![[dr. bob]](/dr-bob-sm.gif)
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 Solstice on February 28, 2012, at 21:21:56
Yesterday the PDoc said to withhold the Saphris. She didn't say specifically why. I asked about withholding Lithium instead, and she said "No.. don't give her Saphris tonight." Anyway, after talking to my daughter let's call her "Moon" and discussing it here, I decided to go with Moon's instincts and last night she took Saphris, but not the Lithium.
So... early this morning PDoc called and left a voice mail "I wanted to check and see how Moon is doing this morning without the antipsychotic" ???? I was so glad I didn't answer the phone! I thought - what the heck! Did she see us on babble and recognize who we are?? Does she know from reading here that I gave her the Saphris last night, but not the lithium - doing exactly the opposite of what she instructed?? I couldn't imagine why else she would call - considering Moon had been asleep the whole time she had 'gone without her antipsychotic' :-) I was paranoid, for sure.
I thought I'd just wait, and maybe call back later after Moon got home from school today.
But PDoc tracked me down - called and got me at about noon.
She asked how Moon was doing. I was evasive.. "Well, she's been at school.." So PDoc said "Well, I wanted to take her off the Saphris because there's this condition called Neuroleptic Malignant Syndrome.." I told her I knew about it, and I told her that although Moon did complain of heat on her neck and lower face Saturday night, that she definitely did not have a fever... and that although she has complained a lot about muscle tension, she does not have rigidity or stiffening, and that I thought it more being about her intense anxiety, which PDoc recognizes as Moon's perfectionism. Anyway, I didn't fess up, but I realized that I'm going to get myself in a bind over it when we see PDoc next week.
That said, Moon told me this afternoon that she felt much better today, and she thinks the residual symptoms are because the lithium hasn't gotten out of her system. I told her she may need to drop the Saphris until we see PDoc, and Moon got very upset. She said "And so do you mean I'll take NOTHING for my bipolar!?!" She does NOT want to take the lithium, and she was emphatic about wanting to give Saphris a chance.
So.. I think I'll call PDoc tomorrow and just tell her that Moon wants to stay on Saphris, and get off Lithium. I'll tell her that we've studied the symptoms, and that she doesn't have the two most 'cardinal' symptoms of NMS (fever & muscle stiffening), and the other ones (disorientation/confusion and tremors) could easily be caused by Lithium alone, or the combination of Lithium and Saphris.
Wish me luck!
Solstice
Posted by Phillipa on February 28, 2012, at 21:41:36
In reply to Saphris vs Lithium - call from PDoc today re Moon, posted by Solstice on February 28, 2012, at 21:21:56
Tell the truth as you aren't doing your Moon or yourself any favors. Maybe it was the start of it? Didn't you post neck stiffness one night that resolved by morning? I myself always have to fess up or how would I really know. The doc did say the opposite. And Good luck Phillipa
Posted by Solstice on February 28, 2012, at 22:10:47
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon » Solstice, posted by Phillipa on February 28, 2012, at 21:41:36
> Tell the truth as you aren't doing your Moon or yourself any favors. Maybe it was the start of it? Didn't you post neck stiffness one night that resolved by morning? I myself always have to fess up or how would I really know. The doc did say the opposite. And Good luck Phillipa
Sunday morning Moon woke up saying her neck was 'stiff,; but as I think I explained in that thread, it turned out it just felt like it had a crick (is that how it's spelled?) in her neck - it wasn't 'stiff' in the way that NMS causes muscle rigidity. And it went away after she got up and got moving.
Still.. if the doctor had told me in the first place *why* she wanted to take Saphris out, we could have straightened it out right then and there. This PDoc tends, at times, to not tell you everything you need to know. I hate just being 'told' to do (or not do) something, without being given the reasoning behind it. And this PDoc knows that about me. So I think that when she told me to drop the Saphris in what seemed to be an arbitrary way, she was leaving the door open for me to do something different if my research and instincts gave me a good reason to drop the lithium and keep the saphris.
But.. I'll call her tomorrow to make my case for keeping saphris and dropping lithium, and see how it goes.
Solstice
Posted by Twinleaf on February 28, 2012, at 22:11:33
In reply to Saphris vs Lithium - call from PDoc today re Moon, posted by Solstice on February 28, 2012, at 21:21:56
Wow. I think you are doing the right thing, and you are very well-informed and observant about side effects. Saphris by itself has the possibility of being a very good medication for her, whereas lithium probably doesn't.
How to get the pdoc on board? She is probably quite fearful about NMS right now. I guess it would be a good idea to let her know what you are doing as soon as you see that your daughter is doing better. Be sure that she knows how much she can trust your knowledge about side effects, as that will ease her anxieties.
Good luck, and I do hope your daughter does well with the Saphris. She seems to have a very positive instinct about it.
Posted by Solstice on February 28, 2012, at 22:34:40
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon, posted by Twinleaf on February 28, 2012, at 22:11:33
> Wow. I think you are doing the right thing, and you are very well-informed and observant about side effects. Saphris by itself has the possibility of being a very good medication for her, whereas lithium probably doesn't.
>
> How to get the pdoc on board? She is probably quite fearful about NMS right now. I guess it would be a good idea to let her know what you are doing as soon as you see that your daughter is doing better. Be sure that she knows how much she can trust your knowledge about side effects, as that will ease her anxieties.
>
> Good luck, and I do hope your daughter does well with the Saphris. She seems to have a very positive instinct about it.
Thanks so much, Twin..And she does trust me. When we talked about the NMS, and it was clear that I understood it, she seemed relieved. She said "and if she does get worse, don't even call me - just take her to the ER and call me from there" and I said "Trust me, the minute she even gets a fever, we're outta here" and she responded chuckling and saying "Yeah, I knew I could trust you to stay on top of it."
So... I'm hoping I can get her on board with letting Moon work with the Saphris. I think Moon's strong desire to work with it - that alone may assist in mitigating this episode... maybe 'trigger' a resolution to the episode?
Solstice
Posted by SLS on February 29, 2012, at 6:48:17
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon, posted by Twinleaf on February 28, 2012, at 22:11:33
I agree.
- Scott
> Wow. I think you are doing the right thing, and you are very well-informed and observant about side effects. Saphris by itself has the possibility of being a very good medication for her, whereas lithium probably doesn't.
>
> How to get the pdoc on board? She is probably quite fearful about NMS right now. I guess it would be a good idea to let her know what you are doing as soon as you see that your daughter is doing better. Be sure that she knows how much she can trust your knowledge about side effects, as that will ease her anxieties.
>
> Good luck, and I do hope your daughter does well with the Saphris. She seems to have a very positive instinct about it.
Posted by Solstice on February 29, 2012, at 14:06:33
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon, posted by SLS on February 29, 2012, at 6:48:17
Well.. I am very excited! I talked to Moon at about 10 and got an update on how she feels. She's pretty good. Still overwhelmed about how far behind she is academically.. but otherwise seems closer to her *normal* self. (Two days off the lithium).I left a message for PDoc, and she called me back an hour ago. She was great. I told her that Moon insists she wants to take the Saphris, and definitely does NOT want to take the lithium. I said "I don't want to get in trouble over this, but last night I gave her the saphris and we did not do the lithium." PDoc laughed, and said she just really didn't want to see anything 'bad' happen to Moon (she's been involved with Moon since she was 4). I told her "Well, I do know what the symptoms of NMS are, and I will keep an eye out for it." PDoc said "And that Moon wants to work with the Saphris is something we shouldn't ignore." So - we're good to go as far as:
- No Lithium
- Yes SaphrisWe have an apt next Tuesday that I'll have to participate in by phone call.
I'm just so relieved to have that monkey off my back.. and we'll keep our fingers crossed that the Saphris & Lamictal combo is effective
Solstice
> I agree.
>
>
> - Scott
>
>
> > Wow. I think you are doing the right thing, and you are very well-informed and observant about side effects. Saphris by itself has the possibility of being a very good medication for her, whereas lithium probably doesn't.
> >
> > How to get the pdoc on board? She is probably quite fearful about NMS right now. I guess it would be a good idea to let her know what you are doing as soon as you see that your daughter is doing better. Be sure that she knows how much she can trust your knowledge about side effects, as that will ease her anxieties.
> >
> > Good luck, and I do hope your daughter does well with the Saphris. She seems to have a very positive instinct about it.
>
>
Posted by SLS on February 29, 2012, at 14:32:00
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon » SLS, posted by Solstice on February 29, 2012, at 14:06:33
> Well.. I am very excited! I talked to Moon at about 10 and got an update on how she feels. She's pretty good. Still overwhelmed about how far behind she is academically.. but otherwise seems closer to her *normal* self. (Two days off the lithium)
:-)
- Scott
Posted by Beckett on February 29, 2012, at 17:58:14
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon » SLS, posted by Solstice on February 29, 2012, at 14:06:33
Best of luck with this Solstice.
Posted by Phillipa on February 29, 2012, at 18:08:20
In reply to Re: Saphris vs Lithium - call from PDoc today re Moon » SLS, posted by Solstice on February 29, 2012, at 14:06:33
That's great!!!! Phillipa
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.