Husband picked up new script for sertraline (more 25mg tablets) and note from PCP for school. She wrote just what I asked for:
To whom it may concern:
_______ was diagnosed with depression over a year ago. She is currently making some changes with medications. During this process, she may experience some physical and emotional symptoms. Please excuse her absences from school during this time.
Sincerely....
When I let Honey read it, I could see some different emotions. Relief, yes, there was certainly relief, but also something else, almost like "I am different" or "there really is something wrong with me" not sure, but I will have to talk with her about it.
I am strongly considering beginning the steps toward a 504 plan meeting. I have contacted her counselor with my thoughts. I need to get back to her as she asked "what kinds of modifications were we thinking of? Sometimes, we do some simple accommodations without a 504 plan.
I am not sure yet what to ask for, except some homework deadline relief (work done, but handed in at her own pace, allowance for medically necessary absences (work made up) and...?? I will talk with Honey about it when she is feeling better and ask her counselor for some suggestions as well... research, research right now-- that will help me a lot.
Showing posts with label SSRI withdrawal. Show all posts
Showing posts with label SSRI withdrawal. Show all posts
Monday, March 19, 2007
Honey's supportive doctor
I talked with Honey's PCP a while ago on the phone.
I am always impressed with the time she gives Honey and I both on the phone and in the office. I never feel like I am wasting her time nor do I feel like she is thinking that I need to stop telling her (PCP) what I need.
I had a couple goals concerning our conversation.
First, I wanted to update her as to what is going on (that we had not started reducing, that Honey was still trying to transition from tablets to liquid (while maintaining "stability"), and wanted her to know that Honey is just now feeling completely "normal" since the TEVA form of sertraline experience. I told her that I thought "Honey must be pretty sensitive to this medication". I feel if I say this (instead of saying the drug/poison "sucks" and is killing people) that I will not put her on the defensive and still have her seeing that my ideas about tapering really slow and cautiously is best for "Honey".
That goal met.
Second goal was to express my concern over transitioning to the liquid and shared with her my "information" regarding the possibility that the liquid might also trigger withdrawal symptoms (like the TEVA did for Honey) and that I wanted to transition slowly (from tablet to liquid) as well as keep her on at least 12.5mg of the tablet while decreasing the liquid.
Goal met-- she probably thinks I am nuts, but she said she definitely was okay with that and would continue to write refills for both the liquid and tablets as long as needed- would I just keep her updated- I almost thought it sounded like she meant "Keep educating her on this process".
Third goal: Ask PCP if she would write a note for school to inform school of Honey's diagnosis and let them know that she was having medications adjusted and the adjustments might cause physical and psychological symptoms. This is what I asked her to write (or something along those lines)-- we will see what we get. I also asked if she would be willing to help out as needed as far as school goes and she said "Certainly".
third goal met (haven't seen the note yet, but anything at this point from her that informs school of her diagnosis and med changes and knowing that PCP will back us as needed is all I need to get things started with school.
I feel like I accomplished something.
Honey continues to do well. We have started daily documentation as far as dosage, Honey's moods and any physical symptoms- so we will have a good baseline to go by when we start reducing and making poison (med) changes as far as form (tablet to liquid). This is our plan for now:
Currently (for the past 10 days 3/10- 3/19) she is taking 37.5mg Zoloft - 12mg liquid (.6ml) and 25mg tablet.
Starting tomorrow 3/20 she will take ¾ of a 25mg tablet (18.75mg) and 19mg liquid (.95ml) She will continue this for 10 days (until 3/29) as long as there are no withdrawal symptoms.
At that point (on 3/30- Thursday) we will try ½ tablet (12.5mg) and 25mg liquid (1.25ml). After 10 days (starting 4/9) on this ratio of tablet to liquid, I would like to start reducing the liquid (as long as she is baseline). We will reduce at 5% (actually just a bit more) of the total dose of 37.5 (actually reducing 2mg/.1ml). We plan to have her stay at this dose until she feels baseline or better. (at least 2 weeks on this dosage) and will reduce from there as tolerated.
I plan to keep her on 12.5mg of the tablet (½ tablet) as she reduces the liquid. I will have to worry about making a transition with the remainder of the tablet later. (Once she has reduced a good deal of the liquid)
I have never felt this way before... like a pioneer? I feel like Honey and I are creating a map. We can talk to other pioneers, who have been this way before, but their map might be different or maybe they have not been "here" before. Weird. I dont like being here and I dont like being here without a proven map. Honey hates it. But in a way (?) it is actually empowering (?) (I am sure I will take this "empowering" thing back)
It is also weird trusting my gut to this degree. Trusting it over science and mainstream practice. I am proud of my intuition/gut and proud that I listened, as it knew to go slow with the liquid, even before I understood that there might actually be theory behind it (might bring about withdrawal symptoms??- theory/thought)
Uchenna Agu (as in Uchenna and Joyce from Amazing Race All-Stars (yes, I watch)) said something on last night's episode that I loved. I dont have his exact words but it went something like this: By not trusting your instinct/gut/intuition, you are basically telling God or the Universe that He (God) is wrong. Like I said, I got his exact words wrong, but I think I got the gist of it correct. I am going to look for his exact words, because they were great.
I am always impressed with the time she gives Honey and I both on the phone and in the office. I never feel like I am wasting her time nor do I feel like she is thinking that I need to stop telling her (PCP) what I need.
I had a couple goals concerning our conversation.
First, I wanted to update her as to what is going on (that we had not started reducing, that Honey was still trying to transition from tablets to liquid (while maintaining "stability"), and wanted her to know that Honey is just now feeling completely "normal" since the TEVA form of sertraline experience. I told her that I thought "Honey must be pretty sensitive to this medication". I feel if I say this (instead of saying the drug/poison "sucks" and is killing people) that I will not put her on the defensive and still have her seeing that my ideas about tapering really slow and cautiously is best for "Honey".
That goal met.
Second goal was to express my concern over transitioning to the liquid and shared with her my "information" regarding the possibility that the liquid might also trigger withdrawal symptoms (like the TEVA did for Honey) and that I wanted to transition slowly (from tablet to liquid) as well as keep her on at least 12.5mg of the tablet while decreasing the liquid.
Goal met-- she probably thinks I am nuts, but she said she definitely was okay with that and would continue to write refills for both the liquid and tablets as long as needed- would I just keep her updated- I almost thought it sounded like she meant "Keep educating her on this process".
Third goal: Ask PCP if she would write a note for school to inform school of Honey's diagnosis and let them know that she was having medications adjusted and the adjustments might cause physical and psychological symptoms. This is what I asked her to write (or something along those lines)-- we will see what we get. I also asked if she would be willing to help out as needed as far as school goes and she said "Certainly".
third goal met (haven't seen the note yet, but anything at this point from her that informs school of her diagnosis and med changes and knowing that PCP will back us as needed is all I need to get things started with school.
I feel like I accomplished something.
Honey continues to do well. We have started daily documentation as far as dosage, Honey's moods and any physical symptoms- so we will have a good baseline to go by when we start reducing and making poison (med) changes as far as form (tablet to liquid). This is our plan for now:
Currently (for the past 10 days 3/10- 3/19) she is taking 37.5mg Zoloft - 12mg liquid (.6ml) and 25mg tablet.
Starting tomorrow 3/20 she will take ¾ of a 25mg tablet (18.75mg) and 19mg liquid (.95ml) She will continue this for 10 days (until 3/29) as long as there are no withdrawal symptoms.
At that point (on 3/30- Thursday) we will try ½ tablet (12.5mg) and 25mg liquid (1.25ml). After 10 days (starting 4/9) on this ratio of tablet to liquid, I would like to start reducing the liquid (as long as she is baseline). We will reduce at 5% (actually just a bit more) of the total dose of 37.5 (actually reducing 2mg/.1ml). We plan to have her stay at this dose until she feels baseline or better. (at least 2 weeks on this dosage) and will reduce from there as tolerated.
I plan to keep her on 12.5mg of the tablet (½ tablet) as she reduces the liquid. I will have to worry about making a transition with the remainder of the tablet later. (Once she has reduced a good deal of the liquid)
I have never felt this way before... like a pioneer? I feel like Honey and I are creating a map. We can talk to other pioneers, who have been this way before, but their map might be different or maybe they have not been "here" before. Weird. I dont like being here and I dont like being here without a proven map. Honey hates it. But in a way (?) it is actually empowering (?) (I am sure I will take this "empowering" thing back)
It is also weird trusting my gut to this degree. Trusting it over science and mainstream practice. I am proud of my intuition/gut and proud that I listened, as it knew to go slow with the liquid, even before I understood that there might actually be theory behind it (might bring about withdrawal symptoms??- theory/thought)
Uchenna Agu (as in Uchenna and Joyce from Amazing Race All-Stars (yes, I watch)) said something on last night's episode that I loved. I dont have his exact words but it went something like this: By not trusting your instinct/gut/intuition, you are basically telling God or the Universe that He (God) is wrong. Like I said, I got his exact words wrong, but I think I got the gist of it correct. I am going to look for his exact words, because they were great.
Wednesday, March 14, 2007
Letter from the doctor concerning 504/IEP
I wonder what I would want a letter from the doctor to say in regards to a 504 plan for Honey? I feel like I would have to "ghostwrite it" lol, because I still dont think health provider "gets it"- I know Honey has her support, but I dont know how much provider understands.
We just saw provider though, and she knows Honey is struggling. She knows that once this struggle is over (due to generic Zoloft), Honey will begin a slow taper off this crap.
Stephany, I just received your comment from the "bad night"post. I will look for the websites/books on the sidebar of your blog. So for the most part, is this something that I would start now to be implimented by next fall (start of next school year)?
We just saw provider though, and she knows Honey is struggling. She knows that once this struggle is over (due to generic Zoloft), Honey will begin a slow taper off this crap.
Stephany, I just received your comment from the "bad night"post. I will look for the websites/books on the sidebar of your blog. So for the most part, is this something that I would start now to be implimented by next fall (start of next school year)?
IEP?
Stephany and anonymous mom, thanks for the insight and support.
On and off I think about some kind of 504 plan/IEP for Honey. I need to research it/figure out what having one could do for "Honey". She is a good student (last quarter managed 2 B+"s, 2A's and currently has 4 A's) and I think that does get in her way as far as reducing her stress (being a good/type A student. She has high expectations for herself. The B+'s last quarter really upset her.(she had been a straight A student up until those B's. That quarter (with the B's) was also the quarter when the withdrawals got unbearable/we didn't know at the time it was withdrawal- thought it was "depression", and that was also the quarter I filled for on Honey's behalf (and got) the restraining order on her icky x-asshole. It was a crazy time... and she pulled off 2 B's and 2 A's.
So I am thinking the school will think I am crazy and wonder what I am looking for (as far some relief for her.)
I also am hopeful for her future education and wonder if an IEP might affect college acceptance?
As far as help from school... I know that some relief as far as some flexibility with homework (I think she could still do it, but maybe not at the due date? There are just some nights when I dont know how she does it... and then falls apart when it is complete, doesn't sleep well (lots of dreams follow an evening of high stress) Another huge concern for me right now is attendance... she has missed 19 days so far, sometimes going to school when she can hardly stand the thought of it, just because I know she doesn't have much more time to miss before it turns into truancy. Any thoughts?
On and off I think about some kind of 504 plan/IEP for Honey. I need to research it/figure out what having one could do for "Honey". She is a good student (last quarter managed 2 B+"s, 2A's and currently has 4 A's) and I think that does get in her way as far as reducing her stress (being a good/type A student. She has high expectations for herself. The B+'s last quarter really upset her.(she had been a straight A student up until those B's. That quarter (with the B's) was also the quarter when the withdrawals got unbearable/we didn't know at the time it was withdrawal- thought it was "depression", and that was also the quarter I filled for on Honey's behalf (and got) the restraining order on her icky x-asshole. It was a crazy time... and she pulled off 2 B's and 2 A's.
So I am thinking the school will think I am crazy and wonder what I am looking for (as far some relief for her.)
I also am hopeful for her future education and wonder if an IEP might affect college acceptance?
As far as help from school... I know that some relief as far as some flexibility with homework (I think she could still do it, but maybe not at the due date? There are just some nights when I dont know how she does it... and then falls apart when it is complete, doesn't sleep well (lots of dreams follow an evening of high stress) Another huge concern for me right now is attendance... she has missed 19 days so far, sometimes going to school when she can hardly stand the thought of it, just because I know she doesn't have much more time to miss before it turns into truancy. Any thoughts?
Sunday, March 11, 2007
Things are settling down...
Well, I do think things are starting to settle down a bit.
Honey appears and says that she is feeling much better
(since the withdrawal problem caused by the Teva form of sertraline).
She appears more grounded, less irritable and anxious. She continues to have muscle pain and her concentration might be a bit messed up? Sleep continues to be an issue, but I think it will be a huge issue until she is free from the Zoloft.
And I feel a sense of relief and a sense of peace, like I can let go of this a little bit (in a way)
I know now that she is on the right road.
She has what she needs as far as the right medication (read also as poison)
in the oral concentrate Zoloft.
She has her doctors understanding, backing and support.
She has gained some personal confidence in this journey.
She has gained some personal knowledge in her situation that she didn't have before.
We have started the transition to the liquid (from the tablet) in a slow process.
She will be off and running soon!
I know I need to start taking better care of me.
Doing more than existing to get her through another day of this mess.
I know that when I am feeling less than good, I am less than good to Honey, Tootsie and all the rest.
Stephany reminds me that this is my journey.
I may be walking alongside Honey in her journey, but I have a journey too.
I want to celebrate my journey
Honey appears and says that she is feeling much better
(since the withdrawal problem caused by the Teva form of sertraline).
She appears more grounded, less irritable and anxious. She continues to have muscle pain and her concentration might be a bit messed up? Sleep continues to be an issue, but I think it will be a huge issue until she is free from the Zoloft.
And I feel a sense of relief and a sense of peace, like I can let go of this a little bit (in a way)
I know now that she is on the right road.
She has what she needs as far as the right medication (read also as poison)
in the oral concentrate Zoloft.
She has her doctors understanding, backing and support.
She has gained some personal confidence in this journey.
She has gained some personal knowledge in her situation that she didn't have before.
We have started the transition to the liquid (from the tablet) in a slow process.
She will be off and running soon!
I know I need to start taking better care of me.
Doing more than existing to get her through another day of this mess.
I know that when I am feeling less than good, I am less than good to Honey, Tootsie and all the rest.
Stephany reminds me that this is my journey.
I may be walking alongside Honey in her journey, but I have a journey too.
I want to celebrate my journey
Thursday, March 8, 2007
stable self?
Last night I wrote that Honey was "back to her stable self".
Maybe (?) I spoke too soon?
Not sure yet.
She does not feel well today, BUT...
we probably screwed up ( what's new )
We have had tickets F*O*R*E*V*E*R for "Disney's Princess' on Ice" (or whatever it was called)
A special treat for "Tootsie" since we were doing NOTHING for a vacation this year. It seemed a bad year for vacationing, Honey having a tough time and all. So instead, I figured we would take some fun local "trips" throughout the year.
I should have insisted that Honey stay home. I should have known (when, oh when will I learn!!) that it would be too much stimulation for her, especially right now!
A couple day ago, I would have made her stay home.
But yesterday, after getting a proper dosage of her poison (aka Zoloft), she seemed more grounded.
Well, she wants to come, doesn't want to miss it.
She seemed okay this morning, but tired and a little irritable.
The feelings seemed to increase on our way there (about an hour drive)
She was overwhelmed.
When we got there she was-
Overwhelmed by people,
overwhelmed by noise,
overwhelmed by the pure visual stimulation that makes up a "Disney on Ice" performance.
And of course, we forgot to bring the Aconitum Napellus (a homeopathic remedy that Honey has used with success for panic attacks.
She was uncomfortable, I could definitely tell, but she kept denying it.
When the show was over, we stayed in our seats until most everyone had cleared out and the custodial crews were cleaning up. I wanted to be sure that the area was pretty cleared out of people in the lobby area, escalators etc.
We practiced some deep, calming breathing-- tried to trick her body into thinking that she was not overwhelmed.
She slept on the way home.
She cancelled boyfriend plans for the evening.
I need to learn and remember this mistake.
Maybe (?) I spoke too soon?
Not sure yet.
She does not feel well today, BUT...
we probably screwed up ( what's new )
We have had tickets F*O*R*E*V*E*R for "Disney's Princess' on Ice" (or whatever it was called)
A special treat for "Tootsie" since we were doing NOTHING for a vacation this year. It seemed a bad year for vacationing, Honey having a tough time and all. So instead, I figured we would take some fun local "trips" throughout the year.
I should have insisted that Honey stay home. I should have known (when, oh when will I learn!!) that it would be too much stimulation for her, especially right now!
A couple day ago, I would have made her stay home.
But yesterday, after getting a proper dosage of her poison (aka Zoloft), she seemed more grounded.
Well, she wants to come, doesn't want to miss it.
She seemed okay this morning, but tired and a little irritable.
The feelings seemed to increase on our way there (about an hour drive)
She was overwhelmed.
When we got there she was-
Overwhelmed by people,
overwhelmed by noise,
overwhelmed by the pure visual stimulation that makes up a "Disney on Ice" performance.
And of course, we forgot to bring the Aconitum Napellus (a homeopathic remedy that Honey has used with success for panic attacks.
She was uncomfortable, I could definitely tell, but she kept denying it.
When the show was over, we stayed in our seats until most everyone had cleared out and the custodial crews were cleaning up. I wanted to be sure that the area was pretty cleared out of people in the lobby area, escalators etc.
We practiced some deep, calming breathing-- tried to trick her body into thinking that she was not overwhelmed.
She slept on the way home.
She cancelled boyfriend plans for the evening.
I need to learn and remember this mistake.
Wednesday, March 7, 2007
yep, it was withdrawal, yep- got the script for liquid zoloft :) :)
Well, 7 hours after taking her 37.5mg dose of REAL zoloft, Honey is back to her stable self. Irritablity way down, anxiety way down. I cant wait to see how she sleeps tonight since for the past several days, dreams have been dramatic and vivid and waking her up frequently. For two weeks she has been in withdrawal and we just couldn't figure out what was wrong.
Sertraline under the Teva label should be investigated. This drug should not be used as an equal to Pfizer/Greenstone sertraline. It took me a visit to 3 different pharmacies before I found one that carried Greenstone (vs. Teva)
I was so proud of Honey today. We have been talking over (Honey and I) what the goals of the Dr. visit were, what we wanted to share, what we would share if necessary, what we would accept from the doctor and what we would refuse.
Honey presented "her case", presented a review of previous withdrawal (late Aug 06 - started back on sertraline Nov 06 and dosage bumped up Jan 07 (to help with symptoms that seemed to be withdrawal symptoms from previous Zoloft use of 50mg), presented a summary of WHY she wanted off the drug and presented our researched plan for tapering safely.
Honey ROCKED! She did all of this while she was basically "freaking out" due to withdrawal symptoms. She finally had to sit down/lay back on a bench in our final pharmacy. The pharmacist got a dose for Honey immediately. A literal few hours later and she was feeling so much better.
Dr. gave Honey a script for 2 weeks worth of tablets.
She also gave Honey the script for liquid Zoloft.
We decided that Honey would stabilize on the tablets for a couple days, then go to tablets and liquid and gradually go to just liquid. WHY? I dont know- I just feel like we should. Actually, I think I received a helpful, anonymous email from a dear helper who suggested not going straight to the liquid, but to make a gradual change. Who knows, but it seems safer to me and dr. had no problem with it.
Glad the day is over. I am so glad to have solved the withdrawal issue, so proud of Honey- being her own advocate today (I know it something she will be proud of for a while) and so glad we got the liquid :)
Sertraline under the Teva label should be investigated. This drug should not be used as an equal to Pfizer/Greenstone sertraline. It took me a visit to 3 different pharmacies before I found one that carried Greenstone (vs. Teva)
I was so proud of Honey today. We have been talking over (Honey and I) what the goals of the Dr. visit were, what we wanted to share, what we would share if necessary, what we would accept from the doctor and what we would refuse.
Honey presented "her case", presented a review of previous withdrawal (late Aug 06 - started back on sertraline Nov 06 and dosage bumped up Jan 07 (to help with symptoms that seemed to be withdrawal symptoms from previous Zoloft use of 50mg), presented a summary of WHY she wanted off the drug and presented our researched plan for tapering safely.
Honey ROCKED! She did all of this while she was basically "freaking out" due to withdrawal symptoms. She finally had to sit down/lay back on a bench in our final pharmacy. The pharmacist got a dose for Honey immediately. A literal few hours later and she was feeling so much better.
Dr. gave Honey a script for 2 weeks worth of tablets.
She also gave Honey the script for liquid Zoloft.
We decided that Honey would stabilize on the tablets for a couple days, then go to tablets and liquid and gradually go to just liquid. WHY? I dont know- I just feel like we should. Actually, I think I received a helpful, anonymous email from a dear helper who suggested not going straight to the liquid, but to make a gradual change. Who knows, but it seems safer to me and dr. had no problem with it.
Glad the day is over. I am so glad to have solved the withdrawal issue, so proud of Honey- being her own advocate today (I know it something she will be proud of for a while) and so glad we got the liquid :)
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