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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by floatingbridge on August 19, 2011, at 22:09:31
when others here endure so much. But the overall quality of my thoughts is not good. I feel like it's not me, whatever that means. I am not sure how to evaluate the recurrent ideation along with the lack of will.
It's only one month on Emsam. Upped to 9mg a little over two weeks ago. That's not long, is it?
My next appt is two weeks away.
I make myself walk. I sit at my loom and weave a bit. I keep
trying to do those good things. I can't seem to stop pulling back from the world. I can't seem to touch it. I will endure, but not sure what to do. I don't admit certain things to doctors.
Posted by floatingbridge on August 19, 2011, at 22:46:51
In reply to Look, I know I complain,, posted by floatingbridge on August 19, 2011, at 22:09:31
Posted by emmanuel98 on August 19, 2011, at 23:28:40
In reply to Look, I know I complain,, posted by floatingbridge on August 19, 2011, at 22:09:31
What don't you admit to doctors? My DBT therapist urges me to meet with friends and let them know I am depressed, so they can help me. I did this last week, and it really helped. It pulled me out of my self-imposed isolation and forced me to connect with friends, though I was embarassed to admit I was depressed again. I forced myself to exercise, which helped some. I slept a lot, which also helped.
> My next appt is two weeks away.
>
> I make myself walk. I sit at my loom and weave a bit. I keep
> trying to do those good things. I can't seem to stop pulling back from the world. I can't seem to touch it. I will endure, but not sure what to do. I don't admit certain things to doctors.
Posted by floatingbridge on August 20, 2011, at 1:55:34
In reply to Re: Look, I know I complain,, posted by emmanuel98 on August 19, 2011, at 23:28:40
That I am tired of trying. That if I need to keep trying this much, what is the point? That medication doesn't work. My body doesn't work. That I want to give up now. That I do those things and feel blank. That my son is laughing and the chickens are loose in the yard, and the world seems bright and buzzing, and I cannot meet it because my fatigue is so great that I move in a stupor and stare at the colors that were once my love the way I stare at the food on my plate without appetite.
Posted by floatingbridge on August 20, 2011, at 8:55:30
In reply to Look, I know I complain,, posted by floatingbridge on August 19, 2011, at 22:09:31
I haven 't tried ami yet, though worry about the sides, tolerating them.
Lamictal has some analgesic qualities.
Nuerontin for sleep and pain.
Anyone else deal with fibromyalgia?
The current big three, Lyrica, cymbalta, Savella, do not work.
Posted by Phillipa on August 20, 2011, at 11:12:52
In reply to Lowvdose amitriptylne with emsam for fibromyalgia, posted by floatingbridge on August 20, 2011, at 8:55:30
Are you positive it's not something else? I know you have been scanned tested over and over again. I do know the feeling but I do force myself to excercise only bike rides but better than nothing. Love Phillipa
Posted by floatingbridge on August 20, 2011, at 18:57:44
In reply to Re: Lowvdose amitriptylne with emsam for fibromyalgia » floatingbridge, posted by Phillipa on August 20, 2011, at 11:12:52
http://www.ncbi.nlm.nih.gov/corecgi/tileshop/tileshop.fcgi?p=PMC3&id=245281&s=26&r=1&c=1
I don't know what else to do. Or if working within there guidelines will address depression.....
Posted by Phillipa on August 20, 2011, at 21:54:05
In reply to Anyone with fibromyalgia? New treatment algorithm » Phillipa, posted by floatingbridge on August 20, 2011, at 18:57:44
FB have no idea? Where to now? Love Phillipa
Posted by SLS on August 20, 2011, at 23:23:22
In reply to Look, I know I complain,, posted by floatingbridge on August 19, 2011, at 22:09:31
> when others here endure so much. But the overall quality of my thoughts is not good. I feel like it's not me, whatever that means. I am not sure how to evaluate the recurrent ideation along with the lack of will.
>
> It's only one month on Emsam. Upped to 9mg a little over two weeks ago. That's not long, is it?
>
> My next appt is two weeks away.
>
> I make myself walk. I sit at my loom and weave a bit. I keep
> trying to do those good things. I can't seem to stop pulling back from the world. I can't seem to touch it. I will endure, but not sure what to do. I don't admit certain things to doctors.
It would be interesting to see how Zyprexa affects you, even if used as a probe for a short trial. One week should be enough to see if it produces an improvement in your condition. It might provide a clue as to which direction to head in. I know one woman who did wonderfully on a combination of Zyprexa and Trileptal. She was being treated for BPD. Concurrent treatment using CBT helped a great deal. I know we are not sure if you have BPD, but perhaps there are overlapping etiologies.Trileptal, like its cousin drug, Tegretol, is good for reducing anger, irritability and impulse control.
- Scott
Posted by SLS on August 20, 2011, at 23:30:00
In reply to Lowvdose amitriptylne with emsam for fibromyalgia, posted by floatingbridge on August 20, 2011, at 8:55:30
> I haven 't tried ami yet, though worry about the sides, tolerating them.
>
> Lamictal has some analgesic qualities.
>
> Nuerontin for sleep and pain.
>
> Anyone else deal with fibromyalgia?
>
> The current big three, Lyrica, cymbalta, Savella, do not work.
LDN maybe?If amitriptyline is intolerable, perhaps nortriptyline would provide similar results. It is likely that you can mix both of these TCAs with Emsam. I was on Emsam and nortriptyline concurrently. I did not react well to Emsam. It made me dysphoric and agitated.
- Scott
Posted by floatingbridge on August 21, 2011, at 6:49:17
In reply to Re: Look, I know I complain, » floatingbridge, posted by SLS on August 20, 2011, at 23:23:22
Scott, thanks for taking my posts seriously.
Triliptal looks tolerable enough. Plus it is said to have a positive mood effect.
I had been considering lamictal because I had encountered mention of analgesic qualities.
Zyprexa is an interesting suggestion in conjunction w/ triliptal. I did alright on risperdone. My fear with AP's is the DA binding qualities (that I suspect tanked abilify and seroquel) given my brightest response being to amphetamine.
I had hoped to capture that with Emsam, but am thinking contemplating it's failure, and I find you experience with Emsam interesting. I have been holding out so much hope for it.
My idea of gabapentin was for help sleeping. I'm not sure any of the meds you mention help with that.
To decrease the bouts of dyshoria would be wonderful.
Thanks for some new directions. I am not sure if I should just fold the Mao inhibitor hand at this point.
Thanks for your kindness,
fb
Posted by Phillipa on August 21, 2011, at 19:40:18
In reply to Fibromyalgia, fatigue, BPD, posted by floatingbridge on August 21, 2011, at 6:49:17
I took low dose trileptal and not a single side effect was supposed to raise dose and couldn't afford the med as was new then. As for neurotin next door neighbor takes it with her xanax for sleep and says it really helps her sleep though the night well. I've been thinking of it also. Love Phillipa
Posted by floatingbridge on August 21, 2011, at 20:16:54
In reply to Re: Fibromyalgia, fatigue, BPD » floatingbridge, posted by Phillipa on August 21, 2011, at 19:40:18
Thanks Phillipa. I need to sleep for more than two hours at a time. Thanks for the encouragement about sx's, too. You know that's a concern for me.
Posted by B2chica on August 22, 2011, at 8:35:34
In reply to Re: Look, I know I complain, » emmanuel98, posted by floatingbridge on August 20, 2011, at 1:55:34
it looks like i may have written that post...
b2c.
Posted by hyperfocus on August 22, 2011, at 21:40:28
In reply to Look, I know I complain,, posted by floatingbridge on August 19, 2011, at 22:09:31
It's not complaining. Writing about how you feel always has a positive effect both on you and the people who care about you. It's the silences that are worrying.
Yes, getting better will be a non-linear thing. There are going to be days, months, or longer when you feel like absolute crap. Do you keep a daily journal? You should record your daily med intake and mood and depression level, etc. so you can analyze it later.
I'd say stick on the Emsam for at least 8 weeks. You don't really know for sure what a med is doing for you even if it doesn't produce significant surface effects on your day-to-day functioning. And, more importantly, you've been on it for a couple of weeks already - might as well stick it out for a full trial. MAOIs can begin working after a couple of weeks, from reports I've read here. It's a pretty crappy deal, but it's not impossible.
The side-effects of amitriptyline at 10mg should be much reduced, and at a low dose it means you could (MAYBE, ask your doc) take it concomitantly with the Emsam. I don't see the SEs of amitrip as being worse than a full theraputic dose of something like like Zyprexa. Even without the AD effects, it can manage the fibro pain and insomnia very effectively.
Why go on? Well one reason would be your family. Even if you're in a lot of pain you still make them happy. If can't do it for yourself then you can do it for them. Like I told you before: if you try looking back at the past or divining years into the future all you're going to do is freak yourself out. Even if you want to, you can't live your life more than one day at a time. You're so lucky to have your own family - I envy you. So try not to think about next month and don't freak out if your mood dips very low on a given day - you still have a huge amount of living to do.
I was watching this mini-series on Florence Nightingale on how though she tried her best for the soldiers she cared for and they all loved her, it was discovered that death rates at her hospital were actually way higher than the average because she neglected sanitation and waste management and water sources. She spent a week catatonic, unable to eat, sleep or talk, consumed with despair on what a terrible person she was and how badly she had screwed up what God called her to do. And then her father told her that she was mortal, and made mistakes, and maybe the mistakes were what God wanted her to do as well. She then took her knowledge and went on to create the modern practice of nursing as we know it - principles which are followed in every hospital to this day. So the point I'm making is that pain and despair and mistakes we make can be part of living too - it's not wasted effort.
Posted by floatingbridge on August 24, 2011, at 22:37:42
In reply to Re: Look, I know I complain, » floatingbridge, posted by hyperfocus on August 22, 2011, at 21:40:28
Hi HP,
I thought about the Florence Nightingale story for a few days. At first, I didn't get it. Yesterday, I had a conference with my son's play therapist, and she gave me solid marks on parenting. I really tried to take that in and not discount it. I seem to concentrate on what I cannot do. So your story came back to me last night, like, oh, maybe that's what he meant.
Thanks for your support. I wish you to have what you wish for, too. You seem to have such ability to foster positive change. You are right that I am lucky to have a family, a good family, really. Being a mom has reopened many issues. I fear having the audacity to have had a child. The responsibility of parenting, even the intimacy involved are major efforts. They really don't come easily to me. The love
does, but not the skills. And fear can create such an eclipse. Then there is the worry. You can imagine. But then, it's that phenomena I experience of others being somehow more alright than myself.Jeez, with Emsam on board my pdoc will not script the ami. So I am staying steady on the Emsam and risperdone. That's good advice, and I appreciate you reminding me to stay steady. That was my doc's advice today too.
Thanks HP.
Posted by floatingbridge on August 24, 2011, at 22:38:44
In reply to Re: Look, I know I complain, » floatingbridge, posted by B2chica on August 22, 2011, at 8:35:34
> it looks like i may have written that post...
> b2c.:-/
You hanging in there?
Posted by Phillipa on August 24, 2011, at 23:44:10
In reply to Re: Look, I know I complain, » B2chica, posted by floatingbridge on August 24, 2011, at 22:38:44
FB back on the resperidone? And EMSAM 6 or 9mg? Xanax also? Love Phillipa
Posted by B2chica on August 25, 2011, at 13:32:54
In reply to Re: Look, I know I complain, » B2chica, posted by floatingbridge on August 24, 2011, at 22:38:44
Posted by floatingbridge on August 25, 2011, at 13:51:39
In reply to not very well (nm) » floatingbridge, posted by B2chica on August 25, 2011, at 13:32:54
I'm sorry B2c. Are you have some major stressors in addition to the usual?
When you see your doc next?
fb
Posted by maggiemae on September 11, 2011, at 15:25:44
In reply to Anyone with fibromyalgia? New treatment algorithm » Phillipa, posted by floatingbridge on August 20, 2011, at 18:57:44
> http://www.ncbi.nlm.nih.gov/corecgi/tileshop/tileshop.fcgi?p=PMC3&id=245281&s=26&r=1&c=1
>
> I don't know what else to do. Or if working within there guidelines will address depression.....Do you have the citation to the above chart?
Posted by floatingbridge on September 12, 2011, at 0:33:07
In reply to Re: Anyone with fibromyalgia? New treatment algorithm, posted by maggiemae on September 11, 2011, at 15:25:44
> > http://www.ncbi.nlm.nih.gov/corecgi/tileshop/tileshop.fcgi?p=PMC3&id=245281&s=26&r=1&c=1
> >
> > I don't know what else to do. Or if working within there guidelines will address depression.....
>
> Do you have the citation to the above chart?
>Darn, Maggiemae, I do not. I did a little googling tonight and did not recover the source.
I found it similarly by googling. Maybe go to the address only omitting everything after .gov.
Hmmm. Let me see....
You dealing with fibromyalgia?
Posted by floatingbridge on September 12, 2011, at 0:57:20
In reply to Re: Anyone with fibromyalgia? New treatment algorithm, posted by maggiemae on September 11, 2011, at 15:25:44
> > http://www.ncbi.nlm.nih.gov/corecgi/tileshop/tileshop.fcgi?p=PMC3&id=245281&s=26&r=1&c=1
> >
> > I don't know what else to do. Or if working within there guidelines will address depression.....
>
> Do you have the citation to the above
This should provide full text articles. Still didn't find that one.
This is the end of the thread.
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