![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by BarbaraCat on July 27, 2002, at 22:16:23
Gentle Babblers,
I can't tell you how utterly frustrated I am with how hard it is to get a valid diagnosis. And I know I'm not the only one here feeling this way. First I was major depressed, now I'm bp-2. I'm taking Remeron, lithium, neurontin, thyroid, ativan, blah blah. But I'm seriously wondering about a little tetch of ADD in there. The symptoms are definitely there but like many of you, the questions revolve around is it ADD or bipolar (why would hypomania suddenly be surfacing if I'm taking lithium?)? Or perhaps GAD? Lately my thoughts have been boinging about like a truckload of ping-pong balls. I try to straighten up the house but leave a trail of destruction in my wake instead. I get sidetracked, can't complete tasks. Is this flying-apart feeling ADD? Would a pstim help? hurt? Had an upsetting day yesterday, maybe it's just anxiety? Is is hypomania? I know I could be feeling better than I am.So here is the issue: My health provider is a big HMO outfit. I'm absurdly fortunate to even be seeing a pdoc, even tho it's only for 20 minutes every 8 weeks. He doesn't know me! How can my diagnosis be anything but a shot in the dark? I sympathize with him and all doctors trying to work with this unworkable HMO debacle, but truth is, he's not considering me or my condition for one minute outside the office. Am I misdiagnosed? Am I missing out on an effective med? I don't know and I WANT BETTER CARE!!! I've asked him about SPECT tests and he chucklingly commented about how nice if we could all have Dr. Beverly Crusher's little StarTrek gizmo. Costly tests are frowned upon, especially as he states, there aren't any that are accurate. I don't believe him. There's got to be something that with time, effort and yes, money, can home in a lot better than diagnostic and treatment roulette.
What rights do I have as a patient in insisting I receive additional 'expensive tests'. What are these tests? What's available as far as reliable sensitive diagnostic tools? Is the SPECT available other than at Dr. Amen's? What other functional imaging tests are out there? Who would I call within this HMO health system to get an honest answer - not some toady in the 'costs reduction' department? Without a doubt, I'm managing my own health much better than my managed care 'team', but without a prescription pad I can only go so far. Has anyone here had satisfaction in pursuing these matters? Are you all happy with your psych care? - BCat
Posted by velaguff on July 27, 2002, at 23:56:11
In reply to Diagnostic discombobulation - need advice, posted by BarbaraCat on July 27, 2002, at 22:16:23
Sorry I can't offer any useful advice, but I've read Dr. Amen's book "Change Your Brain, Change your Life" and I admire your intiative in finding this book, and reading it (if that's what you read?). We need more doctors like him, who are PATIENT centered, instead of SELF-interested. Frankly, he may have his legitimate critics, whose side of the story I'm unfamiliar with, and maybe he only tells us about his sucesses, and not his failures. People who can afford it, though, apprently value his counsel especially highly. He does not appear to be a typical Dr. Fat'n'happy.
> Gentle Babblers,
> I can't tell you how utterly frustrated I am with how hard it is to get a valid diagnosis. And I know I'm not the only one here feeling this way. First I was major depressed, now I'm bp-2. I'm taking Remeron, lithium, neurontin, thyroid, ativan, blah blah. But I'm seriously wondering about a little tetch of ADD in there. The symptoms are definitely there but like many of you, the questions revolve around is it ADD or bipolar (why would hypomania suddenly be surfacing if I'm taking lithium?)? Or perhaps GAD? Lately my thoughts have been boinging about like a truckload of ping-pong balls. I try to straighten up the house but leave a trail of destruction in my wake instead. I get sidetracked, can't complete tasks. Is this flying-apart feeling ADD? Would a pstim help? hurt? Had an upsetting day yesterday, maybe it's just anxiety? Is is hypomania? I know I could be feeling better than I am.
>
> So here is the issue: My health provider is a big HMO outfit. I'm absurdly fortunate to even be seeing a pdoc, even tho it's only for 20 minutes every 8 weeks. He doesn't know me! How can my diagnosis be anything but a shot in the dark? I sympathize with him and all doctors trying to work with this unworkable HMO debacle, but truth is, he's not considering me or my condition for one minute outside the office. Am I misdiagnosed? Am I missing out on an effective med? I don't know and I WANT BETTER CARE!!! I've asked him about SPECT tests and he chucklingly commented about how nice if we could all have Dr. Beverly Crusher's little StarTrek gizmo. Costly tests are frowned upon, especially as he states, there aren't any that are accurate. I don't believe him. There's got to be something that with time, effort and yes, money, can home in a lot better than diagnostic and treatment roulette.
>
> What rights do I have as a patient in insisting I receive additional 'expensive tests'. What are these tests? What's available as far as reliable sensitive diagnostic tools? Is the SPECT available other than at Dr. Amen's? What other functional imaging tests are out there? Who would I call within this HMO health system to get an honest answer - not some toady in the 'costs reduction' department? Without a doubt, I'm managing my own health much better than my managed care 'team', but without a prescription pad I can only go so far. Has anyone here had satisfaction in pursuing these matters? Are you all happy with your psych care? - BCat
Posted by Squiggles on July 28, 2002, at 9:25:23
In reply to Diagnostic discombobulation - need advice, posted by BarbaraCat on July 27, 2002, at 22:16:23
Hi,
You're an enchanting writer - i can only
give a little advice for your sorry and maybe
common story - regarding patient rights, i
know of a good, reliable group set up by
David Oaks, named Support Coalition International:http://www.mindfreedom.org/about_oaks.shtml
You might get some info. there (he has given
me his word that he and the group are not
associated with Scientology);good luck
Squiggles
Posted by BarbaraCat on July 28, 2002, at 11:20:43
In reply to Re: Diagnostic discombobulation - need advice, posted by Squiggles on July 28, 2002, at 9:25:23
Posted by oracle on July 28, 2002, at 19:16:42
In reply to Diagnostic discombobulation - need advice, posted by BarbaraCat on July 27, 2002, at 22:16:23
What rights do I have as a patient in insisting I receive additional 'expensive tests'. What are these tests? What's available as far as reliable sensitive diagnostic tools? Is the
SPECT available other than at Dr. Amen's? What other functional imaging tests are out there? Who would I call within this HMO health system to get an honest answer -
not some toady in the 'costs reduction' department?
SPECT scans for mental illness are experimental, so
a HMO would not pay for this.
Posted by Iago Camboa on July 30, 2002, at 14:18:34
In reply to Diagnostic discombobulation - need advice, posted by BarbaraCat on July 27, 2002, at 22:16:23
My dear Barbara,
I have just now (Jul 30, 8:20 p.m.) found out your post of past July 27. I shall write to you as soon as possible. I'm so sorry I missed your words for 3 days.
Be sure I am always yours,
Iago
Posted by katekite on July 30, 2002, at 15:24:49
In reply to Diagnostic discombobulation - need advice, posted by BarbaraCat on July 27, 2002, at 22:16:23
Spect scans really are still highly questionable. I'd love to have one, but it probably wouldn't have influenced my pdocs ideas (or lack thereof) whatsoever in the past. I don't think you are missing much. There isn't an insurance company in the US that would foot the bill. Which is not to say that if any one of us won a lottery we wouldn't put it on a list of things to get done.
I'd try to get a trial few doses of Ritalin to see. You will have to try to convince the pdoc that the attention, messiness, getting lost, daydreaming, and impulsiveness pre-date all your meds and other problems. For some reason ADD is ok to treat with stimulants, but most docs would feel attentional issues from other causes (like hormonal or med induced or from depression itself) don't deserve treatment since they are 'secondary'.
Lastly, if your thyroid is even a little high that could contribute. Rather than attempt to fit yourself squarely into the middle of the 'normal range' through testing, you could experiment by holding all the rest of your meds the same and dropping the dose of the thyroid replacement by just a hair. And of course you've heard me go on about checking all hormones... something to keep in mind anyhow.
Good luck. I've been there, stretched thin between diagnoses of ADD, bipolar II, GAD. Not knowing if meds are helping or hurting, not knowing if the stable periods are happening on their own or because of something I changed, or ate, or thought, or the sunlight I got, or didn't. Very frustrating.
kate
Posted by jazzdog on July 30, 2002, at 16:19:16
In reply to spect, posted by katekite on July 30, 2002, at 15:24:49
I agree with KateKite. When my tsh gets too low, I get quite hyper, with all the distractibility and chaos that entails. I would try reducing the thyroxin by 25% for a week, and see if there's any change. Or even skip a day altogether.
Posted by BarbaraCat on July 30, 2002, at 18:26:05
In reply to Re: Diagnostic discombobulation - need advice » BarbaraCat, posted by Iago Camboa on July 30, 2002, at 14:18:34
Missed you too, Iago. I haven't seen your posts on the board in a while and wondered if you took off somewhere on an exciting adventure.
> My dear Barbara,
>
> I have just now (Jul 30, 8:20 p.m.) found out your post of past July 27. I shall write to you as soon as possible. I'm so sorry I missed your words for 3 days.
> Be sure I am always yours,
> Iago
Posted by BarbaraCat on July 31, 2002, at 0:22:48
In reply to spect, posted by katekite on July 30, 2002, at 15:24:49
Hi Kate,
Thanks for your post. I always enjoy reading your intelligent, caring posts on this board. I'm doing much better these past few days. The day I wrote I was still dealing some very stressful financial issues. Money woes can send me over the edge in a big way and when I get anxious I'm not mindful of anything. I run hither and thither, can't focus, become disorganized. Since I've spent alot of my life in this state, ADD comes to mind. But I've also had far too many stressors which have warranted anxiety - just not quite that much.As far as thyroid, it's interesting, but I've slowly increased my Armour thyroid from 1.5 grains to 3.5 grains and it's been quite beneficial. My fibromyalgia symptoms have improved tremendously, my energy is good and not at all speedy (when I'm not freaked out), my brain feels like it's woken up. And Halleluia, joy of joys! I'm no longer constipated! I sure don't want hyperthyroid symptoms, no no no, so I'll hold it at this level and getting a full panel hormone testing by my naturopath tomorrow. BTW, my TSH was 1.9 when I started to increase the dose. Some schools of thought say that a TSH of .2 isn't too low depending on the person, so I decided to experiment since all my symptoms sounded so much like low thyroid. Wouldn't it be a kicker if all this time my miseries have been due to undertreated hypothyroidism?
A question for you; are your suspected ADD symptoms periodic or constant? I've always been under the impression that ADD is consistent and doesn't usually fluctuate into the normal range. But I'm hearing lately that this isn't necessarily so, especially with all the different subtypes presenting different pathologies. Too bad SPECT isn't up to snuff yet cause we all sure could use a good diagnostic tool. - BarbaraCat
> Spect scans really are still highly questionable. I'd love to have one, but it probably wouldn't have influenced my pdocs ideas (or lack thereof) whatsoever in the past. I don't think you are missing much. There isn't an insurance company in the US that would foot the bill. Which is not to say that if any one of us won a lottery we wouldn't put it on a list of things to get done.
>
> I'd try to get a trial few doses of Ritalin to see. You will have to try to convince the pdoc that the attention, messiness, getting lost, daydreaming, and impulsiveness pre-date all your meds and other problems. For some reason ADD is ok to treat with stimulants, but most docs would feel attentional issues from other causes (like hormonal or med induced or from depression itself) don't deserve treatment since they are 'secondary'.
>
> Lastly, if your thyroid is even a little high that could contribute. Rather than attempt to fit yourself squarely into the middle of the 'normal range' through testing, you could experiment by holding all the rest of your meds the same and dropping the dose of the thyroid replacement by just a hair. And of course you've heard me go on about checking all hormones... something to keep in mind anyhow.
>
> Good luck. I've been there, stretched thin between diagnoses of ADD, bipolar II, GAD. Not knowing if meds are helping or hurting, not knowing if the stable periods are happening on their own or because of something I changed, or ate, or thought, or the sunlight I got, or didn't. Very frustrating.
>
> kate
Posted by Iago Camboa on July 31, 2002, at 5:51:14
In reply to Re: Diagnostic discombobulation - need advice » Iago Camboa, posted by BarbaraCat on July 30, 2002, at 18:26:05
Barbara,
My most exciting adventure would be getting near you, learn all about you, all your symptoms, all your medicines and dietary supplements and 'solve' once and for all your sensitive and fascinating mind as a precious and valuable little masterpiece of Nature. There are so many good things in life (even [or especially ;-)] at our age) to enjoy that one should never take rest before one got that calm attitude of mind of not allowing any single day to pass without feeling a lot of (or at least some) happiness and pleasure in it...
Of course 20 minutes every 2 months your pdoc spends with you is worth nothing if it were not you to suggest to him what to prescribe; I do the same with my doc myself: I give her a list of medicines for 2 months to copy and she passes me the scrips that allow me to buy the meds cheap enough and so long! and bye-bye that I left the car ill-parked at the parking-lot...
I also agree (as almost always) with Katekite: our dear Kate is a bit like Nature itself: prodigal, true and indifferent!... (let me take care, cause she may be reading this). Stims are always great as long as you find out a way to sleep reasonably well at night and don't get too anxious during daytime. I myself substituted 112.5mg per day clomipramine/Anafranil by 75mg Effexor plus 50mg clomipramine and I've done pretty well after a few days of insomnia at first: it acts as a mild stim on my system... I add adrafinil also and feel much better than I can say (and I would deserve!...) To end my cocktail I take .5mg Xanax at 5 pm and 1.5mg at bedtime.
I promise I shall concentrate myself to pass all my positive energy on you.A smooch to you, my soul.
Yours always, Iago
> Missed you too, Iago. I haven't seen your posts on the board in a while and wondered if you took off somewhere on an exciting adventure.
>
> > My dear Barbara,
> >
> > I have just now (Jul 30, 8:20 p.m.) found out your post of past July 27. I shall write to you as soon as possible. I'm so sorry I missed your words for 3 days.
> > Be sure I am always yours,
> > Iago
>
>
Posted by katekite on July 31, 2002, at 10:20:43
In reply to Re: spect » katekite, posted by BarbaraCat on July 31, 2002, at 0:22:48
My ADD symptoms are periodic. ADD runs in my family, but I had no problems with it as kid. It has only been a problem in the last couple years, and definitely comes and goes. I seem to have intermittent elevations in my cortisol and so that could be the reason for it all.
I have started a dexamethasone suppression test today to see where my high cortisol comes from. I feel terrible. I just wrote a really nasty post to the Lexapro rep, LOL. I could have been more polite but my fight-or-flight system is not looking like its being suppressed. My ADD symptoms are worse as well today. I don't know if its related or not.
People with auto-immune thyroid problems can later go on to get other hormonal problems. Make sure they are checking cortisol and estrogen and testoterone and all the rest at least every few years.
Take care,
Kate
Posted by BarbaraCat on August 1, 2002, at 1:28:05
In reply to Re: Diagnostic discombobulation - need advice, posted by Iago Camboa on July 31, 2002, at 5:51:14
Oh, dear friend, your words as always cheered my heart. I read your post this morning and then drove into the city for appointments and errands. It turned out to be a very difficult day with many tempers flying - mine, store clerks, drivers. Your sweet words stayed with me and helped put a smile on my face.
I have an idea for you; I think you should write a book. This book would share your life story, which is very fascinating from what I've read here. It might also share your struggles with your mood disorder if it felt safe to do so. But mainly, it would be about how an intelligent, fascinating yet vulnerable man knows how to make a woman feel cherished. This is not something most men, at least in this country, know how to do very well and they could definitely use some good advice from someone of their own gender. I'm sure that millions of women would buy this book and force their men to read it. You would be a guest on Oprah Winfrey's TV show and then billions of women would buy your book. Perhaps you want to remain anonomous (although we here would be thrilled to see you become a big star!). Even if you write under an assumed name and identity, you would still do the women of the world a huge favor. I'm not kidding, Iago. You're a gem. - ***Smooches*** - Barbara
Posted by Iago Camboa on August 2, 2002, at 5:32:37
In reply to A smooch for Iago » Iago Camboa, posted by BarbaraCat on August 1, 2002, at 1:28:05
Barbara,
Before proceeding any further you are going to promise me that you will allow me to think for quite some time on your most kind ideas regarding me. You made me so very happy with all your sweet words but you must consider that you are seeing things through the augmenting glasses of heart and not of reason, so we both have got to chill our minds for a while. Don't be afraid: the world is not going to end shortly and we have all the time before us.
I have thought many times to write something myself but I think anything interesting enough would only be feasible with an enormous contribution and the decisive help of your indispensable and essential writing talents. So my first proposal will be the following: we are going to 'enlarge' the scope of the 'book' to include both you and me and (perhaps??) some piece of romance (real or 'built-up' to the effect). What do you think?Now you should get an 'Hotmail' or 'Yahoo' account and begin to email me from there about our 'project & partnership'. Don't be scared and please don't think I am the Web's 'bugaboo' or the 'netbogyman'...
Any need to add that I love it, I mean that I happen to like you and you happen to like me...
Take care wondrous ducky.
Yours for sure, Iago
> Oh, dear friend, your words as always cheered my heart. I read your post this morning and then drove into the city for appointments and errands. It turned out to be a very difficult day with many tempers flying - mine, store clerks, drivers. Your sweet words stayed with me and helped put a smile on my face.
>
> I have an idea for you; I think you should write a book. This book would share your life story, which is very fascinating from what I've read here. It might also share your struggles with your mood disorder if it felt safe to do so. But mainly, it would be about how an intelligent, fascinating yet vulnerable man knows how to make a woman feel cherished. This is not something most men, at least in this country, know how to do very well and they could definitely use some good advice from someone of their own gender. I'm sure that millions of women would buy this book and force their men to read it. You would be a guest on Oprah Winfrey's TV show and then billions of women would buy your book. Perhaps you want to remain anonomous (although we here would be thrilled to see you become a big star!). Even if you write under an assumed name and identity, you would still do the women of the world a huge favor. I'm not kidding, Iago. You're a gem. - ***Smooches*** - Barbara
Posted by Iago Camboa on August 4, 2002, at 3:21:57
In reply to A smooch for Iago » Iago Camboa, posted by BarbaraCat on August 1, 2002, at 1:28:05
Barbara,
I only want to beg your pardon.
I'm afraid I behaved as an 'impossible' 'convinced' worthless male and you, as always, as an impeccable lady, full of dignity...
I only admire you more...Yours, Iago
Posted by BarbaraCat on August 4, 2002, at 4:00:53
In reply to Re: A smooch for Iago » BarbaraCat, posted by Iago Camboa on August 4, 2002, at 3:21:57
Don't you ever call my dear friend, Iago, worthless. He's a gentleman and a scholar.
Posted by Iago Camboa on August 4, 2002, at 10:09:44
In reply to Re: A smooch for Iago » Iago Camboa, posted by BarbaraCat on August 4, 2002, at 4:00:53
My dear Barbara,
Now you have me worried. How is it that you are awake at 4 am? It is me, your Iago, who implores you to get to bed and take enough rest even if/when you cannot sleep: every 2 hours you stay in bed well at rest are worth 1 hour of full sleep...
Be a nice girl and take care, will you my most precious one?Yours always, Iago
Posted by BarbaraCat on August 4, 2002, at 14:20:41
In reply to awake at 4 am !? » BarbaraCat, posted by Iago Camboa on August 4, 2002, at 10:09:44
Was it that late? I was actually out and about that evening with friends, so much more fun than insomnia. But you are so kind to look out for my beauty rest needs. And you need to start writing that book! Your friend, Barbara
> My dear Barbara,
>
> Now you have me worried. How is it that you are awake at 4 am? It is me, your Iago, who implores you to get to bed and take enough rest even if/when you cannot sleep: every 2 hours you stay in bed well at rest are worth 1 hour of full sleep...
> Be a nice girl and take care, will you my most precious one?
>
> Yours always, Iago
>
>
>
>
Posted by Iago Camboa on August 5, 2002, at 6:18:54
In reply to Re: awake at 4 am !? » Iago Camboa, posted by BarbaraCat on August 4, 2002, at 14:20:41
My dear Barbara,
Would you, please, get thoughtful & serious for a while and tell me without cheating how do you feel with respect to your BP2? Are you sure you are not 'doing' a little mania? Have you been sleeping reasonably well? I've got a lot of tenderness toward you and I would not like your precious little head be harmed. Please respond to this post and tell to your friend all it comes to your mind: be sure it will do you good...
I'm alone at home. My wife, my daughter and her boyfriend (who is passing a few vacation days with us) went to the beach. The weather is not that fine but at times it seems it's going to clear up: perhaps it's going to turn out a hot afternoon? Would like you and your hubby were here. My cousin's widow has just gone to the US (California) with her son for a week or so and I've always her house's keys... Her house is two minutes on foot from mine... Do you know Europe? Do you like the seaside? I prefer the mountain and I will go there with all my people by the middle of August or so for a week...May I send you a respectful gentle kiss?
Best of luck for you, my dear.
Iago
> Was it that late? I was actually out and about that evening with friends, so much more fun than insomnia. But you are so kind to look out for my beauty rest needs. And you need to start writing that book! Your friend, Barbara
>
> > My dear Barbara,
> >
> > Now you have me worried. How is it that you are awake at 4 am? It is me, your Iago, who implores you to get to bed and take enough rest even if/when you cannot sleep: every 2 hours you stay in bed well at rest are worth 1 hour of full sleep...
> > Be a nice girl and take care, will you my most precious one?
> >
> > Yours always, Iago
> >
Posted by BarbaraCat on August 5, 2002, at 11:36:47
In reply to Best of luck! » BarbaraCat, posted by Iago Camboa on August 5, 2002, at 6:18:54
I'm doing well, thank you Iago. The little town I live in had a festival going all weekend, kind of like a country fair. I've been having a very good time, being with old friends and meeting new ones. But it's been hectic anyway and I'm looking forward to some quiet time. As far the as the BP2, I haven't had any uncomfortable symptoms of it for a while. The only relapse was back in April when I ran out of lithium for almost 2 weeks and started getting hyper. But it was more funny than disruptive. I started buying whole palletts of flowers and plants and was digging dirt like mad well into the night. The lithium arrived before it descended into anything other than high energy and swirling ideas. Just recently I had an enjoyable spell of very high energy and creative output. It's difficult to get to sleep during these times because my brain is so brightly firing. It never crossed over into mania. Getting enough sleep is the key, and I'm careful to do so. But I hope to have more episodes like that. They're very productive and I remain relatively sane.
I'm reducing Remeron these days and hope to be off it completely in a few months. I've been feeling it but it hasn't been that bad. Gabapentin and benzos are important for me. I've never considered using benzos before. Tranquilizers have a bad reputation for causing unclarity and dependence, especially with people who practice yoga & meditation, as I do. Well, anxiety and stress are worse, so benzos will remain in my medicine cabinet from now on.
I was in Europe about 15 years ago, no farther south than nortwestern Italy along the Mediterranean. I enjoyed Switzerland alot because I love to hike in the mountains. Europe was wonderful. I loved the ancient historical feeling of it, so unlike this country. Would you feel OK sharing what country you live in? My guess would be Spain, or perhaps Italy.
It sounds like the meds you're taking are helping very much. My wish is that you continue to feel good. I've considered taking Adrafinal, and tried it for 2 weeks. Unfortunately, it made me feel tense and irritable, somewhat like I felt on Topamax. Everyone's chemistry is so unique. It must be very difficult for a doctor who sincerely wants to help.
Your caring friend,
Barbara
>
> Would you, please, get thoughtful & serious for a while and tell me without cheating how do you feel with respect to your BP2? Are you sure you are not 'doing' a little mania? Have you been sleeping reasonably well? I've got a lot of tenderness toward you and I would not like your precious little head be harmed. Please respond to this post and tell to your friend all it comes to your mind: be sure it will do you good...
> I'm alone at home. My wife, my daughter and her boyfriend (who is passing a few vacation days with us) went to the beach. The weather is not that fine but at times it seems it's going to clear up: perhaps it's going to turn out a hot afternoon? Would like you and your hubby were here. My cousin's widow has just gone to the US (California) with her son for a week or so and I've always her house's keys... Her house is two minutes on foot from mine... Do you know Europe? Do you like the seaside? I prefer the mountain and I will go there with all my people by the middle of August or so for a week...
>
> May I send you a respectful gentle kiss?
> Best of luck for you, my dear.
> Iago
>
>
> > Was it that late? I was actually out and about that evening with friends, so much more fun than insomnia. But you are so kind to look out for my beauty rest needs. And you need to start writing that book! Your friend, Barbara
> >
> > > My dear Barbara,
> > >
> > > Now you have me worried. How is it that you are awake at 4 am? It is me, your Iago, who implores you to get to bed and take enough rest even if/when you cannot sleep: every 2 hours you stay in bed well at rest are worth 1 hour of full sleep...
> > > Be a nice girl and take care, will you my most precious one?
> > >
> > > Yours always, Iago
> > >
>
Posted by Iago Camboa on August 11, 2002, at 3:54:49
In reply to Re: Best of luck! » Iago Camboa, posted by BarbaraCat on August 5, 2002, at 11:36:47
Barbara,
I'm just having a tenderness attack (guess toward whom?) and I've got to write to you without delay. It felt very nice to me to learn you're doing well. Of course you should enjoy and feel happy with your 'spells of very high energy and creative output'! Even mild hypomania is not any crime and may be a lot of fun... If I were you, I would 'occasionally forget' to take just one dose of lithium now and then just to see what happened...
I also know about your weight problems with the Remeron and I understand your resolve to try to get off it; only I'm not sure whether it will be the right thing not to have in your system any AD: after all if you are BP2, as it seems reasonable to assume, it would be easier for you to control your depressive phases if you had some little available. I know you felt 'tense and irritable' with the adrafinil and I recall you didn't enjoy the Effexor as well but that for me is perhaps less due to those two than to a lack of a powerful enough 'anxiolytic' even if this had to be a mild and carefully titrated anti-psychotic (but that only if you remained fog-free, clear-minded and non-oversleeping). These are only a few ideas I happened upon while I was thinking about you; of course all the decisions are and should always be yours. There are things I don't even dare to suggest (e.g. the possibility of Xanax) because they may be too risky...
I also have a very little story about weight problems. I once (some 23-24 years ago) had a little ECT in a clinic and I recall I was on an AD and on an anti-psychotic (the sole one in my whole life and I think today it was not needed) amidst several other meds. At the time it was the fashion for pdocs to prescribe 10 or 12 medicines or even more... I was ultra-euphoric (but also ultra-amnesic!), I slept a lot and... I put on not less than 22 lbs in 3 weeks... I could not put on any of my former clothes and it took me more than a whole year to get rid of that weight...
You were very close as far as my homeland is concerned. I was born and live in Portugal, in a medium-sized city on the Atlantic, in the north of the country. I also know Spain, France & Britain (many times in each), Switzerland (twice, 2 weeks), Italy (twice, 2 months), Greece (once, a week), Turkey (once, 2 weeks), Sweden (once, a week) & Denmark (once, 2 weeks). If I had to choose a very nice place to spend in a week this Aug. or Sep., I'd choose perhaps the Basque Country (NE Spain, SW France, both sides of the border, but based on a very nice hotel on the French side...)Yours, Iago
> I'm doing well, thank you Iago. The little town I live in had a festival going all weekend, kind of like a country fair. I've been having a very good time, being with old friends and meeting new ones. But it's been hectic anyway and I'm looking forward to some quiet time. As far the as the BP2, I haven't had any uncomfortable symptoms of it for a while. The only relapse was back in April when I ran out of lithium for almost 2 weeks and started getting hyper. But it was more funny than disruptive. I started buying whole palletts of flowers and plants and was digging dirt like mad well into the night. The lithium arrived before it descended into anything other than high energy and swirling ideas. Just recently I had an enjoyable spell of very high energy and creative output. It's difficult to get to sleep during these times because my brain is so brightly firing. It never crossed over into mania. Getting enough sleep is the key, and I'm careful to do so. But I hope to have more episodes like that. They're very productive and I remain relatively sane.
>
> I'm reducing Remeron these days and hope to be off it completely in a few months. I've been feeling it but it hasn't been that bad. Gabapentin and benzos are important for me. I've never considered using benzos before. Tranquilizers have a bad reputation for causing unclarity and dependence, especially with people who practice yoga & meditation, as I do. Well, anxiety and stress are worse, so benzos will remain in my medicine cabinet from now on.
>
> I was in Europe about 15 years ago, no farther south than nortwestern Italy along the Mediterranean. I enjoyed Switzerland alot because I love to hike in the mountains. Europe was wonderful. I loved the ancient historical feeling of it, so unlike this country. Would you feel OK sharing what country you live in? My guess would be Spain, or perhaps Italy.
>
> It sounds like the meds you're taking are helping very much. My wish is that you continue to feel good. I've considered taking Adrafinal, and tried it for 2 weeks. Unfortunately, it made me feel tense and irritable, somewhat like I felt on Topamax. Everyone's chemistry is so unique. It must be very difficult for a doctor who sincerely wants to help.
> Your caring friend,
> Barbara
>
Posted by BarbaraCat on August 11, 2002, at 14:33:18
In reply to Tenderness attack » BarbaraCat, posted by Iago Camboa on August 11, 2002, at 3:54:49
Good Morning Dear Iago,
Thank you so much for your helpful post, and as always, it's so nice to hear from you. I remember your saying many months ago how Xanax has helped you so much. I'm going to tell my pdoc that I now wish to try Xanax. About 4 years ago I was on it for a short time and liked it very much. There was a soothing quality to it. This is what I'm looking for in a benzo. Others don't have this soft quality, or if they do, it wears off so quickly. I've been on Klonopin and now lorezapam, and although they help to blunt edges, I'd like more. I'd like the feeling of inner peace, even though chemically induced. I've also started taking valerian root and passion flower extract, as well as getting back to a daily yoga practice. Although I don't presume that I'll ever be totally free of drugs, I'm trying to at least add nutritional and body/mind support. I haven't lost many pounds so far, but am building strength and muscle tone - and have so much more energy!I take your warning about AD's much to heart. I've been down that road before, thinking that I could do it without an AD and learned to my dismay that I could not. I'm titrating down very, very slowly from Remeron. With each reduction in dose, I have a few days of flashes of temper and impatience, but after a week or two it goes away and I feel more clear. Sure wish I could find the 'perfect' drug - don't we all? Your suggestion to skip a lithium every now and then is very interesting. Mainly, because I realize that I had inadvertently skipped my morning dose a few times and was beginning to wonder where all my glee and bustling project plans were coming from. There's such a fine line between the exhileration and scintillation of mild hypomania, and the disorganized frenzy where black depression inevitably follows as night follows day. Have you seen the movie "A Beautiful Mind"? It may not be in your country, but if it is, I wholeheartedly recommend it. It won the much deserved Academy Award for best picture here in the States. While my condition is nowhere near as devastating or brilliant as John Nash's, the movie so touchingly conveys someone who was determined to not let his illness or his medications deprive him of his spark of genius. For me the secret is this: as long as I can drag my body out of bed and get moving, I can free up energy that gets easily jammed up. From there, all else that is good for me is more evident and I have the energy and calmness to pursue it.
So you're in Portugal? I've never been there but it seems to be a beautiful and relatively unspoiled country, not as frenetic as some other European areas. The Basque Region seems very wonderful, from what I've read and heard. You're very lucky to be there, have a life and history there. I find it hard to imagine that you had ECT. It seems to be true, thought, that those who are the wisest and most compassionate beings are those who had great suffering in their lives. In order to be a shaman, it was required that the initiate was 'touched by madness' as well as possessing other more beneficial gifts. So, it helps me to think that we all who suffer from these horrible frightening conditions are really high priests and priestesses in training.
This is the end of the thread.
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