o.k.
that's part of the anxiety.So, about your other post, ativan would not cut panic for me unless it was an astronomical (relative to me) amount.
Klonopin worked very deeply on anxiety for me as maintenance. But for an acute
episode, well, I would find it better than
nothing for myself.There just has to be ways to shush that panic button. It cannot be healthy to endure. That's something else *not* to panic about :-/
Does your doctor know the frequency
and quality of your episodes?
Posted by lepus on July 4, 2011, at 13:35:16
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 7:40:37
Do you have any links to your Emsam threads? I don't see a lot of them when I search for Emsam.
Posted by floatingbridge on July 4, 2011, at 13:43:00
In reply to Re: Encouragement - Emsam, posted by lepus on July 4, 2011, at 13:35:16
Crumbs. No, not good on the computer.
What about searching my screen name, floatingbridge?
Wait, archives for this May and June?
Don't expect to much info, but if it helps to see how flipping desperate I was....
I'll try to hunt up some thread names.
Nothing comes up from searching emsam? Hmmmm.
Posted by Lepus on July 4, 2011, at 20:52:18
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 13:31:27
I'm sorry to hear you're having such a hard time too and having to go to urgent care.
I think I have been on benzos too long. None of them really destroy the panic like they used to. Is that where you are now or are you having some dependency issues?
My doctor knows I'm suffering. Maybe she doesn't know quite how badly. I'm not sure how to get that across to anyone. The fact that I willingly checked myself into a hospital should be a decent clue. I didn't call her today. It is a holiday and what can she do anyway. I don't think there is anything left to do.
Honestly I'm starting to get suicidal but where do I go? Back to the hospital that victimized me? Forget it. I just can't believe this. I fight and fight and I'm getting nowhere.
Posted by floatingbridge on July 4, 2011, at 22:19:44
In reply to Re: Encouragement - Emsam, posted by Lepus on July 4, 2011, at 20:52:18
Lepus, what kinda' suicidal? Like maybe it would be better, I am exhausted and scared type thoughts? Thank you for telling me and the board. I am going to have to think a bit.
Besides anxiety and panic, have you or do you have major depression? (God, I hope I don't sound like a dodo.)
Would you be willing to list your current medications and doses?
Hmmm. I am wondering if your benzo of choice is way under dosed. When I was hospitalized about 12 years ago, I was trying to manage everything (anxiety/depression) with a tiny bit of xanax. Like 0.75 for sleep.
Regarding dependcy issues. It was the wierdest thing. You know that old drama rule of thumb that when a gun enters a play it has to go off? I still don't know how I was goaded into such a place, but once soneone said addiction, it was like watching a big macine come and try to eat me up. On a bad day it was like
Kafka. On a good day, more like Beckett. Absurd but unstoppable. It was finally my beleaguered, rationally minded husband (another med-phobe) who had to tell my pdoc that if he was trying to provoke a healing crisis, he was very wrong.Oh boy. I'm going on. But this time
around I barely missed the hospital.So, yeah. I am concerned about you because the non-stop onslaught of predictabley random yet consistent panic and anxiety is harmful and needs to be treated. So please, let's find a way for you, okay? There are answers. That's the despair talking. Write me, and I will gently remind you that relief is very possible for you.
I do not like calling doctors either ever. I think I understand. But maybe it might be worthwhile to call her tomorrow?
If you haven't listed your meds somewhere with doses, that would be
helpful. Even in a new thread if you are comfortable. I'll look for it.I undermedicated for years and that wasn't really good for me. I didn't understand the impact of anxiety to just
wreck my life. Unfortunately, this last go round, my docs try to hand me the 'just anxiety' card, the 'just ptsd' card. I needed 'skills'. After I finally just broke
under all this that dumb ole' pdoc of mine finally said, oh yeah, maybe Nardil is indicated. I sent up all the flares I could and to have the addict card thrown at me really, really hurt. It still does--can you tell? All I wanted was an AD my body could tolerate and sleep.Sorry for the outburst Lepus.
Will you update?
fb
> I'm sorry to hear you're having such a hard time too and having to go to urgent care.
>
> I think I have been on benzos too long. None of them really destroy the panic like they used to. Is that where you are now or are you having some dependency issues?
>
> My doctor knows I'm suffering. Maybe she doesn't know quite how badly. I'm not sure how to get that across to anyone. The fact that I willingly checked myself into a hospital should be a decent clue. I didn't call her today. It is a holiday and what can she do anyway. I don't think there is anything left to do.
>
> Honestly I'm starting to get suicidal but where do I go? Back to the hospital that victimized me? Forget it. I just can't believe this. I fight and fight and I'm getting nowhere.
Posted by lepus on July 4, 2011, at 23:08:35
In reply to Re: Encouragement - Emsam » Lepus, posted by floatingbridge on July 4, 2011, at 22:19:44
I am not 100% certain what my full diagnosis is. My therapist said it is just panic disorder with agoraphobia but I recall another pdoc saying I had MDD. But then another pdoc said I was Bipolar II so who the blank knows.
Suicidal as in I don't really want to die but this has to end somehow and everything I am doing isn't working. I get a hospital bed, it turns into a disaster that is giving me nightmares. I start the Emsam, I wake up with a wicked panic attack that last well into the afternoon (with varying intensity).
I don't know if the Emsam caused the panic attack. I do know I need some stronger benzos.
Current meds are Klonopin 1mg 3 times a day, thyroid med, and then Ativan .5mg as needed. Not much.
I'm afraid if I go up on Klonopin I'll be a zombie. But it is a consideration. However, my dependency on Klonopin is a concern. My doctor thinks it is causing a lot of the brain fog and depression. I have been on it almost 20 years.
What did they mean by addiction? With benzos addiction and dependency are such different beasts. I don't get high off Klonopin but I can't live without it. I'm dependent on it. So your doctor thought you might be developing issues? I remember reading posts about you going off Xanax. Or wait...asking for Nardil made you an addict? Who gets addicted to Nardil? I'm a little lost on what happened to you and could use the Cliff Notes version. I am very sorry you are having such a hard time but also am envious you can go to Stanford for help. Nothing like that exists here. There is one hospital that treats anxiety disorders but it is $25,000 for 30 days. I don't have that money or the right insurance to cover it.
I'm very concerned about me too. I really am now. I don't feel stable. I don't feel hopeful. I don't want to see another day like this. I'm so alone and feel terrible. It is very hard to be optimistic after the hospital fiasco and then after another horrible night/day like today. I don't know what meds are left. Nardil. That is about it. Keep trying with Emsam. I have no hospital support. I'm burning out my therapist. I burnt out my friends. I am burning out my family.
I will call the doctor tomorrow. I just didn't see the point today. It is a holiday and there isn't much she can do right now.
Posted by floatingbridge on July 5, 2011, at 0:01:51
In reply to Re: Encouragement - Emsam, posted by lepus on July 4, 2011, at 23:08:35
Hey Lepus,
I'm gonna go to bed, but just wanted to say something after this post. If one more person says to me it's *just* anxiety, I think I'll blow their hair back with a lion roar (then collapse because I have some kinda' cfs type fatigue). Don't let anyone sell you short. I think anxiety burns out support people just as much as any other disorder. I can't *snap out of it*. Fear sucks.
I read a website, maybe the University of Huston, not sure, about their anxiety clinic, and they are like an anxiety
disorder is a very real medical condition that can wreck lives. It is amendable to all sorts of treatment. It may never *go
away* but it can get better. That is my hope now. If not this clinic, I am going to keep going. I have had so many clinic and specialist hopes, that I think I am walking the line between hope and curiosity (that's the xanax talking. I was becoming unable to post even).This is the first time in my half century life that I have decent insurance. Otherwise I would not be going. I had to let go of rTMS therapy because insurance didn't cover it.
I will share with you whatever I can. I have no idea what to expect. It could be a rubber stamp and a trip out the revolving door :-/ Just gotta go.
If you are feeling like you cannot go on, that sounds depressed. Depression can lift with treatment. Did *they* or you put aside the BP dx? That's how I entered psychiatry. My BP was 'soft' or, I guess cyclothymic? I remember that word. I've had dx's of dysthmia, double depression, MDD, social phobia, chronic ptsd. I think that's about it :-)
I think I need cliff notes, too :-/
I'm glad you're calling your doctor tomorrow. I'm extending you some reasonable hope. I feel like with some good treatment, you can feel somewhat better. I don't think nardil is the end of the world. Good lord, scared as I am, if some doctor would help me slowly start, talk me through start up and give me sleep support, I'd do it. I hear you. I am so exhausted and scared and hounded and I just want it to stop.
Do you ever read posts by Jedi? He's really helpful. There alot of folks here with massive anxiety :-/
Hang in there. I'll be thinking of you.
fb> I am not 100% certain what my full diagnosis is. My therapist said it is just panic disorder with agoraphobia but I recall another pdoc saying I had MDD. But then another pdoc said I was Bipolar II so who the blank knows.
>
> Suicidal as in I don't really want to die but this has to end somehow and everything I am doing isn't working. I get a hospital bed, it turns into a disaster that is giving me nightmares. I start the Emsam, I wake up with a wicked panic attack that last well into the afternoon (with varying intensity).
>
> I don't know if the Emsam caused the panic attack. I do know I need some stronger benzos.
>
> Current meds are Klonopin 1mg 3 times a day, thyroid med, and then Ativan .5mg as needed. Not much.
>
> I'm afraid if I go up on Klonopin I'll be a zombie. But it is a consideration. However, my dependency on Klonopin is a concern. My doctor thinks it is causing a lot of the brain fog and depression. I have been on it almost 20 years.
>
> What did they mean by addiction? With benzos addiction and dependency are such different beasts. I don't get high off Klonopin but I can't live without it. I'm dependent on it. So your doctor thought you might be developing issues? I remember reading posts about you going off Xanax. Or wait...asking for Nardil made you an addict? Who gets addicted to Nardil? I'm a little lost on what happened to you and could use the Cliff Notes version. I am very sorry you are having such a hard time but also am envious you can go to Stanford for help. Nothing like that exists here. There is one hospital that treats anxiety disorders but it is $25,000 for 30 days. I don't have that money or the right insurance to cover it.
>
> I'm very concerned about me too. I really am now. I don't feel stable. I don't feel hopeful. I don't want to see another day like this. I'm so alone and feel terrible. It is very hard to be optimistic after the hospital fiasco and then after another horrible night/day like today. I don't know what meds are left. Nardil. That is about it. Keep trying with Emsam. I have no hospital support. I'm burning out my therapist. I burnt out my friends. I am burning out my family.
>
> I will call the doctor tomorrow. I just didn't see the point today. It is a holiday and there isn't much she can do right now.
Posted by lepus on July 5, 2011, at 15:58:11
In reply to Re: Encouragement - Emsam, posted by floatingbridge on July 5, 2011, at 0:01:51
Oh, I hear you on the "just anxiety" bit. In the HOSPITAL!! I heard that all the time. "No one has ever died from a panic attack." "It's just a panic attack. Go back to sleep." Morons. Absolute morons.
I'm living proof it can wreck lives.
I really hope the clinic can help you. I hope my salvation is on its way too.
I think the doctors put aside the BP dx. The thought was that maybe when I was "manic" that was why I was anxious. But I have full blown panic attacks brought on by the usual triggers so it seems unlikely to be BP. I've had every dx too, short of schizophrenia and the other thought disorders. They even threw in a few personality disorders. I'm borderline? Okay. Well, I've never cut myself in my life or had the slightest desire to. I know who I am. I don't feel empty; I just feel anxious.
I'm not doing well today and haven't called my doctor. I just need a day to wallow I think.
I haven't seen any posts by Jedi but I will look for them.
Thinking of you too. Hope we get our answers and much needed relief.
Posted by Phillipa on July 5, 2011, at 19:10:58
In reply to Re: Encouragement - Emsam, posted by lepus on July 5, 2011, at 15:58:11
Lepus did you get your doc and any new instructions. I've been on benzos differing ones and doses for 41 years. Then do nothing now but tire me. Used to give energy Phillipa
Posted by Chris O on July 9, 2011, at 23:28:25
In reply to Encouragement - Emsam, posted by lepus on July 2, 2011, at 13:36:16
Lepus:
After many failed drug experiments for my GAD and depression, I am getting ready to start Nardil (with some trepidation). Today, I decided to read some of the posts regarding MAOI experiences and happened upon yours. I can certainly relate to your situation. I have struggled with panic and anxiety all of my life. I have tried pretty much every SSRI over the last decade. With the minor exceptions, nothing has really helped me. I am still in a constant state of worry and fear and would all likelihood be on disability were it not for the support of my wife. Like you (it sounds like), I am pretty much at the end of my rope. You hospital stay sounds terrible. It's impossible to be around unempathic people when you are having a panic attack, I know. The way they treated you in that hospital was completely inappropriate. And the feeling of God and humanity abandoning you, man, that is my nightly prayer: Where is the help? What have I done to deserve this? All that being said, I would totally try the Emsam. It's the least powerful of the MAOI inhibitors and has the least chance of negative side effects. At worst, it may not work, even at higher doses. If that's the case, perhaps you can try Nardil or Parnate. My psychiatrist thinks, for my GAD and depression at least, and given my many drug failures, it's best to go straight for the Nardil. I share your fears about taking these drugs, but personally, I am out of options. If I ever want to lead an even slightly productive life, one of these friggin' drugs better work. Praying certainly isn't.
Hoping for the best for you, man.
Chris
This is the end of the thread.
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