Getting the Right Mix: Meds and Time

One thing that some people are kind of sketchy about discussing is mental illness and what those of us with mental illness issues do to make things right. For the record, I'm an advocate for talking about these things, but I understand and have taken advantage of the right to plead the fifth or just stay silent.

The problem with staying silent is that you learn nothing about what can happen.

I've been on Prozac for about 14 years now off and on (mostly on). Over the years, it has served me well. I have been able to achieve quite a bit that I would have not had the stamina to otherwise. I have made and formed quality relationships. Most importantly, I've been able to keep my greyness (what I call depression) at bay. That is, until more recently.

Over the past few months, I've noticed changes in my ability to control my moods. It's not a psychological problem (the way in which I view and deal with the world) but something more organic than that (inside of me, uncontrollable). Eventually my therapist and a good friend convinced me that it's okay that the Prozac was no longer working--in fact, there are better things out there now than there were before.

What I didn't know until I saw the psychiatrist on Friday was that Prozac can truly have a "shelf life" so to speak. In other words, prozac (and any SSRI) can eventually stop working for someone after a period of years. In fact, the psychiatrist was surprised I got this long of a life out of it. It's called the "Prozac Poop Out" effect.

In order to spare someone else the time of having to look this stuff up, I've compiled a list of resources about this here: Depression Returns with Prozac Poop Out, an FAQ on Prozac Poop Out, and You and Your Antidepressant.

So now to combat the poop out, we are trying to add Wellbutrin into the mix. Apparently it helps remedy the poop out problem in some people. Since Prozac has been good for me for so long, it was worth a shot.

The lesson, though, is this: don't be afraid to talk to someone about your meds. This can be even more trying in cases of mental illness, but it's that much more important. And as always, The Body Chronic is a big supporter of having a good sense of humor about this and every other chronic condition. So don't take offense over the picture I chose...it's important to learn to laugh at yourself.

Has anyone else had this happen? Any experiences with moving past it? Let's discuss!

Safer is better

I love that when I get a prescription or a refill from my primary care doc, he just types it into his computer and it magically shows up at the pharmacy. Brilliant.

I never thought about the technical benefits of it before, just the convenience. According to a survey done of Metro Detroit doctors, they prefer e-prescribing as it leaves less room for error. True that.

Some 75 percent of doctors strongly believe electronic prescribing improves patient safety, according to the survey by the Southeast Michigan ePrescribing Initiative. SEMI was created three years ago by General Motors Corp., Ford Motor Co., Chrysler L.L.C., Medco Health Solutions, and several health plans.

Apparently, it's such a big deal, the federal government is deciding to cause it to spread like wildfire.

Last December, Sen. John Kerry, D-Mass., and Rep. Allyson Schwartz, D-Penn., introduced legislation that would require physicians serving Medicare beneficiaries to adopt electronic prescribing by 2011 or face possible financial penalties.

The bills, SB 2408 and HR 4296, also provides funding to help physicians purchase computers and the software to use electronic prescribing.

Doctors also would be paid a 1 percent bonus for every claim they submitted that included an electronic prescription.

“As a company this is a good business decision to ensure employees get medical care in a safe environment,” Kohn-Parrott said.

Excellent. I can't help but think this is going to do nothing but good for the millions of people on prescription meds, especially those of us on many prescription meds. Less hassle, less chance for mishaps and less paper. Sounds good all around.

Thoughts?

The Body Chronic Strikes Back

I've been meaning to blog about my Day o' Doctors on Tuesday, but I haven't had the time nor the energy. It's an important story to tell, though, because it compacts a lot of what I've been going through into one stressful day.

9 a.m.
I go to see the nurse practitioner about my PFD/IC/VV. Last time I was there she gave me a prescription for Lyrica and a prescription for lidocane ointment. Neither have worked well. The Lyrica has cause me to gain about 15 pounds in a month and my clothes are much tighter. Not to mention, I have issues with weight gain/loss anyhow, I don't need any more uncertainty in that department. The lidocane wasn't not working but it wasn't working either. I'd have bouts of stinging and burning for 10-15 minutes after applying it that would cause me to flare up. The numbing properties were totally outweighed by this.
Now, instead, I'm on Neurotonin, which is like Lyrica only allegedly devoid of some of the side effects. I've only been on it for two days really, so I can't tell. I also have a small dose of Flexirill to take for muscle spasms. And the lidocane has been replaced by a compounded medecine cream with elavil in it (and other things). I still have to get the last one filled.

10 a.m.
Enjoy breakfast at a coney island. Go to the pet supply store to get cat food.

11 a.m.
Go to physical therapy.

1:30 p.m.
Go to new endocrinologist. Not surprisingly he bumps up my Metformin from 1000 mg to 2000 mg per day, orders blood tests and actually switches the Metformin to Glumetza, which has fewer side-effects (allegedly). I asked about Byetta after reading about people's success with it on the Soulcysters board. He says it might be a possibility but we should get the blood results first. He brought up the dreaded "obesity" word and the idea of bariatric surgery. He told me to keep an open mind but I've pretty much already made up my mind in the negative on that subject.

5:30 p.m.
Go to therapy...and definitely need it after having such a hectic day of doctors and medical professionals.

Net gain of medications: 1
Net gain of pills to take per day: 3 (Glumetza only comes in 500 mg)

So far, I haven't been able to tell anything except the following:
1. The Glumetza while not as harsh as the Met still has some side effects. I've had a couple bouts of nasty afternoon-nausea at work from it. I've decided to split it up--1000 mg in the morning, 1000 mg at night.
2. The Neurotonin/Flexirill makes it really hard to get up in the morning.

The one thing I have simply GOT to do is to change my eating habits. But I know what it requires and it's not easy. I've had much success before with a low-carb lifestyle and exercise, but my circumstances have changed a lot since then. But more than that I know how hard it was for the first month especially. And I'm not sure I currently have the inclination to put myself through that.

So we'll see. As all things medical go, we shall see.