![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 56. Go back in thread:
Posted by Cam W. on August 9, 2001, at 22:06:25
In reply to Re: parnate questions » Cam W., posted by Elizabeth on August 9, 2001, at 21:53:00
Elizabeth - Thanks for the info, much appreciated. Like I say, working in community pharmacy, we don't get all the fun you see on ER.
;^)Thanks again - Cam
Posted by shelliR on August 9, 2001, at 23:40:54
In reply to Re: parnate questions » Cam W., posted by Elizabeth on August 9, 2001, at 21:53:00
Elizabeth, Cam
> Seriously: nifedipine is pretty commonly used for this purpose.So you think this is a good idea. I think there are definitely two schools of thought on this. I do have a blood pressure monitor at home, but I don't carry it with me. And nifedipine could cause harm if you take it and you are not hypertensive, right? I am in my forties, but am cardiovascularly fit.
> > Also, would you know if you were having a hypertensive crisis?
> This is always a question. I'm pretty sure I would know even without taking my BP because it's happened to me a few times. But a lot of things can cause headaches, nausea, etc. Hypertensive headache is pretty distinctive, but I don't know if a person who'd never experienced it would be able to identify it positively. And even if there is hypertension associated with the event, it may be misattributed. Before I realised that I was having spontaneous hypertensive episodes on Parnate, I was convinced that I'd had a reaction to some hummus.I had two non-serious hypertensive crises when combining nardil with adrafinil. Non-serious in the sense that my BP went up to 160 and not any higher. I didn't experience a headache, I experienced a specific tightness in my shoulders. And my pulse went very low- like 45. If your blood pressure shoots up like that, is a reduction of pulse a given? I mean can that be an accurate indication that you are having a hypertensive episode.
When I started selegiline only 5 days after stopping nardil, I had the same tighening of my shoulders and was BP was up to 140, instead of it's usual 100. But then after that I had the same shoulder thing only my BP was not up. That was my reaction to the selegiline. But it felt exactly like my hypertensive shoulder. So I became less confident that I would know if I was having a reaction. But now that I'm off the selegiline, I think if my shoulders tighten up like that I would immediately take my BP.
Maybe I should carry one of those mini ones that hook up to your finger. Are they accurate?I never ever worried about a reaction to nardil, because I ate absolutely everything, and even was given demerol during an exploratory procedure and had no reaction. But I'm thinking that parnate is not nardil and I don't know if I can be so cavilier about the whole thing. I think I read (don't know if it's true) that parnate is more likely to cause a hypertensive episode than nardil. True, false, don't know?
>>
> > I would recommend a Medic Alert-type bracelet or chain for anyone taking MAOIs.
> >So demeral is the only reason to wear one for an MAOI?None of my pdocs have ever brought this up to me. I'm going to ask my pdoc why he didn't suggest it.
I've never worn one and would rather not, but I would also not like to not put myself in crisis.Shelli
Posted by Kristi on August 10, 2001, at 1:04:49
In reply to Re: Suicide » SalArmy4me, posted by Cam W. on August 9, 2001, at 8:09:22
I think Sal is just trying to help. There are so many times I wish there are people who are just willing to listen that I don't have to fork out my money too. Sal, thanks for caring!
> Sal - Be careful, dude! That's counseling without a licence. - Cam
>
> > If you're about to do the unthinkable, or can't see a way out, talk to me first. My screenname is "SalArmy4me" on AOL Instant Messenger and Yahoo Messenger...
Posted by may_b on August 10, 2001, at 2:03:40
In reply to Re: parnate questions » may_b, posted by Cam W. on August 9, 2001, at 19:35:58
Hi Cam
Thanks for your thoughtful answer.
>There are too many liability concerns.
That's exactly what I felt was going on in emerg: do nothing, and maybe she'll pull through.
>Also, would you know if you were having a hypertensive crisis?
It was a pretty classic presentation of the symptoms in the literature--though I had only made mental note of severe headache and stiff neck. I had studied the literature re food restrictions and thought I had proceeded with my usual paranoid overcaution. Some of the detailed diet recommendations say local canned or bottle US beer is supposedly safe per the info on this very website. This is what I chose. Immediately (within 5 minutes) I had palpitations (which I ignored for about 2 or 3 minutes) and then neck stiffening and headache. By that time, I barely had time to convey the message that I had to go to emergency. In another five minutes I was nearly too weak to speak. In ten minutes I was vomitting in emergency (which helped get some attention). I knew it was hypertensive crisis: believe me, it feels like you are about to die.
>
> Have you talked to your doc about your reaction to the beer?Tried. Earliest appointment was 10 days away.
>You should phone him/her before you go in, so the doc will know how severe it was, and he/she can formulate a plan before you go in.
This is a good plan, except she doesn't take phonecalls. I'd have to tell the girl on the front desk...sigh. This requires some humility.
>Also, ask about carrying the meds you mention. The doc is less likely to dismiss the idea, if he/she has time to think about it (although I not sure it would be a good idea, for the reasons mentioned above.
Your comments are confirmation of my anxieties: I had worried that she would refuse me the nifedipine for the reasons you mention. But I will certainly try.
>Also ask the doc about restarting the Parnate; five days is too long to wait.
I agree. However, it seems too scary to pursue right now.
>
> I would recommend a Medic Alert-type bracelet or chain for anyone taking MAOIs.This would have helped.
> Also, learning as much as you can about the drugs you are taking (as you have) empowers a person to take charge of there illness, and not leave it all up to the doctor.
I wish this learning was respected in emerg. They seemed to resent it.
> You are doing the right thing by researching the meds (perhaps take a copy of any articles you have with you to your appointment), but don't read to much into the articles.
Thanks, and yes, I have detected the provisionary tone of all statements in the articles -- CYA?.
>Let anyone who you dine with know that you have restrictions to your diet and educate them in what to do in case you should have a hypertensive crisis (call 911).
This is good advice. More humility required.
:-).Thanks so much for your input,
may_b
Posted by Cam W. on August 10, 2001, at 4:48:32
In reply to Re: Suicide-sal, posted by Kristi on August 10, 2001, at 1:04:49
Kristi - I know Sal is just trying to help. I commend him on that, but you really have to be careful what you say to people, who you don't know. Without a medical history, it is almost impossible to second guess the doctor. That is why I try to stick to answering questions about medications and always caution people to check with their doctor.
I am a community pharmacist, so I don't have the diagnostic skill of a psychiatrist, no matter how bad that psychiatrist may seem. On this site we only hear their stories from one side, which is not the most objective point of view, especially if that person is hurting. People who ask for advice are, for the most part, honest in describing their perceptions of their situation, but we can't take for granted what we are reading is an objective description of the situation (although, in most cases, I do believe that we are reading true views). The impact of what is said on this site is far-reaching (so I have been finding out - eg. getting calls from journalists wanting to know what my opinion is on certain medications - that scares me, even though I may have extensively researched a topic).
First we must try to do no harm. This is why I will only answer questions posed on this site and none through my email. I always just delete any questions I get via email from people I don't know. I need other people (posters and lurkers on this site) to make sure I am not giving erroneous information. I only know my answers from my point of view; it is important, and necessary, to have second and third opinions, especially in this type of format.
If Sal isolates anyone by a Messenger system, then others cannot confirm if what he is saying is potentially helpful or harmful, especially when he is doing it without any formal training. This is why I said what I did to Sal. I am not trying to pick on him, but I wouldn't pretend that I could counsel a suicidal person. Even when working in a pharmacy and I get a phonecall from a suicidal person, I try to get them to call the crisis line, because this sort of situation is beyond the scope of what I feel I can handle appropriately.
Suicidal people should be convinced to get help in person, not over the internet. This is what crisis lines attempt to do. The operators are trained to assess the situation and to try to get the person to seek help in person (ie. in an emergency room, when necessary). Besides, if we try to help someone who is suicidal and we push them over the edge, we could be held liable for their death. This is why we try to answer questions by consensus on this site, rather than individually.
Sincerely, Cam
Posted by ChrisK on August 10, 2001, at 5:04:27
In reply to Re: Suicide-sal » Kristi, posted by Cam W. on August 10, 2001, at 4:48:32
Cam,
I applaud your efforts on this site and wish you the best in everyday life. Your answer to Kristi is dead on. Thanks for helping out in the manner you do.
Respectfully,
Chris
Posted by Kristi on August 10, 2001, at 9:00:30
In reply to Re: Suicide-sal » Kristi, posted by Cam W. on August 10, 2001, at 4:48:32
Cam,
Point well taken. But I sort of took it like he was trying to offer support. But we really do need to be careful. :-) Thanks, Kristi
> Kristi - I know Sal is just trying to help. I commend him on that, but you really have to be careful what you say to people, who you don't know. Without a medical history, it is almost impossible to second guess the doctor. That is why I try to stick to answering questions about medications and always caution people to check with their doctor.
>
> I am a community pharmacist, so I don't have the diagnostic skill of a psychiatrist, no matter how bad that psychiatrist may seem. On this site we only hear their stories from one side, which is not the most objective point of view, especially if that person is hurting. People who ask for advice are, for the most part, honest in describing their perceptions of their situation, but we can't take for granted what we are reading is an objective description of the situation (although, in most cases, I do believe that we are reading true views). The impact of what is said on this site is far-reaching (so I have been finding out - eg. getting calls from journalists wanting to know what my opinion is on certain medications - that scares me, even though I may have extensively researched a topic).
>
> First we must try to do no harm. This is why I will only answer questions posed on this site and none through my email. I always just delete any questions I get via email from people I don't know. I need other people (posters and lurkers on this site) to make sure I am not giving erroneous information. I only know my answers from my point of view; it is important, and necessary, to have second and third opinions, especially in this type of format.
>
> If Sal isolates anyone by a Messenger system, then others cannot confirm if what he is saying is potentially helpful or harmful, especially when he is doing it without any formal training. This is why I said what I did to Sal. I am not trying to pick on him, but I wouldn't pretend that I could counsel a suicidal person. Even when working in a pharmacy and I get a phonecall from a suicidal person, I try to get them to call the crisis line, because this sort of situation is beyond the scope of what I feel I can handle appropriately.
>
> Suicidal people should be convinced to get help in person, not over the internet. This is what crisis lines attempt to do. The operators are trained to assess the situation and to try to get the person to seek help in person (ie. in an emergency room, when necessary). Besides, if we try to help someone who is suicidal and we push them over the edge, we could be held liable for their death. This is why we try to answer questions by consensus on this site, rather than individually.
>
> Sincerely, Cam
Posted by Elizabeth on August 10, 2001, at 15:56:05
In reply to Re: parnate questions » Elizabeth, posted by Cam W. on August 9, 2001, at 22:06:25
> Elizabeth - Thanks for the info, much appreciated. Like I say, working in community pharmacy, we don't get all the fun you see on ER.
I should send them some plot ideas, perhaps in the form of my medical records. Lots of wild crazy stuff in there, I'm sure they could make a few suitably dramatic episodes out of it with some artistic license. < g >
I appreciated your response to Sal and Kristi. As always, very reasonable.
So, do you think that people on chronic opioid therapy should have emergency medical bracelets or tags? I'm imagining a situation where hospital staff didn't realise that a person was tolerant and as a result the patient didn't receive adequate pain medication. On the other hand, I can appreciate why people on MMT would not want to advertise that information.
-elizabeth
Posted by Cam W. on August 10, 2001, at 16:04:06
In reply to Re: parnate questions » Cam W., posted by Elizabeth on August 10, 2001, at 15:56:05
Elizabeth - It might be a good idea to at least have a card in a wallet (not as noticeable) in the form of an I.D., with medical information in red, on it. Of course it might be missed, but emerg will go through your pockets and purse to find out who you are (hopefully).
Do you think that "Smart Cards" would be of help in an instance such as this?
- Cam
Posted by Elizabeth on August 10, 2001, at 16:56:10
In reply to Re: parnate questions » Elizabeth, posted by Cam W. on August 10, 2001, at 16:04:06
> Elizabeth - It might be a good idea to at least have a card in a wallet (not as noticeable) in the form of an I.D., with medical information in red, on it. Of course it might be missed, but emerg will go through your pockets and purse to find out who you are (hopefully).
I do have a wallet card that says I take buprenorphine and the dose. It's outdated, unfortunately (has former pdoc's number and old address, and says I'm taking Parnate as well). I should probably replace that.
> Do you think that "Smart Cards" would be of help in an instance such as this?
Umm. That depends on what "Smart Cards" are! :-)
-elizabeth
Posted by shelliR on August 10, 2001, at 17:56:03
In reply to Re: parnate questions » Cam W., posted by Elizabeth on August 10, 2001, at 16:56:10
> > Elizabeth - It might be a good idea to at least have a card in a wallet (not as noticeable) in the form of an I.D., with medical information in red, on it. Of course it might be missed, but emerg will go through your pockets and purse to find out who you are (hopefully).
>
> Umm. That depends on what "Smart Cards" are! :-)Yes, I would also like to know this. (a guess: digital cards?)
Neither of you answered my questions, above. please (I do really hate to beg) : *(
And since neither of you answered, I'll ask another, the most important to me at this moment.Is it possible that my use of opiates (oxycontin, pdoc prescribed) for depression can have any negative impact on my reaction to parnate which I started on Tuesday. I am in pretty bad shape and am hoping that the oxycontin is not compromising the potential of a successful outcome with parnate. A pdoc in the hospital once told me codeine can render ADs ineffective. And now I'm wondering why he said that, and my pdoc is away (August).
Any thoughts.Shelli
Posted by Cam W. on August 10, 2001, at 17:58:06
In reply to Re: parnate questions » Cam W., posted by Elizabeth on August 10, 2001, at 16:56:10
Elizabeth - Smart Cards will be like a credit card with your entire medical history on it. They swipe it and can tell the who, what, when, wheres and whys of your treatment. They would save a lot of time, but there are people who say it is an infringement on privacy. - Cam
Posted by may_b on August 10, 2001, at 19:32:39
In reply to Re: Smart Cards » Elizabeth, posted by Cam W. on August 10, 2001, at 17:58:06
Cam
I love the idea, in theory. When I was too sick to talk in emerg, it might have given me the credibility that I seemed to lack in the eyes of the attending team. Or at least entertained them while they refused me treatment. [Good thing I am not bitter!] < g >
Falling ill in locations where there was no reader, the bracelet would be better...
It is a good idea nevertheless,
may_b
Posted by Elizabeth on August 11, 2001, at 0:16:20
In reply to Re: parnate questions-CAM, ELIZABETH, posted by shelliR on August 10, 2001, at 17:56:03
> Neither of you answered my questions, above.
Oops! OK, looking back at your earlier post:
> So you think this is a good idea. I think there are definitely two schools of thought on this. I do have a blood pressure monitor at home, but I don't carry it with me. And nifedipine could cause harm if you take it and you are not hypertensive, right? I am in my forties, but am cardiovascularly fit.
You shouldn't take nifedipine unless you have confirmed that your BP is elevated, that's correct. I think that the digital sphygmomanometers that you can get in pharmacies are small enough to carry around (assuming you're like me and have a gigantic purse/handbag that you carry everywhere!).
> I had two non-serious hypertensive crises when combining nardil with adrafinil. Non-serious in the sense that my BP went up to 160 and not any higher. I didn't experience a headache, I experienced a specific tightness in my shoulders. And my pulse went very low- like 45. If your blood pressure shoots up like that, is a reduction of pulse a given? I mean can that be an accurate indication that you are having a hypertensive episode.
It doesn't prove that your BP is elevated, but it does often happen. It's an attempt made by your CV system to compensate for the constriction of blood vessels by reducing cardiac output. (BTW, I'm not sure that a "non-serious" elevation in blood pressure should be referred to as "hypertensive crisis.")
> Maybe I should carry one of those mini ones that hook up to your finger. Are they accurate?
The finger and wrist ones supposedly are less accurate than the arm ones. I have a digital arm BP monitor, and it's always served me well.
> I think I read (don't know if it's true) that parnate is more likely to cause a hypertensive episode than nardil. True, false, don't know?
The dose of tyramine required to raise a person's blood pressure by a particular amount is significantly lower with Parnate than it is with Nardil. The Demerol thing is another matter; I don't know of any evidence that one or the other MAOI carries more risk of interacting with Demerol.
> Is it possible that my use of opiates (oxycontin, pdoc prescribed) for depression can have any negative impact on my reaction to parnate which I started on Tuesday.
I would like to know what is meant by that also. I can envision a possible reason, but the words to explain this possible reason seem to be escaping me.
I hope this helps.
-elizabeth
Posted by Elizabeth on August 11, 2001, at 0:20:37
In reply to Re: Smart Cards, posted by may_b on August 10, 2001, at 19:32:39
Hmm, well unlike May_b, I'm not so happy about the idea. I'm a person who values privacy a lot. I prefer the type of card I carry -- it's an old-fashioned card (no magnetic strip) that has my medications and doctors' names and phone numbers written on it (it does need to be updated). It doesn't go into details like diagnosis, history, indications and uses for each medication, etc.
-e
Posted by shelliR on August 11, 2001, at 0:51:05
In reply to Re: parnate questions » shelliR, posted by Elizabeth on August 11, 2001, at 0:16:20
> You shouldn't take nifedipine unless you have confirmed that your BP is elevated, that's correct. I think that the digital sphygmomanometers that you can get in pharmacies are small enough to carry around (assuming you're like me and have a gigantic purse/handbag that you carry everywhere!).
>
> > I had two non-serious hypertensive crises when combining nardil with adrafinil. Non-serious in the sense that my BP went up to 160 and not any higher. I didn't experience a headache, I experienced a specific tightness in my shoulders.
>
>. (BTW, I'm not sure that a "non-serious" elevation in blood pressure should be referred to as "hypertensive crisis.")
>
Okay, episodes, whatever. But if my BP is rises quicky from 100 to 160 then that's the time I would take nifedipine, I assume. Because you don't know until you wait how high it will go, just that it is rising much higher than usual. So 160 would be my evaluation point, maybe. I alway come up with so many more questions when my doctors go out of town :-) I don't have nifedipine anyway, but someone is covering for my pdoc who I could check with.> > Maybe I should carry one of those mini ones that hook up to your finger. Are they accurate? >
> The finger and wrist ones supposedly are less accurate than the arm ones. I have a digital arm BP monitor, and it's always served me well.
I have digital arm one also, but I wouldn't want to take it with me to a restaurant, for example. I was thinking of the other because it would easily fit into my purse and it is less obtrustive. I don't have huge purses because what ever size I carry will fill up, anyway.> > I think I read (don't know if it's true) that parnate is more likely to cause a hypertensive episode than nardil. True, false, don't know?
> The dose of tyramine required to raise a person's blood pressure by a particular amount is significantly lower with Parnate than it is with Nardil.
I was spoiled by nardil; it was like MAOI, what's the big deal. I have to start out at least a little more careful with parnate.> > Is it possible that my use of opiates (oxycontin, pdoc prescribed) for depression can have any negative impact on my reaction to parnate which I started on Tuesday.
>
> I would like to know what is meant by that also. I can envision a possible reason, but the words to explain this possible reason seem to be escaping me.Well if the words come to you, please let me know. I could call the pdoc who said that to me next week, but he is so anti-opiates for depression. So I will probably wait to ask my pdoc. But I can't imagine *just* waiting for the parnate to kick in , if it does kick in. It could be weeks and I have been in a lot of depressive pain.
> I hope this helps.
all information helps, thanks.Shelli
Posted by Elizabeth on August 11, 2001, at 13:27:13
In reply to Re: parnate questions » Elizabeth, posted by shelliR on August 11, 2001, at 0:51:05
> ... But if my BP rises quicky from 100 to 160 then that's the time I would take nifedipine, I assume.
I think that 160 systolic was the number my pdoc told me to use.
> Because you don't know until you wait how high it will go, just that it is rising much higher than usual.
Exactly.
> I have digital arm one also, but I wouldn't want to take it with me to a restaurant, for example. I was thinking of the other because it would easily fit into my purse and it is less obtrustive. I don't have huge purses because what ever size I carry will fill up, anyway.
Heh. I carry a handbag that is big enough for me to have lots of useful stuff on me at all times (wallet, mosturising lotion, palm pilot, flashlight, sunglasses, lockpicks, etc. < g >). I carried around the BP monitor for a while when I first started each MAOI. After I'd been taking them for a while I felt comfortable leaving it at home unless I was going out of town. (It was just my luck not to have it when I had an episode while at a memorial service in Connecticut!).
> I was spoiled by nardil; it was like MAOI, what's the big deal. I have to start out at least a little more careful with parnate.
Don't let yourself go overboard, though. Anxiety can make your blood pressure go up too. :-)
> Well if the words come to you, please let me know. I could call the pdoc who said that to me next week, but he is so anti-opiates for depression.
I think it might just mean that the MAOI wouldn't be enough to prevent rebound depression if you stopped the OxyContin abruptly (which is why you shouldn't do that).
> It could be weeks and I have been in a lot of depressive pain.
You know, it's so nice that there's someone else here who "gets it" about how depression is analogous to nocioceptive pain. People give me such a hard time about using buprenorphine, but I really don't think there's any significant difference between using it for depression versus using it for chronic pain from an injury (for example).
-elizabeth
Posted by Michael K on August 12, 2001, at 13:04:00
In reply to Re: parnate questions » Elizabeth, posted by shelliR on August 11, 2001, at 0:51:05
>
> > You shouldn't take nifedipine unless you have confirmed that your BP is elevated, that's correct. I think that the digital sphygmomanometers that you can get in pharmacies are small enough to carry around (assuming you're like me and have a gigantic purse/handbag that you carry everywhere!).
> >
> > > I had two non-serious hypertensive crises when combining nardil with adrafinil. Non-serious in the sense that my BP went up to 160 and not any higher. I didn't experience a headache, I experienced a specific tightness in my shoulders.
> >
> >. (BTW, I'm not sure that a "non-serious" elevation in blood pressure should be referred to as "hypertensive crisis.")
> >
> Okay, episodes, whatever. But if my BP is rises quicky from 100 to 160 then that's the time I would take nifedipine, I assume. Because you don't know until you wait how high it will go, just that it is rising much higher than usual. So 160 would be my evaluation point, maybe. I alway come up with so many more questions when my doctors go out of town :-) I don't have nifedipine anyway, but someone is covering for my pdoc who I could check with.
>
> > > Maybe I should carry one of those mini ones that hook up to your finger. Are they accurate? >
> > The finger and wrist ones supposedly are less accurate than the arm ones. I have a digital arm BP monitor, and it's always served me well.
> I have digital arm one also, but I wouldn't want to take it with me to a restaurant, for example. I was thinking of the other because it would easily fit into my purse and it is less obtrustive. I don't have huge purses because what ever size I carry will fill up, anyway.
>
> > > I think I read (don't know if it's true) that parnate is more likely to cause a hypertensive episode than nardil. True, false, don't know?
> > The dose of tyramine required to raise a person's blood pressure by a particular amount is significantly lower with Parnate than it is with Nardil.
> I was spoiled by nardil; it was like MAOI, what's the big deal. I have to start out at least a little more careful with parnate.
>
> > > Is it possible that my use of opiates (oxycontin, pdoc prescribed) for depression can have any negative impact on my reaction to parnate which I started on Tuesday.
> >
> > I would like to know what is meant by that also. I can envision a possible reason, but the words to explain this possible reason seem to be escaping me.
>
> Well if the words come to you, please let me know. I could call the pdoc who said that to me next week, but he is so anti-opiates for depression. So I will probably wait to ask my pdoc. But I can't imagine *just* waiting for the parnate to kick in , if it does kick in. It could be weeks and I have been in a lot of depressive pain.
>
>
> > I hope this helps.
> all information helps, thanks.
>
> ShelliShelli
Generally speaking, if Parnate is going to work, you should feel some relief within a few days.
Mike
Posted by Zo on August 12, 2001, at 23:37:21
In reply to Re: Suicide-sal » Kristi, posted by Cam W. on August 10, 2001, at 4:48:32
Cam,
While what you say makes a great deal of sense, it does so only within the context you have set out for it. By that I mean, if this is Sal's or anyone's form of service, if service is how they choose to live, how can we possibly say this is wrong. Wrong-headed, misguided. I think what we have here, again, are conflicting paradigms. The rules of the way in which you serve, at least insofar as I know you on this board, make sense. So does a suicidal person having Sal's messenger ID to call upon in a pinch. It is also common-sensical that a listening, caring ear at the right moment can make the difference. And you cannot regulate care! It springs up all around us, it springs from the human heart, it takes whatever form it will. This is the nature of life.
Controls are important -- and so is respect for that which cannot be controlled. Let Sal give his gift, you tend to yours.
Zo
Posted by shelliR on August 13, 2001, at 10:43:38
In reply to Re: Suicide - Sal » Cam W., posted by Zo on August 12, 2001, at 23:37:21
> Cam,
>
> While what you say makes a great deal of sense, it does so only within the context you have set out for it. By that I mean, if this is Sal's or anyone's form of service, if service is how they choose to live, how can we possibly say this is wrong. Wrong-headed, misguided. I think what we have here, again, are conflicting paradigms. The rules of the way in which you serve, at least insofar as I know you on this board, make sense. So does a suicidal person having Sal's messenger ID to call upon in a pinch. It is also common-sensical that a listening, caring ear at the right moment can make the difference. And you cannot regulate care! It springs up all around us, it springs from the human heart, it takes whatever form it will. This is the nature of life.
>
> Controls are important -- and so is respect for that which cannot be controlled. Let Sal give his gift, you tend to yours.
>
> ZoZo,
I think it is fine for Sal for give his "gift" on the board. I still don't have any problems with Sal's citation of studies, in fact I would acknowledge that they could help some people.
I do see a problem having Sal get into direct contact with someone suicidal on the board. If I trusted that Sal would just be there to listen, to offer support, get someone to go to the ER or call their pdoc, I wouldn't have a problem with that. As you said, a listening, caring ear at the right moment... However, because in the past Sal has directly told people what meds they should stay on, or to get immediately off of a drug , I feel safer, also, having Sal's participation be on the board. This approach seems to be Sal's way of caring, and I don't see it as the best way of caring when someone is suicidal.
Once someone is off the board, there are not the usual checks and balances. And yes, I do think Sal's style works better in a place where those checks and balances are in place. On the other hand, if someone takes Sal up on his offer, it *is* out of our control, and I hope he takes that responsibility very seriously. I do think Sal has a good heart, but not always the people skills , so I worry about him in a crisis situation.
Shelli
Posted by Zo on August 14, 2001, at 2:23:48
In reply to Re: Suicide - Sal » Zo, posted by shelliR on August 13, 2001, at 10:43:38
V. helpful post, Shelli. Thanks.
Zo
Posted by Elizabeth on August 15, 2001, at 18:21:26
In reply to Re: parnate questions, posted by Michael K on August 12, 2001, at 13:04:00
> Generally speaking, if Parnate is going to work, you should feel some relief within a few days.
Hi Mike. I don't think this is necessarily true, especially since Shelli is on a subtherapeutic dose of Parnate (10 mg/day).
My experience has been that Parnate works faster than it's "supposed" to, but I have known people for whom it took a month or more.
-elizabeth
Posted by Michael K on August 15, 2001, at 22:01:48
In reply to Re: parnate questions » Michael K, posted by Elizabeth on August 15, 2001, at 18:21:26
> > Generally speaking, if Parnate is going to work, you should feel some relief within a few days.
>
> Hi Mike. I don't think this is necessarily true, especially since Shelli is on a subtherapeutic dose of Parnate (10 mg/day).
>
> My experience has been that Parnate works faster than it's "supposed" to, but I have known people for whom it took a month or more.
>
> -elizabethElizabeth,
It was probably a mistake to generalize. The first doctor who prescribed Parnate for me told me that. Sure enough, although I was suffering from one of the worst depressions of my life, the first 10mg gave me some relief. The relief was almost immediate, like a stimulant. I was still deeply depressed, but I had the strength to hang around for the next 10 mg. It did take about 2 weeks with an eventual dosage of 40 mg to work completely. I may have just been lucky to experience that first "kick."Mike
Posted by shelliR on August 15, 2001, at 23:22:29
In reply to Re: parnate questions » Elizabeth, posted by Michael K on August 15, 2001, at 22:01:48
> > > Generally speaking, if Parnate is going to work, you should feel some relief within a few days.
> >
> > Hi Mike. I don't think this is necessarily true, especially since Shelli is on a subtherapeutic dose of Parnate (10 mg/day).
> >
> > My experience has been that Parnate works faster than it's "supposed" to, but I have known people for whom it took a month or more.
> >
> > -elizabeth
>
> Elizabeth,
> It was probably a mistake to generalize. The first doctor who prescribed Parnate for me told me that. Sure enough, although I was suffering from one of the worst depressions of my life, the first 10mg gave me some relief. The relief was almost immediate, like a stimulant. I was still deeply depressed, but I had the strength to hang around for the next 10 mg. It did take about 2 weeks with an eventual dosage of 40 mg to work completely. I may have just been lucky to experience that first "kick."
>
> MikeHi Mike. I think your experience is quite common for folks who do succeed on Parnate. Several people mentioned that they had an immediate stimulent effect. If I had felt any "kick" I might have hung in for longer, but it's too hard going through both fatigue and nausea, and feeling that it will probably not succeed.
Shelli
Posted by manowar on December 8, 2001, at 17:06:41
In reply to VNS Operation vs drugs vs ECT vs MCS, posted by susan C on August 8, 2001, at 16:03:14
The post below sounds very interesting. I'm surprised that nobody followed up on this. Is there anyone including Elizabeth or Cam that has looked into microcurrent stimulation (MCS)? Susan C. said she did well with it. I found out that it is FDA approved and that insurance will sometimes pay for the device. The Alpha Stim 100 is $800. I also read somewhere that you can build an electrical stimulation unit of your own for about $15.
http://www.dtaresources.com/alpha_stim_100.asp
BTW- Is that Cela Ward?
Susan C. posted this---
> If we are looking at ECT, VNS, drugs and combinations there of, look also at Alpha Stim 100. It is microcurrent stimulation (MCS), similar, but different from a TENS unit, which used for chronic pain, has had studies done for depression and in the process of getting approved for use. I used it successfully for a year or so when I was very depressed and nothing worked. I was ready to try anything, and, unlike VNS, which requires an operation to install unit and wrap nerve and later to replace battery, Alpha Stim 100 just clips to your ears. Just thought I'd mention it.
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