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About Silver

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    Adopt, adapt, improve.

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  1. Google Calendar will, amazingly, email or text you a near-limitless number of reminders to any event you care to add to it. Want to remember a friend's birthday? Every year? Ta-da! My mom now thinks my memory is soooo much better... Also handy for remembering to take meds, I find, or to take the dog to the vet, or whatever. You could think of it as a "LG sucks" thing, if you choose, or you could interpret it as "LG has a lot of concern for her friends." You're taking the emphasis now (in the above post, I mean) off your friends and putting it on your flaws (or that's how I'm reading it), but you could put it back on how fortunate you are to have such cool forgiving friends, and how motivated you are to try to change your behavior. Just a thought. Happy birthday to your friends!
  2. Emperor, it isn't generally described as one of the more effective antipsychotics for anxiety, and it's not being given at an anti-psychotic dose - but apparently the plan is to see how you do and then titrate it up. The akathisia with it can be remarkable, so if you feel antsy, try to sort out if it's anxiety or akathisia. I kind of hate to say all that and maybe squick you out, but you're a grown up, a very rational one at that, and you won't fret too much over the details. Monitor your dietary intake rationally and see how it goes. Maybe, if inpatient (voluntary) treatment isn't an option, is there an outpatient partial day treatment program you can try for some intensive targeted therapy?
  3. Keep as regular a schedule as you can - up at the same time every day. Try to normalize your sleep schedule. It'll make going to bed and getting up much easier if your brain is "pre-set" for it, if that makes any sense. Call your psychiatrist's office and leave a check-in message tomorrow. Usually a slower taper would be nice, but it sounds like it's helping to get off the Cymbalta, so maybe not so much in your case. When you say "panic attack as [you're] falling asleep," what kind of symptoms did you have? And what helped last night?
  4. Silver

    Is it me?

    gizmo: Since Topamax is, as it turns out, officially indicated (on-label) for migraine and specific types of epilepsy, and since it ISN'T on-label for anything psychiatric at this time... and since GP and psychiatry can certainly treat migraine... I have no damn idea what their problem is. Sometimes going through the PI sheet with a quizzical look can be more hurtful than helpful, of course, in this type of situation, but, still. Sheesh.
  5. OK, so, Jibbz, there's this thing: it's not about just Feeling Real Good. It's about getting better and staying better. (And you're not going to Feel Good All The Time, but I'm pretty sure you know that.) See- it's not an issue of just thinking of your problems in a way of fixing them. The next part is getting up and doing something. This might be where the therapy helps you problem-solve. Anyway, good luck.
  6. You could talk to your psychiatrist about using a very, very low dose of doxepin instead - 10mg -and see if that works. About as close as you'll get. Or Benadryl, 25-50 mg - not more.
  7. Been looking around - my state doesn't allow insurers to drop you when you are eligible for Medicare, if you're in a small business or large group plan. Looking through the regs and when that one was put into place, it was in response to the crunch in availability. So that probably varies by state, I'm guessing...
  8. So: you're complaining that Depakote made you lay around all the time and do nothing and eat a lot. And you're thinking the solution to your problems is weed? [snorf] OK. Now that I'm through with my fits of giggles. One thing your posts are notable for is some "all or nothing" thinking. (example: You want the clonazepam to work "perfectly.") Might want to discuss that with your psychiatrist. No drug is 100% all of the time. No, not even cannabis. Another thing I'd recommend is that you and s/he come up with some objective methods of assessing your actual function, not just "wow, I'm, like, totally better." That's super that you feel like that. Sometimes I don't have great insight. It's kind of characteristic of the disorder. Also, if you're high, some people might consider your assessment skills impaired. I'm sorry if that offends you, but it's reality, and, if you want to be taken seriously, then having something objective you can track might help a lot. So things like "getting out of the house 4 days per week" or "working 12 hours per week" or "doing the dishes 3 days" or whatever (those aren't suggestions, those are just random made-up functional goals) might be helpful. credibility.
  9. Bonus: I find if I do Pilates or yoga at home, I also manage to pick up a LOT of dog and cat hair if I just use the rug. So that allows me to get housework and exercise in at the same time. Two goals in one! (the slatternliness of my house is directly proportionate to my mental status)
  10. Your private insurer often has no incentive whatsoever to drop you. Here's the thing - and I'm assuming no one here is on dialysis, rules are different there. If someone who's more intimately involved in reimbursement knows differently and can provide citations, please do so; I'm writing from a public health system financing perspective, and as someone who looks at barriers to care faced by people on Medicare. Medicare is almost always the primary payer - UNLESS your other insurance comes from someone's employment and it is a large group plan (the employer has >100 employees.) If you have a private pay plan: Medicare is the primary payer. If you or your spouse or your parent work for a small group: Medicare is the primary payer. If you receive Medicaid and Medicare, Medicare is the primary payer. If you receive health benefits from your own (or your spouse's/parent's) employment at a large group, then Medicare becomes secondary. There are also some issues around dialysis that can bump Medicare around in the payer ranking - and that is the only ever disincentive. But let's not go there right now. Because here is why your insurance plans should be fucking thrilled that you're on Medicare, with the exception of the large group: As soon as Medicare becomes primary, then the Medicare rates, which are between 20-30% of usual, apply. And your insurance only ever pays the 20% (50% for psych) copay. And it's 20% of the Medicare rate. So the psych visit that might have cost $150 before to Aetna can not cost more than, say, $60 to Medicare, and Aetna now only pays $30. Of course, you then may have some real problems accessing care. But that is also another issue. Now - your private insurer may want to switch you to a supplemental plan - partly because of the dialysis reasons - and Medicare does one sweet, sweet job of covering dialysis, so, fine. (Consider your risks of dialysis, perhaps, in this analysis. Remember that your private plan will have a lifetime maximum. Remember that dialysis can get you there.) Also, those supplemental plans are usually significantly less expensive. However, for anyone out there who has the option of continuing large-group coverage that's secondary to active employment (not retirement) in addition to Medicare - I'd really recommend you think about this if you can afford it. Or, if you're on the fence - call your doctors' office managers and ask them if they take Medicare and if they will continue on with you if you're a Medicare patient, and what your community situation is for Medicare patients. In some parts of the country (like mine), it's really, really grim. In others, with a higher percentage of retirees, everyone takes Medicare, and it works well. And the whole situation may change radically, of course, in the next few years.
  11. Yeah, well, that's kind of the million dollar question, isn't it. I can do it if it's not too far out of sync, and I can do it if I focus on one thing at a time for 1 or 2 weeks - as in "I'll take the dog for a run 20 minutes per day" (or "I won't run more than an hour," because that's the other way stuff gets out of control.) If I try to alter more than 1 thing at a time, I can't handle it. Other people may be able to handle more complexity, but I can't juggle that kind of stuff.
  12. It sure as hell HELPS, but, no, it's not a cure. It's definitely symptomatic for me when that stuff gets way out of whack. Too much caffeine - even if lithium is adjusted for it - will make me weird, I've learned. Even if I'm still sleeping. Cutting out breakfast makes me weird. Living on nothing but Diet Coke and Triscuits and almonds (we buy these things in bulk at the office) makes me weird. Running or the equivalent for 3h a day makes me weird, and beats the crap out of my joints as a bonus. But most of those behaviors, in retrospect, are symptomatic of other rhythms that have been disrupted. I'm good about diet, mostly, and I move my body around daily. When I get the diet/exercise back into place, then the basic rhythms I need seem to fall back into place as well. I don't know how to put it more coherently.
  13. Ash, some stability does sound like it will be a good break for you... I don't know if your chemist/pharmacist can give you your pills in a 7 or 14 day at a time fill, if you think that would help (and Miab - well, that's just darned civilized, is all I can say!) enjoy the neuro Christmas party!
  14. Had it, as soon as my workplace had enough for highest-risk staff members (such as the pregnant ones.) Karuna, really, none of them? That's a moment of culture shock for me. What's the reason cited by the people you know? Every direct patient care health care worker I know has now had it, as well as every pharmacist with patient contact. At the local hospital, they issued stickers for "H1N1 09" and "FLU 09" that were placed on ID badges after vaccination; they always do this with seasonal flu shots. Patients and infection control can then tell which staff members have been vaccinated and have not been vaccinated. Inpatient orders can (and often do) specify vaccinated staff only for immunocompromised and other high-risk patients. They do get some good outcomes with this, I have to say. The peak seems to have subsided in North America, just in time to move into seasonal flu - but there's plenty of H1N1 to go around. I'd still get the vaccination, as well as regular seasonal flu vaccine, certainly if under age 50. And if anyone is pregnant, likely to become pregnant, or spends lots of time around a pregnant person, this is not something to mess around with - you don't want swine flu. Vaccination is a very good idea if you're in an appropriate population. H1N1 plus pregnancy = bad news. By the way, RapidFlu screening is not particularly useful for H1N1 (which would test out as influenza A); it's definitely not catching cases that do in fact culture positive for H1N1 in the hospital. I believe the infection control department presented at the local public health meeting that Rapidflu only caught 10% of culture positive cases? (something like that.) Don't rely on this. I also wouldn't rely on Tamiflu's availability. Plus remember that Tamiflu isn't always effective - and that while it reduces symptoms of flu (by one day's duration), it may not reduce the complications of flu, which is the bad scary stuff (think pneumonia. Pneumonia is BAD.) There is supposed to be an article that just came out on this, I think. I'll post link if I see it. It was all over the epi news yesterday, will search my inbox... Ah. It's a Cochrane review. Here. The gist re: complications/sequelae is that the prior data re: modest reduction in pneumonia are only from drug company data and that the researchers are requesting release of information/data. Prevention - vaccination, common sense precautions (no licking snotty-faced toddlers), and hand-washing - should always come first. When prevention is ineffective, Tamiflu is the second line. Even more importantly, at a macro level, Tamiflu doesn't prevent spread of the virus. And that's a major problem. Fall into winter is always such a fun time... between flu A, flu B, rhinoviruses, RSV, and now H1N1, it's just nonstop partying! Yours in handwashing, Silver
  15. hey, Ash, let me sidetrack for a second - can you get your meds put in a mediset? There is the kind you set up yourself - sometimes you can pull one day out at a time, and then put the rest of the pillbox somewhere that is a pain to get to. It gives you a couple seconds' delay. Or there is the kind the pharmacist sets up, which they charge a fee for, but it is a blister pack of medications, so you have to punch them out of the pack. That might help with the impulse thing. It's just a thought. These are also good for those of us who forget if we already took that day's meds. Like me.
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