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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jerrympls on April 27, 2005, at 4:52:28
Weird that my depression has improved and my insomnia has gotten worse - infact - it's gotten so bad over the past year that it's gonna cost me my job. My manager told me that - although I do good work - my absences and arriving late to work have been too much and they want to let me go.
Yes, I am registered with our Disability Services dept. and have a case worker who has been trying to work with my managers to work out some accomodations. They've been supportive for a long time now, but I've missed so much work that I'm out of sick leave and vacation time. Plus, I've exhausted my FMLA leave time (12-weeks/year). I was also rejected for short-term disability insurance because of my WEIGHT!!!!!!
I saw a sleep specialist today and he evaluated 3 weeks of a sleep diary I kept and said I have a severe sleep phase disorder. No cure and VERY VERY difficult to get back on track. Very grim news. I mentioned that my sleep problems are going to get me fired and although he was sympathetic - he said "You really should go on medical leave for 3 weeks until we can figure something out." But I can't take any medical leave....
I'm going crazy not being able to sleep when I "should" and wake when I "should." I'm basically at the point where I'm so worn out/burnt out that I don't care if they fire me. But I do care.
I have no savings...nothing. Barely any support from my parents. When I get fired - what do I do for money? How do I pay my bills? What about my insurance???
I'm at the end of my rope. I don't know what to do - where to turn. I've been up all night again (it's 4:45am now) and I'm so exhausted I'm gonna have to call in sick to work otherwise I'll get physically sick due to the exhaustion (as I have before - nausea, vomiting, slightly psychotic episodes). So, just forcing myself to go to work is not gonna work.
Sorry for the long email - but I need help. I am alone here - literally. What can I do? WHat do I do? How do I pay my rent? Food?
Please...anyone...please....
Jerry
P.S. I thought this post might be redirected, so I have also posted on the social board too - here's the link:
http://www.dr-bob.org/babble/social/20050426/msgs/490232.html
Posted by nicky77 on April 27, 2005, at 5:14:14
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
I had the insomnia aswell, and 15mg's of Remeron (mirtazapine) every night saved my life... Dunno, seems too simple doesn't it?
Good luck regardless though.Nick
Posted by alienatari on April 27, 2005, at 8:02:47
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
I really feel for you. I hope things work out for you and you dont lose your job. I dont know if i can offer much advice. I agree with the other poster, remeron is great for sleep. so is seroquel, and the benzo's. Personally if I dont take something to sleep i dont sleep at all. Sometimes i go for a week without sleeping and it freaks me out. im in Australia and I guess your in America, but im wondering do they have the disability pension there? maybe you could apply for that if you do lose your job? Just hang in there, I am sure something will be worked out soon. Sorry I couldnt be of much help. Take care.
> Weird that my depression has improved and my insomnia has gotten worse - infact - it's gotten so bad over the past year that it's gonna cost me my job. My manager told me that - although I do good work - my absences and arriving late to work have been too much and they want to let me go.
>
> Yes, I am registered with our Disability Services dept. and have a case worker who has been trying to work with my managers to work out some accomodations. They've been supportive for a long time now, but I've missed so much work that I'm out of sick leave and vacation time. Plus, I've exhausted my FMLA leave time (12-weeks/year). I was also rejected for short-term disability insurance because of my WEIGHT!!!!!!
>
> I saw a sleep specialist today and he evaluated 3 weeks of a sleep diary I kept and said I have a severe sleep phase disorder. No cure and VERY VERY difficult to get back on track. Very grim news. I mentioned that my sleep problems are going to get me fired and although he was sympathetic - he said "You really should go on medical leave for 3 weeks until we can figure something out." But I can't take any medical leave....
>
> I'm going crazy not being able to sleep when I "should" and wake when I "should." I'm basically at the point where I'm so worn out/burnt out that I don't care if they fire me. But I do care.
>
> I have no savings...nothing. Barely any support from my parents. When I get fired - what do I do for money? How do I pay my bills? What about my insurance???
>
> I'm at the end of my rope. I don't know what to do - where to turn. I've been up all night again (it's 4:45am now) and I'm so exhausted I'm gonna have to call in sick to work otherwise I'll get physically sick due to the exhaustion (as I have before - nausea, vomiting, slightly psychotic episodes). So, just forcing myself to go to work is not gonna work.
>
> Sorry for the long email - but I need help. I am alone here - literally. What can I do? WHat do I do? How do I pay my rent? Food?
>
> Please...anyone...please....
>
> Jerry
>
> P.S. I thought this post might be redirected, so I have also posted on the social board too - here's the link:
>
>
> http://www.dr-bob.org/babble/social/20050426/msgs/490232.html
Posted by ed_uk on April 27, 2005, at 8:19:55
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
Hi Jerry,
How does the hydrocodone affect your sleep? I think you are taking 5mg four times a day. Perhaps you could try taking 5mg hydrocodone three times a day and 5mg oxycodone at night (immediate release, not OxyContin). You said that you found oxycodone more sedating, I don't remember whether it helped you sleep though.
I vaguely remember that you also found morphine more sedating. An alternative would be to try taking 5mg hydrocodone three times a day and 5mg morphine (immediate release) in the evening.
Re Lunesta. Considering that up to 15mg of zopiclone (Zimovane etc) has been used to treat insomnia, I would expect that some people might need 6-8mg eszopiclone (Lunesta). Do you think that it might help to take Lunesta earlier in the evening? It can take a while to 'kick in'.
RE your other medication. Perhaps you could alter your Dexedrine regimen (timing/size of doses etc) so that its effects are more prominent during the morning/early afternoon and so that it has completely worn off by bedtime. If the Lexapro aggravates your insomnia, perhaps you could reduce the dose. Personally, I find SSRIs quite sleep-inducing, if I couldn't sleep I might increase the dose!
RE other sleep aids. I think you said that you got a hangover when you tried Seroquel, Remeron etc. Perhaps you could take a much smaller dose to help reduce this effect.
Kind regards,
Ed.
Posted by synteq7 on April 27, 2005, at 12:11:27
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
Try seroquel 25 mg to start at bedtime, that will help you relax,sleep. I experienced no adverse reactions,
hope that helps
Posted by ixus on April 27, 2005, at 16:27:49
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
Hi Jerry,
although "you may feel that you feel better" most probably you are not in reemision. Remember, your vision of the future is caused by the current state.> I saw a sleep specialist today and he evaluated > 3 weeks of a sleep diary I kept and said I have > a severe sleep phase disorder. No cure and VERY > VERY difficult to get back on track. Very grim > news.
Once I was severly depressed and could not even read one single line of newspaper header, I visited a psychiatrist. He said: "That is the way you will live, basically no cure, you have some genes deffects, chromosome 13" and put me on low dose of imipramine. The next one made me even more depressed prescribing tegretol and saying: "you have temporal lobe epilepsy". Now I know, maybe there is no cure, but everyone of us should have one goal - full reemision.
/ixus
Posted by medhed on April 27, 2005, at 20:59:09
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
opates cause me sever insomnia. I try never to take them unless I have time to catch up on sleep. I may be taking a much larger dose than you though. I generally use opiate doses that are suitable for severe pain relief, I experience a vacation from life while sitting in my recliner and I find opium dreams to be insiteful and recreational. most sleep aids intensify the effects of opiates, therefore my sleep is actually more disturbed paradoxally. I'm sorry your life is going so wrong, I'll keep you in mind during meditation. luck to you.
Posted by B2chica on April 28, 2005, at 12:26:54
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
((((((Jerry))))))
so sorry you are in such a tough spot right now.many pdocs use low doses of AD to help with sleep, remeron, trazadone are a couple i've tried.
FYI, i've had Terrible insomnia for what seems like forever, i've tried (i think) almost every sleep aid out there and they work for a couple weeks and poop out. i've been on seroquel (100mg) and that really worked but it caused me cognitive disfunction during the day.
i'm now on zyprexa 10mg. it worked great with my sleep issues at first but its been harder and harder to get to sleep at night (however!- i do sleep all through the night now after being on it)and maybe do a seperate post about "$$aid with Rx" many people on this board i think can help with suggestions.
just some insight.
hth
b2c.
Posted by Wildflower on April 28, 2005, at 12:42:29
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
I know how you must feel. I took off two months of work last year for insomnia and depression. Lately, I'm starting to feel like that again. You've probably tried everything but have you tried light therapy or a dawn simulator? This along with something to help you sleep may get your internal clock back in check. I usually have to set several alarms around my room forcing me to get up. Some days it works, some days it doesn't.
Is flextime an option for you where you could start at 10 and leave at 7 (providing you work an hour day?) What about working from home? There has to be some middleground.
Should the worst happen, there are part-time temp jobs you could take to help with the bills. If you're pretty sure the end is near, you may want to start looking for a new job now.
Posted by Dr. Bob on April 28, 2005, at 23:51:11
In reply to Insomnia is costing me my job-HELP, posted by jerrympls on April 27, 2005, at 4:52:28
> P.S. I thought this post might be redirected, so I have also posted on the social board too - here's the link:
>
> http://www.dr-bob.org/babble/social/20050426/msgs/490232.htmlThanks for doing that, I would in fact like follow-ups not about medication to be redirected there.
Bob
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