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    living better through chemistry

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  1. I keep a list of my current meds with dosages in the health app on my phone. That list is available from the lock screen in the event EMTs need it, but I also reference it at regular appointments. I get my meds from Walgreens. Through their app, I can see pictures of what each pill/capsule dispensed looks like. I think that is generally less important to know than what you're currently taking and how much. It's not generally necessary to bring your history in more than once (per provider). Just the list of current meds.
  2. When you have any kind of illness, particularly a chronic illness, it is important to track information like treatments (meds, surgeries, other), effects, and the names of the doctors who performed those treatments (prescribed meds, led the surgery team, etc.). Otherwise any new doctors treating the illness (or something related/adjacent to it) have to start almost from ground zero. This will slow the progress on your treatment and prevent doctors from seeing patterns or new treatment options that might be beneficial. My memory is shit. I keep two spreadsheets (because this Geek is a geek). Others here keep word documents. It's never too late to start! Take a look at a recent post I made on exactly this topic.
  3. I would bring a bullet point list of your history, noting highs and lows and possible causes. Bring your mood tracking data to offer at the end, I wouldn't spend session time on it specifically. Bring a list of any meds you've tried, their effects (helped or not, what side effects), the max dose, how long you took it, and with what else (or whatever of that information you can remember). Review your family history of mental illness. Bring notes on that if there's much you might not remember. I would feel comfortable saying "I'm know you're the doctor, but I've done a lot of reading and I think XX fits well with the symptoms I've noticed." Be willing to follow her lead, but honestly that's a line for me - my doctors have to treat me like an intelligent, educated individual and not feel threatened. That's not to say I refuse treatment that doesn't match my self-diagnosis, but I will ask questions about the method and treatment and reasoning. They've gotta be okay with that.
  4. I have a sense that "recovery" and "remission" are different things. "Remission" as others have noted, is a technical term with a strict definition. "Recovery" seems to me to be related but separate. Is depression, like addiction, something which one is eternally "in recovery" from, even if asymptomatic? Not sure...
  5. Trouble at pharmacy

    That's horrible, @Beachbeach. I'm so sorry it happened to you. Is there another Walmart nearby you could try? Maybe it's just this store/pharmacist? I haven't gotten my prescriptions from Walmart in a long time, though I used them and Sam's Club when I had no insurance. I never had those kinds of issues though. Sam's Club has the same or better prescription prices as Walmart and you do not have to be a member to use their pharmacy. Might be worth a try? Did they at least give you back the paper rx for the Adderall so you could get it filled at CVS? Another thought would be to check out GoodRx.com, which can often help you get discounts even with insurance (or better than insurance), even for generics like you'd be taking. Also, their app for your phone will tell you the prices at all the local pharmacies so you can decide where to go. I use Walgreens for my prescriptions, which are, currently, Prozac 40mg & Vyvanse 70mg daily in the morning, Abilify 10mg, Trazodone 200mg & Xanax 1mg at bedtime, plus Singulair 10mg for asthma/allergies. I use a couple different Walgreens locations based on convenience. I've taken more complicated cocktails also. The only issue I had was recently I was told a pharmacist (rather than a tech) had to be the one to release one of my meds to me based on (I assume new) state law. She asked if I had any questions, I said I've been taking both a long time and am familiar with their effects, and then they let me check out. Nobody even mentioned the name of the meds let alone which was the issue (I was picking up Trazodone & Singulair).
  6. You know the saying don't think about pink elephants? And then all you can think about is pink elephants? SH is like that, for me. I really don't think that cutting while you're on a psych ward will get you what you're hoping in the long run. In the short run it will just make life that much more miserable as you lose what few freedoms you might otherwise have had. Can you try some harm reduction stuff? Look through the lists pinned in this forum for ideas - stuff like cold shower, squeezing ice, that kind of thing.
  7. Hi @rainyday107. I hope your consult went well. I was in a trial for using ketamine to treat depression. I explained how it worked for me in a post over in the depression forum. My issues include complex PTSD, as well as severe, treatment-resistant depression. Ketamine by IV probably would have made it possible to do work on my trauma without completely losing it. Unfortunately for me, the effects only lasted about 4-6 weeks. I can't afford the time or money to do outpatient, out-of-pocket IV infusions so... I continue on with options covered by insurance. For what it's worth, although I did not enjoy the dissociative effects of ketamine, it didn't stir up any trauma for me. I was fairly relaxed/laid back and just sort of stared off into space. I imagined working/living in a universe with more spacial dimensions, among other (geeky) things. YMMV of course, but if you start getting upset or triggered, just tell the staff. They know what to do to help you out.
  8. @Wonderful.Cheese how'd it go? I hate salesmen. I hope you found something you like (or at least can tolerate). @jt07, I have found I can't highlight/select and delete, but if you set your cursor directly before the tag and then press delete/backspace, that usually works for me. Tags behave oddly. Like Rabbit, I didn't get notified of the quote, which is also weird.
  9. My pdoc views these kinds of dreams, at least for me, as a symptom of anxiety. When I have reported dreams like this (though in mine the suicides are never successful, so I wake up even more mad) she increased or added a benzo.
  10. I hate adjusting to a new car. I drive a subcompact. It replaced the subcompact that I totaled in November. However, I sometimes need to drive my friends A&T's cars. A drives a small SUV, T drives a small pickup truck. What I noticed is that from their cars in some ways I feel safer. The sightlines are better because you sit higher up. I can see better around me. I bet, once you get used to it, you'll like the SUV as much as or better than your small car. Are there any really big companies near you? Sometimes really big companies have "campuses" with multiple buildings. Those are great places to go on weekends to practice driving because the streets are full size but there's no one there. You can also use google maps to search for business parks, universities, or deserted malls. Any of those places would be good for practicing driving. My practice order would be empty parking lots/business parks, then quiet residential streets, then main streets, then county highways, then interstates once you're confident in how the car responds to gas and brakes. You can do this, Cheese. Really! Keep us updated.
  11. (apologies if this should be in a different forum, I wasn't quite sure where to put it) Many users here take multiple medications for MI. Many if not most of us have not found the first med we tried (or second or third or...) to work - or it did work, but the side effects were unacceptable. I want to encourage everyone to keep track of what meds they've taken, for how long, at what dosages, the prescribing Dr and (importantly) your overall thoughts on their effects. While our pdocs do keep this information in our charts, it is to our benefit to have our own notes on it. That lets us educate other pdocs we might work with and be knowledgeable ourselves about our history. MI can impact our memory and once you get past a certain number of meds it can be hard to remember the details. I have two files that I keep this information in, both are Excel spreadsheets. The first is my psych med history. Here's a screenshot of part of it. You can see I list the max dose I tried as well as the dates I took it, who prescribed it (deleted from the screenshot for confidentiality), and so on. This file has multiple tables divided out by purpose of the med, so there are also tables lower down for sleep, ADHD, other meds (e.g. cogentin, deplin, etc.), and other treatments (TMS, ECT & ketamine). I also have a section on hospitalizations (dates I was IP, which hospital, and I recently added a column with my thoughts/reflections on the stay, so I can remember for future why I will NOT go to a certain hospital again). At the bottom of the document I have "last updated on <date>" The other file I have is new, I only recently created it. It is meant to complement the history file, not replace it. I was realizing that it is hard to look at the history tables and see what was taken concurrently and where the hospitalizations occurred relative to other med trials. I created a second spreadsheet where I divided out each med by class and show it as a horizontal bar (merged cells). Each column in this spreadsheet is roughly equivalent to a week, with 4 weeks/month (meaning 48 weeks per year, but I was unwilling to figure out which months had 5 weeks in which years, I decided this was accurate enough). From this screenshot, you can see how easy it is to see what was going on for me in 2015/2016. This is a rather geeky approach to data management. However it has been highly beneficial. I printed out this second chart (landscape orientation, to maximize how much fits per page) and brought it to my pdoc the other day - she absolutely loved it. If you don't have all the information, don't despair! Most pharmacies will allow you to download prescription records going back 12-24 months, or even longer if you so desire. You can use look for posts you made here about med changes you were considering. You can even talk to your doctor(s) about getting a list of meds/doses they've had you try. Your charts don't have to be complete (mine aren't, and I've been tracking in some way for years - for example, pretty sure I was on Ambien for longer than shown in the screenshot above), but having some data is better than none. Feel free to reply here or PM me if you want help setting up your own record keeping charts.
  12. recommend a diet please

    I'll echo the advice for a nutritionist or dietician used to working with people with MI. I sat down with one about 6 months ago and she recommended following the diet outlined in this book: The Ultimate Diabetes Meal Planner. I don't have diabetes, but she said it is a good, balanced diet with lots of flexibility. The book is great because it comes with 12 weeks of meal plans (3 meals + 0-3 snacks per day) for 5 different daily calorie totals. There's shopping lists and stuff as well. The dietician I saw primarily works with people recovering from EDs, so the structure is really helpful if that's what you want. You can also use it more as a guide and switch things out following diabetes exchange lists (google it, there's lots of info about that). I'll note that this dietician and a pdoc I saw (who both work at the top area ED treatment facility) warned me away from no-carb diets. Carbs are important. They break down into glucose and your brain needs glucose to operate. Low carb is one thing, but be careful not to cut too much carbs out.
  13. From AAPs, I have tried Abilify, Rexulti and Vraylar - always with an antidepressant, though apparently not an SSRI specifically. I took Abilify in combination with Parnate (MAOI) (as well as, simultaneously, Lithium, Lamictal and Ritalin - making @jt07's magic formula). I took Rexulti with Trintellix and later Imipramine (a tricyclic), and simultaneously with Vyvanse. I took Vraylar while also taking Remeron (and Vyvanse). I augmented EffexorXR (SNRI) with Lamictal prior to washing out and trying Parnate. When I took Lexapro this winter, and when I switched to Pristiq in February, I was not augmenting either with an AAP. Trazodone (for sleep, no more than 200mg) and Vyvanse. Other SSRIs I've tried (Paxil and Zoloft) didn't agree with me. Wellbutrin was too stimulating and had no benefits. Mirapex made me ill, as did Buprenorphine. I took Strattera for a while, with Lexapro (many years ago) and more recently with Imipramine. It was less effective than stimulants. I prefer amphetamines to methylphenidates. --- I saw pdoc today. She wants to try Nardil (an MAOI), because I had a better response to Parnate than any other AD (until it pooped out or something) and she thinks Nardil is worth a shot because I have pretty anxious depression. I'm to taper quite quickly off of the Pristiq (100mg every other day for 3 doses, then nothing). She's also introducing Abilify (2.5mg for two nights, then up to 5mg on-going) to help "bridge" the washout. She did that when I took Parnate too, and I stayed on Abilify for almost 2 years. I am not looking forward to taking an MAOI again. The diet and drug restrictions, regularly taking my blood pressure, no Vyvanse (or even Ritalin derivatives, at least initially)... *sigh* On the other hand, the other thing that had much benefit was ECT (but I can't work while getting it frequently enough to be beneficial).
  14. Update, 5 months later... Lexapro didn't help. I took up to 40mg from late November 2017 thru early February 2018, culminating in a 6-day IP stay at the beginning of February. While IP, I was (abruptly) taken off of 40mg Lexapro and started on 100mg Pristiq. I saw my outpatient pdoc two days after discharge and she said to reduce the Pristiq to 50mg/day (due to no studies proving increased efficacy at 100mg/day) and said I could take some Lexapro to attenuate the discontinuation effects I was having. I tapered off the Lexapro over the course of about 2 weeks. She also added, temporarily, up to 0.5mg Xanax nightly because anxiety was keeping me awake. I had been prescribed 150-200mg/night of Trazodone for sleep and found that with Pristiq I had to take 200mg. Pristiq seems to have had minimal to no benefit. My pdoc added Mirapex, quickly tapering up from 0.125mg/day to 0.75mg/day (taper was 0.125mg increase every 3-4 days). Upon reaching 0.75mg daily dose I started getting daily low-level headaches (3/10 pain level) and had 3 migraines within 6 days of the dose change (my previous most-recent migraine was 5-6 months prior). So pdoc had me stop that. About 4 weeks ago, pdoc had me increase the Pristiq to 100mg. No benefits. Sleep is harder. I started having weird/vivid dreams (I don't usually dream). She suggested perhaps with the 200mg Traz I was getting too much serotonin so had me try reducing that to 150mg/night. That didn't change the dreams but did reduce the amount of sleep I was getting (I fall asleep okay, but have been waking up early). After a week, she said I could go back up to 200mg/night because lack of sleep is a big/quick trigger for my depression. My depression ebbs and flows, always has. I am doing quite poorly at the moment, and am (again) not far from being sent IP, if I were honest with my care team. Last Friday I cried in my pdoc's office for the first time since February (I see her weekly). She said she was going to do a deep review of my chart and have a plan for when I see her tomorrow. I know that two meds she's talked about before are Fetzima and Depakote. I'm not excited about weight gain from Depakote. Given how Pristiq is (not) working, another SNRI like Fetzima seems like a long shot. I'm feeling pretty hopeless and out of options.