Tuesday, 18 April 2006

New theories on medical stuff

This entry is basically for my own records, read it, don't read it up to you.

Last Thursday I felt so bad (down) that I rang the doctors and got an emergency appointment. And it turned out the duty doctor was my doc so that was good. I'd just basically reached the point where I couldn't cope any longer and the idea of feeling that bad until today when the doctors reopened after the long Easter weekend scared me. A lot. Read into that what you will, you're getting no more details from me.

It was tough but I pretty much told Dr H the whole truth - including my spell of non-compliance with my meds. In a way its pretty sad but I was pretty proud of myself for finding the stength to face going to the docs, to insist on an emergency appt (I had made a non emergency appt the day before and that would have been 8th May.) and to then be able to sit there and say I've been feeling so bad that...

There are two possible theories for why this is:

  • For whatever reason the meds aren't working for me any longer.

  • I have two much of my medication (fluoxetine/prozac) in my system and as a result have gone from too little serotonin - this is a SSRI - to too much in a short time and thats making me jittery/anxious/have sleeping issues and down as a result.

  • So basically my dose has been cut from 40mg daily to 20mg daily since last thursday and I go back on the 8th of May. Dr. H is leaning towards it being theory two but I'm not sure.

    I imagine if it is that theory that things will remain as they are now but I'm not sure as I found 20mg didn;'t help my depression after a while. If it's the first theory, the med isn't working any more he's going to complete the wean and get me off of fluoxetine. At that point I would then go back onto a TCA instead of another SSRI - probably lofepramine as I took that for ages and got on pretty well with it. Again an issue with going back to lofepramine would be doseage - starting dose is 70mg daily, therapeutic dose is 70mg BID (twice daily) and after a while I ended up on 70mg am and 140mg pm which depending on which GP you speak to is, higher than the maximum dose, the maximum dose or the preferred maximum dose but you can take 140mg BID in rare cases. It's confusing. And its also pretty dangerous - surely there should be some consequenous as to what actually is an acceptable doseage/the maximum dose? that really does little for my faith in the medical profession.

    I'm trying hard not to worry about that at the moment but it's not easy!

    I'm feeling a little better - i can't determine if its the med change or the fact I took control back and I'm controling the depression rather than it controlling me. And no nausea for a while.

    My legs are incredibly spastic lately - i suspect it's a depression thing as I very much have bio/chemical depression but I don't remember spasticity being an issue that way before. I've been playing w/ my baclofen dose lately but might have a word w/ dr H when I go back about upping it permanently. I should probably point out I have permission from both Dr H and my consultant at the hosp to play w/ the dose under certain guidelines which I'm following. And finally I guess I need to ask him about if I need to have bloods I had done before I started baclofen redone - lfts and fbc/

    1 comment:

    starhearts said...

    Hi Emma! I really, really hope you are feeling better soon as I have missed chatting with you and only now from having a few minutes to catch up realized that I could have been writing to say hi sooner! Meds are a challenge and I wish you all the luck and God's care as this gets all sorted out. Chemistry is a strange thing to balance out but I know your doc will take great care of you now that he knows you need a helping hand. I know my doc is just great and if I had to go to him tomorrow I would be off work on leave in a heart beat with nothing more than...things aren't going well... (they are ok now but that is an example of the past of what he has been like). If your doc cares (which I think most do in their own ways), he will give you the best care he can. :) HUGS in the mean time and if you want to chat email or msn me!!!! I have this week off so I have tons of time and am always glad to chat with you anyways as you know :) Love ya!! C.


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