Prescription Medication Knowledge Base » Of Flovent And » When to use nebulizer?

When to use nebulizer?

Question:

What are your thoughts on very dry skin, crack on fingers and heels, very dry scalp. Bruising easily. ON Flovent 110, Atrovent, Serevent and Proventil as needed. Also Claritan D. Am feeling much better and will soon decrease to eventual ceasing of Atrovent. Thank you for your help. jane

Response:

What are your thoughts on very dry skin, crack on fingers and heels, very dry scalp. Bruising easily. ON Flovent 110, Atrovent, Serevent and Proventil as needed. Also Claritan D…..

my skin still seems okay but my finger nails are very dry and brittle. I don’t think it is the meds. The decongestant in claritin may be dehydrating you a bit though – Hide quoted text — Show quoted text –

Response:

If you are able to use the MDI with spacer well then the neb machines are just a hassle, expense, and source of infection.

Source of infection…??? Please elaborate.

Response:

If they are not well maintained some can harbor molds. If you are allergic to them it can be a problem. It was probably a little inaccurate of me to imply that you will get an actual lung infection as I don’t think this is common. Forgive me it was late. — Good Luck, CBI, M.D. – Hide quoted text — Show quoted text – If you are able to use the MDI with spacer well then the neb machines are just a hassle, expense, and source of infection. Source of infection…??? Please elaborate.

Response:

If I read your post right I think you are asking what a nebulizer is and if you may benefit from it. If not …. Sorry. A nebulizer is a machine that takes the medicine and makes a mist out of it. It takes about 10 minutes to take a single treatment. The "nebs" do deliver more drug to the lower respiratory tree (lungs). The question is; does this make a difference, or ; do you need the extra amount of drug. The answer is probably not. Studies that looked at relative dose have found that 2.5 mg of albuterol nebulized is about equal to ten puffs of the MDI with spacer. Studies looking at effect and outcome find three or four puffs with spacer to be equally effective as nebs. I put this apparent discrepancy together by theorizing that the extra drug above four puffs doesn’t add much. If you are able to use the MDI with spacer well then the neb machines are just a hassle, expense, and source of infection. People in extreme distress cannot use the MDI well and need a neb. — Good Luck, CBI, M.D.

– Hide quoted text — Show quoted text -I take Flovent 110, two puffs twice a day. That usually controls my symptons. I also take allergy shots. When my asathma acts up, I also take an inhaled albuterol. In the past the doctor has prescribed a couple of prednisone bursts when that did not work, and that brought everything under control. Not real frequent — my last burst was 14 months ago. Should I be using a nebulizer when the inhaled meds don’t seem to knock it out? What exactly is a nebulizer and what are the pros and cons. In the past my asthma seems to have been triggered by cold or flu viruses or cold temperatures, but I think this spring I am getting my first allergy one — everything is blooming here in Iowa, the spring flowers are glorious, the flowering trees are glorious and the air is full of pollen. Any thoughts or comments? I will see my allergist shortly — he left town for two weeks. Kathy from Iowa

Response:

To my doctor the cons of having an at home nebulizer outway the pros. Using a nebulizer gives you the same medication as an inhaled albuterol inhaler. This is the same medicne that they usually give me when I need to visit the ER. The thing about using albuterol in high doses is that it really speeds up your heart rate, something that you might want monitered by the ER staff. Seccondly at the ER they add extra oxygen to their nebulizers. This may not help your astma symptoms much, but it is really nice to get some oxygen after having an 80% blood oxygen level when you come in the door. The third advantage of going to the ER instead of having an at home nebulizer is that in the ER they can give you intravenus steroids. Although I hate to get them because of the side effects, this works a lot faster than calling your doctor and having him prescribe you a prednisone burst. To me going to the ER at 3:00 in the morning is a real pain. I live 11 miles from the hospital, which is about a 25 minute drive. Once you get there they treat you like an idoit, make you put on a gown, start drawing blood, and then after they hook you up to a blood oxygen monitor finaly realize that you are having a severe astma attack start giving you nebulizer treatments. All of this is annoying, but when my breathing is so bad that my albuterol inhaler isn’t working I am glad to have the doctors close at hand.

Response:

I take Flovent 110, two puffs twice a day. That usually controls my symptons. I also take allergy shots. When my asathma acts up, I also take an inhaled albuterol. In the past the doctor has prescribed a couple of prednisone bursts when that did not work, and that brought everything under control. Not real frequent — my last burst was 14 months ago. Should I be using a nebulizer when the inhaled meds don’t seem to knock it out? What exactly is a nebulizer and what are the pros and cons. In the past my asthma seems to have been triggered by cold or flu viruses or cold temperatures, but I think this spring I am getting my first allergy one — everything is blooming here in Iowa, the spring flowers are glorious, the flowering trees are glorious and the air is full of pollen. Any thoughts or comments? I will see my allergist shortly — he left town for two weeks. Kathy from Iowa

Response:

What you and your doctor need to do is sit down and work out a detailed treatment plan on when and how to use your rescue medications, when to call the ER, etc. This is often tied to a PFM, with certain actions being taken when your flows drop below certain levels. Chris Owens

Response:

- Hide quoted text — Show quoted text – I take Flovent 110, two puffs twice a day. That usually controls my symptons. I also take allergy shots. When my asathma acts up, I also take an inhaled albuterol. In the past the doctor has prescribed a couple of prednisone bursts when that did not work, and that brought everything under control. Not real frequent — my last burst was 14 months ago. Should I be using a nebulizer when the inhaled meds don’t seem to knock it out? What exactly is a nebulizer and what are the pros and cons. In the past my asthma seems to have been triggered by cold or flu viruses or cold temperatures, but I think this spring I am getting my first allergy one — everything is blooming here in Iowa, the spring flowers are glorious, the flowering trees are glorious and the air is full of pollen. Any thoughts or comments? I will see my allergist shortly — he left town for two weeks. Kathy from Iowa

Hi Kathy, My family , all of us have asthma. My husband has had it all his life, but when he was younger they called it everything but asthma. My son has had asthma since he was 2. I was diagnosed last fall with asthma. We have a nebulizer and all of us have benefitted from it too. We also have a portable nebulizer that runs off a battery. We tend to use the nebulizer when we don’t seem to be getting much relief from the regular inhaler. If you use the nebulizer it delivers the medication to your lungs alot better than an inhaler will. Also we double the flovent and that sometimes helps. There are times when prednisone is also to be used. I would not be with out a nebulizer at all. My son does complain that it takes longer, but the benefits are worth it. Good luck. Susanne Loud

Response:

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Prescription Medication Knowledge Base » Flovent 220 » Medicines sapping energy??

Medicines sapping energy??

Question:

Hi! Sorry about all those bogus Boytko (or whatever) responses you got. A very good suggestion was given to you: to make sure you don’t have sleep apena, and that your asthma isn’t bothering you when you sleep. I would be wary of the theophylline. There are much better drugs for your asthma. Are you on flovent 220 at least 2 times a day? If not, I"d increase that and dump the theophylline. I had *severe* side effects from the theophylline that lasted for years (because I took it for years) and it really affected my sleep. Perhaps try singulair or accolate or something. If you are taking all those medications for asthma you should be seeing a specialist, not just a doctor: and they might be able to help you further with your problems. I personally also had similar side effects from the serevent, but I do know that many others tolerate it well. Intal did nothing for me, and is usually not an "as needed" drug- you have to take it all the time for it to have any affect, right? I found that Intal (and Tilade) actually made my exercise induced asthma *worse* because it irritated me and didn’t help. Also, with all the above, do try to start an exercise program and certainly improve your diet. Just because your diet hasn’t changed in 10 years doesn’t mean *you* haven’t. It can make a big difference in how you feel energetically, and makes your asthma better too.(the exercise part). It might also help you sleep longer- 8 hours is a bit more normal. -j – Hide quoted text — Show quoted text – I am taking Flovent, Serevent, Albuterol, Intal (when needed), and Theophylline. Ever since I’ve been taking them faithfully (around 2 years), I feel so tired….even when I’m not doing anything. My diet is kinda lousy; yet, it hasn’t changed 10 years. I averaged six hours of sleep. Don’t have a strenous job. Rarely exercise, but I do walk alot! Has anyone experienced fatique while on medications? If do, what was the culprit? Thanks.. * Sent from RemarQ http://www.remarq.com The Internet’s Discussion Network * The fastest and easiest way to search and participate in Usenet – Free!

Response:

writes <snip do try to start an exercise program

The original post states they walk ‘a lot’. If that means a brisk walk (e.g. raises the pulse) for half an hour, three or more times a week I would classify that as exercise. IMHO Walking is underrated as exercise but can be really good if it’s on unmade footpaths (much better that roads or gym floors as each step is slightly different) and up and down hills. And it doesn’t carry dangers (or they are greatly reduced) of over-use injuries, and on paths away from roads the air is better and the dangers from traffic go away. And walking is weight-bearing which helps prevent osteoporosis – something swimming doesn’t do though weights, gym works & cycling do. <snip — Surfer!

Response:

Mark, I’m not sure what you expected this device to do for you. Just because you make it harder for yourself to breathe does’nt mean you get less air. Your respiratory center paces your breathing for you and it will make you breathe in such a way as to attain a particular CO2 level in your blood. Putting a restrictive device in line with your respiaratory tract isn’t going to change anything. What you need to do is practice breathing in such a way as to sustain, over a prolonged period of time, a small shortage of air. You need to do this often. Unless you actually feel like you’re not getting enough air while you’re doing this, it’s not going to help your respiratory center accommodate to higher levels of CO2. If you want to knock Buteyko by all means, but make sure you’ve actually done the exercises properly before you do. …. with no effect, and then had the idea that asthmatics don’t need Buteyko, since they have plenty of hypoventilation, with (as follows from medical research) some positive results claimed by Buteyko (e.g., less sclerosis).

In early stage asthma CO2 is low, because of hyperventilation. When asthma is very sever you get to a point where the lungs are so damaged that CO2 can’t get out and Oxygen can’t get in. You’re right, here the asthmatic is hypoventilated from the point of view of the blood gases. But there is a state in between where blood CO2 appears to be normal and Oxygen is low. What happens here is as follows. As the disease progresses part of the lungs becomes so badly blocked that it stops being ventilated all together, but it still gets perfused with blood. That part of the lung which is still functioning becomes hoplessly overventilated, as can be seen from ETCO2 (End tidal CO2) studies. The blood that leaves the lungs to get into the arteries therefore contains a mixture of blood from the overventilated and underventilated areas, which means that the CO2 may appear to be normal. But the CO2 component from the functioning part is very low, and this is what causes it to go into bronchospasm. So we take Ventolin to open it up. But that does’nt actually cure anything. At this stage Buteyko alone won’t help either. You need to supplement with steroids until you can get your breathing under control and then gradually reverse the process by deliberate hypoventilation. As you can imagine, by this stage this can be a very difficult process. Sticking a marble in your nostril won’t solve your problem. Peter Kolb Free information provided by grateful ex-asthmatics http://www.wt.com.au/~pkolb/buteyko.htm

Response:

If you want to knock Buteyko by all means, but make sure you’ve actually done the exercises properly before you do.

So you are saying that I should try something that is dangerous and stupid before I warn others about it? Why don’t you jump off a cliff and then tell us whether or not it is dangerous? In early stage asthma CO2 is low, because of hyperventilation. When asthma is very sever you get to a point where the lungs are so damaged that CO2 can’t get out and Oxygen can’t get in.

What are you talking about? You really need to learn something about asthma instead of relying on the stuff the buteyko promoters fabricated. No electrons were harmed in the posting of this message.

Response:

Can I just mention that I tried Buteyko after seeing a documentary on the TV and found a course run by Sasha Stalmatski in York UK in Oct 99. I was on quite a lot of medication at the time, Flixotide, Ventolin, Atrovent, Serevent, Slo Phyllin etc. and before starting the course was extremely tired and could hardly walk upstairs. I found the course very difficult but persevered. One year on and I am only on Flixotide and Ventolin and although I visit hospital as an out patient regularly for bronchial/chest infections my asthma is under control and from having an asthma attack regularly every night 12 months ago I do not have any attacks at all now, I do have problems when I have a chest infection but the breathing exercises I learnt on the course have been very helpful and last year I had an attack of pluerisy and used the shallow breathing as I was rushed to hospital and it certainly worked for me. By the way I have no medical training whatsoever so I cannot give medical advice it certainly didn’t cure me but it has made my life better, I can at least get up stairs now, I haven’t progressed to cycling yet but I am working on it. I am a middle aged lady and able to do a full time job even if I do occasionally have to have time off for chest infections. – Hide quoted text — Show quoted text – If you want to knock Buteyko by all means, but make sure you’ve actually done the exercises properly before you do. So you are saying that I should try something that is dangerous and stupid before I warn others about it? Why don’t you jump off a cliff and then tell us whether or not it is dangerous? In early stage asthma CO2 is low, because of hyperventilation. When asthma is very sever you get to a point where the lungs are so damaged that CO2 can’t get out and Oxygen can’t get in. What are you talking about? You really need to learn something about asthma instead of relying on the stuff the buteyko promoters fabricated. No electrons were harmed in the posting of this message.

– Christine Varney Dept of Physics University of York YORK YO10 5DD UK tel: 44 (0) 1904 432261 fax: 44 (0) 1904 432214

Response:

I am taking Flovent, Serevent, Albuterol, Intal (when needed), and Theophylline. Ever since I’ve been taking them faithfully (around 2 years), I feel so tired….even when I’m not doing anything. My diet is kinda lousy; yet, it hasn’t changed 10 years. I averaged six hours of sleep. Don’t have a strenous job. Rarely exercise, but I do walk alot! Has anyone experienced fatique while on medications? If do, what was the culprit?

I find fatigue is the product of any single one or combination of the following: 1) that time of the month 2) being ill 3) not getting enough sleep – I usually need 8-9 hours a night 4) emotional upset like when I had to have two cats put to sleep last year – each time the response was to sleep for a couple of weeks, 16 hours a day or more at first. 5) stress at work 6) boredom 7) prevarication – shall I do some decorating or get another ours sleep? lack of exercise 9) not drinking enough water especially if it’s hot – I’ve had a few night cramps 10) eating too much too late – full stomach is not ideal before bed 11) I go to sleep fine if I drink too much (e.g. more than 2-3 glasses wine) but then have disturbed dreams As you might imagine I’m a good sleeper! Luckily too much time in bed gives me a bad back so there’s no danger (at the moment) of my developing a 24-hour per day habit. Before I got my medication (Pulmicort, and inhaled steroid) I *was* chronically tired due to lack of sleep and poor quality sleep. Starting them made a new woman of me. But I can’t find a new man to match! So I’ve got some new cats! so check (with your doctor) your asthma medication is working properly – especially at night. When I’m bad I start snoring and give myself disturbed dreams and intermittent waking especially if I fall asleep with pillows as they prop up my head and close the airway (and are bad for my back & neck). If you don’t have a peak flow meter get one and use it, drawing a chart of the morning & evening results (or put them in Excel!). It should be pretty level – if it’s down in the mornings and responds to Intal it suggests you are possibly under-medicated in the steroid department. Also ask your partner (if you have one) how you sleep. Lots of snoring could be part of, or an indication of, the problem. Especially if you wake yourself up, or wake because you have almost stopped breathing (sleep apnoea). Good Luck PS Peter Kolb seems to reckon that everything is caused by CHVS. — Surfer!

Response:

– Hide quoted text — Show quoted text – I am taking Flovent, Serevent, Albuterol, Intal (when needed), and Theophylline. Ever since I’ve been taking them faithfully (around 2 years), I feel so tired….even when I’m not doing anything. My diet is kinda lousy; yet, it hasn’t changed 10 years. I averaged six hours of sleep. Don’t have a strenous job. Rarely exercise, but I do walk alot! Has anyone experienced fatique while on medications? If do, what was the culprit? Thanks.. Hello I can’t say whether or not your medications cause fatigue, but what I can tell you is that fatigue, listlessness and inability to exercise are some of the very many symptoms of Chronic hyperventilation syndrome (CHVS). This was first discovered by American Field Surgeon DaCosta in 1870 when he descibed this condition sufffered by American Soldiers under combat stress during the civil war. While the mechanism by which such stress can cause chronic hyperventilation is well known and understood, few doctors even seem to be aware of its existence. This is in spite of the fact that prevalence in the community is between 6 and 11% (References have been given on an earlier occasion). There is a very logical treatment which has been developed in Russia for CHVS. They found it so successful (and quite dramatically so) in the treatment of asthma, that it has been brought to the west largely as a therapy that reverses the asthma condition. But any of the symptoms of CHVS can be successfully treated with this therapy. Unfortunately, unlike with conventional medicine, there are no magic bullets. Buteyko therapy requires a lot of work and a lot of time, but at least it enables you to get your health back. Many people have found that there is sufficient information on our web site to help you get rid of your asthma. Peter Kolb BSc(Eng),MSc(Med),CPEng(Biomed) BIOMEDICAL ENGINEER Free information provided by grateful ex-asthmatics

Mark: I’m 76 and for over 2 years have persistent (without attacks) old age asthma. In times of remission, all breathing parameters are OK. I’ve tried daily 20 min. exercises with a restricted air flow device for about 2 months – with no effect, and then had the idea that asthmatics don’t need Buteyko, since they have plenty of hypoventilation, with (as follows from medical research) some positive results claimed by Buteyko (e.g., less sclerosis). – Hide quoted text — Show quoted text – http://www.wt.com.au/~pkolb/buteyko.htm

Response:

Hello I can’t say whether or not your medications cause fatigue, but what I can tell you is that fatigue, listlessness and inability to exercise are some of the very many symptoms of Chronic hyperventilation syndrome (CHVS). This was first discovered by American Field Surgeon DaCosta in 1870 when he descibed this condition sufffered by American Soldiers under combat stress during the civil war. While the mechanism by which such stress can cause chronic hyperventilation is well known and understood, few doctors even seem to be aware of its existence. This is in spite of the fact that prevalence in the community is between 6 and 11% (References have been given on an earlier occasion). There is a very logical treatment which has been developed in Russia for CHVS. They found it so successful (and quite dramatically so) in the treatment of asthma, that it has been brought to the west largely as a therapy that reverses the asthma condition. But any of the symptoms of CHVS can be successfully treated with this therapy. Unfortunately, unlike with conventional medicine, there are no magic bullets. Buteyko therapy requires a lot of work and a lot of time, but at least it enables you to get your health back. Many people have found that there is sufficient information on our web site to help you get rid of your asthma. Peter Kolb BSc(Eng),MSc(Med),CPEng(Biomed) BIOMEDICAL ENGINEER Free information provided by grateful ex-asthmatics http://www.wt.com.au/~pkolb/buteyko.htm

Response:

Try sleeping an extra 1/2 hour. Most people do not get the amount of sleep they need. No electrons were harmed in the posting of this message.

Response:

I can’t say whether or not your medications cause fatigue, but what I can tell you is that fatigue, listlessness and inability to exercise are some of the very many symptoms of Chronic hyperventilation syndrome (CHVS).

Can you name something that is not a symptom of this imaginary ailment? BTW, can you provide any current medical references that support your diagnosis? And how about providing your qualifications to dispense medical advice? No electrons were harmed in the posting of this message.

Response:

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Prescription Medication Knowledge Base » Zoloft Sertraline » What the heck is that drug called…

What the heck is that drug called…

Question:

[Uthur] I’m trying to remember the name of a drug someone told me about a while back. It begins with ‘z’ (in Europe) and is used for treating anxiety. It *might* be a newish one. I’d remember it if I heard it again. Can you help me out please?

Xanax (alprazolam) ? zolpidem? (more a sleeping pil) zopiclon? (more a sleeping pil) Kind regards, Henk J. van Dijk — The charter is available at:

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Prescription Medication Knowledge Base » Effexor Xr 150 » anyone have experience with Atarax?

anyone have experience with Atarax?

Question:

- Hide quoted text — Show quoted text – i’ve used this three times for bad panic attacks, and while it does sedate me, the after effects are really awful. the next day when i wake up, i feel like my body is still asleep, like i have to drag my limbs around. my teeth kind of buzz in my head (like with SSRI withdrawal), and i feel very "out of it", as though i’m watching myself go through the motions from outside my body (depersonalization?). my pulse seems high, and i just have trouble doing every day things. this lasts for at least 32 hours after i take even a minute dose (10 mg, my prescription is for 25). i’ve taken this before for allergies and never had this reaction. it feel so much like SSRI withdrawal, i wonder if it could be blocking my Effexor or something? i’m only taking Effexor SR 150 mg regularly, no other meds except Atatax 25mg as needed. -kelly

atarax was originally designed as a mild antihistamine similar to other first generation drugs like benadryl-it had a few other effects that seemed to be useful for treating other conditions one being its sedating ability-it really isn’t an anxiolytic-it was also and still is used as a presurgical med-it helps knock you out. It can potentiate the effects of effexor or vice versa, so you may be more deeply sedated from it. The response you have and the side effects you are having are not uncommon even when the drug is used alone LM

Response:

thanks, i’ll be asking for something different at my next appt. i can’t use a medication that knocks me out for 32 hours afterwards. -kelly

Response:

Atarax is not a good med for anx/pan. Take a benzo like Xanax or Ativan *as needed*, they actually work.

ok… but for now, all i have is Atarax, and i was wondering if anyone else had any similar experiences with it. -kelly

Response:

Atarax is not a good med for anx/pan. Take a benzo like Xanax or Ativan *as needed*, they actually work. Philip – Hide quoted text — Show quoted text –

Response:

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Prescription Medication Knowledge Base » Effexor Withdrawal » Effexor Withdrawal Causing Crackling Sounds in the Brain

Effexor Withdrawal Causing Crackling Sounds in the Brain

Question:

Effexor Withdrawal Causing Crackling Sounds in the Brain Antidepressants "Thank God for this website." I had a nervous breakdown six years ago and after being on other

anti-depressants without a problem, my psychiatrist felt that Effexor had less of an effect on the heart, and so switched me to Effexor. I have tried unsuccessfully to quit on many

occasions, even though I only take 37.5 mgs per day. The extreme lethargy I feel when I have tried to quit, the tingling in various parts of my body, the weird dreams and most

troublesome of all, the crackling, electric sounds in my head have caused me too much distress to ever be successful.

Hi, I think that you have to think about all these side effect problems. Maybe they are not side-effect, maybe they are only telling you that you are stressed, and you need to fix your problems, otherwise the side-problems will be forever with you B

Response:

- Hide quoted text — Show quoted text – Effexor Withdrawal Causing Crackling Sounds in the Brain Antidepressants "Thank God for this website." I had a nervous breakdown six years ago and after being on other anti-depressants without a problem, my psychiatrist felt that Effexor had less of an effect on the heart, and so switched me to Effexor. I have tried unsuccessfully to quit on many occasions, even though I only take 37.5 mgs per day. The extreme lethargy I feel when I have tried to quit, the tingling in various parts of my body, the weird dreams and most troublesome of all, the crackling, electric sounds in my head have caused me too much distress to ever be successful. Hi, I think that you have to think about all these side effect problems. Maybe they are not side-effect, maybe they are only telling you that you are stressed, and you need to fix your problems, otherwise the side-problems will be forever with you B

I thought cross-posting to and from different kind of newsgroups was not the reason why they started alt.support.schizofrenia. Btw, is it not forbidden in the FAQ ? Berty

Response:

Effexor Withdrawal Causing Crackling Sounds in the Brain Antidepressants "Thank God for this website." I had a nervous breakdown six years ago and after being on other

anti-depressants without a problem, my psychiatrist felt that Effexor had less of an effect on the heart, and so switched me to Effexor. I have tried unsuccessfully to quit on many

occasions, even though I only take 37.5 mgs per day. The extreme lethargy I feel when I have tried to quit, the tingling in various parts of my body, the weird dreams and most

troublesome of all, the crackling, electric sounds in my head have caused me too much distress to ever be successful.

Response:

I thought cross-posting to and from different kind of newsgroups was not the reason why they started alt.support.schizofrenia. Btw, is it not forbidden in the FAQ ? Berty

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Prescription Medication Knowledge Base » Eessential Tremor Effexor » Self-medicating with extreme amounts of caffeine?

Self-medicating with extreme amounts of caffeine?

Question:

- Hide quoted text — Show quoted text – The philosopher Voltaire was known to have consumed over 50 cups of coffee a day which came as a surprise to readers of Voltaire such as Nikola Tesla, the electrical engineer and inventor. The French mathematician, Poincare, said one his mathematical advances came as the direct result of drinking a single cup of black coffee. Caffeine is a known weak central nervous system stimulant – alerting agent – and it has been extensively studied at different medical schools and universities around the world. Caffeine is known to increase alertness, energy, and the ability to concentrate in some people (not all). Source: http://pubs.acs.org/hotartcl/chemtech/99/jul/negli.html In the midst of my recent efforts to have my daughter and myself assessed for ADD, my new partner and I attended a CHADD meeting. There was a presentation given on diagnosing adults by the woman who had recently assessed me. My partner suddenly began to wonder if he might have it and said he should get assessed. As the meeting was breaking up and right in front of the presenter I asked him, "So you really think you may have ADD?" "Well, not as bad as you do." he said. "Perhaps if you didn’t drink so much coffee, you might think differently." The presenter pointed out, as I already knew, that some people self-medicate with caffeine. Then a couple of days later I asked my partner just how much coffee he consumes in a average day, because I knew he drank a lot, but I had no idea how much. He told me that he drinks an average of 20-22 mugs of coffee each day! I was shocked! I have scoured the net for info on long-term health effects of consuming that much caffeine and there is none. I don’t think anyone else drinks that much coffee…certainly no one that has been part of any study, Excessive intake is said to be about 10 cups and he drinks twice that! There are only long-term studies on people consuming up to 650 mg of caffeine per day (about 6 cups) and there are potential serious effects on that. The so-called toxic dose is 10,000 mg (about 100 cups of coffee). Even so, my partner is consuming what would be considered an "overdose"…and then some! His hands tremor, but otherwise, he is suffering no apparent ill effects. I worry about ulcers and heart irregularities. He has only been drinking this much for about the last year, since he quit drinking alcohol. I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

I used to drink a lot of coffee. I worked good with my ADD my irritated my aniexty something fierce. I was edgy and parinoid and my my hair trigger temper would go off without warning. I was such a joy to be around . But I love coffee so I switched to decaf. Who says you can’t have your cake and eat it too. Dami

Response:

For years I’ve happily consumed large quantities of coffee — 32oz on the way to work, several 20oz during the day, then more at night, never kept me up. Never occured to me it might be "self-medicating", I just thought it was a relatively harmless addiction that seemed to help me get down to business. Is this true of depression, anxiety disorders, or BPD, or is it mainly ADD? – Jeff Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently? I used to drink a lot of coffee. I worked good with my ADD my irritated my aniexty something fierce. I was edgy and parinoid and my my hair trigger temper would go off without warning. I was such a joy to be around . But I love coffee so I switched to decaf. Who says you can’t have your cake and eat it too.

– ‘98 Rans V-Rex ==–% Waltham, MA () O http://www.BlueSNAFU.com – v2.35

Response:

Although, I don’t know for sure, it think it’s mainly ADD. Since caffine is a stimulant and gives you that extra kick in the butt that helps. I remember during some of my caffinated days, I would drink a large iced coffee and clean the whole house. Housecleaning is very difficult for me. My mom was, and is, the same way. She was never diagnosed with ADD but she has all the symptoms, but shes worse than me but that’s another story. I’m not sure if caffine helps depression I have that too but it never seemd to make a difference with me. Anxiety I’m sure it dosen’t help since caffine is a form of amphetmine and as I’ve found personally after long usage it was very bad for my anxiety so I had to stop. Dami – Hide quoted text — Show quoted text – Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently? I used to drink a lot of coffee. I worked good with my ADD my irritated my aniexty something fierce. I was edgy and parinoid and my my hair trigger temper would go off without warning. I was such a joy to be around . But I love coffee so I switched to decaf. Who says you can’t have your cake and eat it too.

Response:

The philosopher Voltaire was known to have consumed over 50 cups of coffee a day which came as a surprise to readers of Voltaire such as Nikola Tesla, the electrical engineer and inventor. The French mathematician, Poincare, said one his mathematical advances came as the direct result of drinking a single cup of black coffee. Caffeine is a known weak central nervous system stimulant – alerting agent – and it has been extensively studied at different medical schools and universities around the world. Caffeine is known to increase alertness, energy, and the ability to concentrate in some people (not all). Source: http://pubs.acs.org/hotartcl/chemtech/99/jul/negli.html – Hide quoted text — Show quoted text – In the midst of my recent efforts to have my daughter and myself assessed for ADD, my new partner and I attended a CHADD meeting. There was a presentation given on diagnosing adults by the woman who had recently assessed me. My partner suddenly began to wonder if he might have it and said he should get assessed. As the meeting was breaking up and right in front of the presenter I asked him, "So you really think you may have ADD?" "Well, not as bad as you do." he said. "Perhaps if you didn’t drink so much coffee, you might think differently." The presenter pointed out, as I already knew, that some people self-medicate with caffeine. Then a couple of days later I asked my partner just how much coffee he consumes in a average day, because I knew he drank a lot, but I had no idea how much. He told me that he drinks an average of 20-22 mugs of coffee each day! I was shocked! I have scoured the net for info on long-term health effects of consuming that much caffeine and there is none. I don’t think anyone else drinks that much coffee…certainly no one that has been part of any study, Excessive intake is said to be about 10 cups and he drinks twice that! There are only long-term studies on people consuming up to 650 mg of caffeine per day (about 6 cups) and there are potential serious effects on that. The so-called toxic dose is 10,000 mg (about 100 cups of coffee). Even so, my partner is consuming what would be considered an "overdose"…and then some! His hands tremor, but otherwise, he is suffering no apparent ill effects. I worry about ulcers and heart irregularities. He has only been drinking this much for about the last year, since he quit drinking alcohol. I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

Before you buy.

Response:

Ugh…I am literally shuddering at the thought of this. For the record, as much as my partner loves his coffee, I hate the taste of it and your recipe sounds disgustingly bitter to me. My reaction to the caffeine contained in colas and coffee: I get horribly nauseous & shaky. I haven’t let cola pass my lips in over 10 years because of this. I prefer weak tea…with a packet of equal & lots of coffeemate. Briana

Response:

Expresso has less caffine than a lighter roast. Also I don’t find it bitter at all if it is fresh which is why I make one cup at a time. – Hide quoted text — Show quoted text – I’ve got you all beat.. at work we make a POT of coffee using THREE scoops of CAFE BUSTELLO (expresso coffee) at home I make A CUP of coffee using TWO SCOOPS (yes two scoops per cup) of the same coffee. (a scoop is 1/8 of a cup) Ugh…I am literally shuddering at the thought of this. For the record, as much as my partner loves his coffee, I hate the taste of it and your recipe sounds disgustingly bitter to me. My reaction to the caffeine contained in colas and coffee: I get horribly nauseous & shaky. I haven’t let cola pass my lips in over 10 years because of this. I prefer weak tea…with a packet of equal & lots of coffeemate. Briana

– Nessa — If trains stop at trains stations, what happens at work stations?

Response:

Expresso has less caffine than a lighter roast. Also I don’t find it bitter at all if it is fresh which is why I make one cup at a time.

i saw my gp today and tried to tell him some of my ‘difficulties’. so i mentioned that i drank loads and loads of coffee and he asked why and i said because it helps me function so he said ‘ah, you’re caffeine addicted.’. i mean , god, how the hell am i going to explaing to a shrink what my life is like when they have such answers parat ? they can only dx within their learned boundaries. i have appt. with shrink in two weeks. is it a good idea to phone with them first or write, or what ? sammi. – Hide quoted text — Show quoted text – I’ve got you all beat.. at work we make a POT of coffee using THREE scoops of CAFE BUSTELLO (expresso coffee) at home I make A CUP of coffee using TWO SCOOPS (yes two scoops per cup) of the same coffee. (a scoop is 1/8 of a cup) Ugh…I am literally shuddering at the thought of this. For the record, as much as my partner loves his coffee, I hate the taste of it and your recipe sounds disgustingly bitter to me. My reaction to the caffeine contained in colas and coffee: I get horribly nauseous & shaky. I haven’t let cola pass my lips in over 10 years because of this. I prefer weak tea…with a packet of equal & lots of coffeemate. Briana — Nessa — If trains stop at trains stations, what happens at work stations?

Response:

If you feel that the central nervous system stimulant – alerting agent – caffeine may be helpful to you, the best place to start is with your family doctor. That’s what I did. C. Thomas Wild The most notable behavioral effects of caffeine – increased alertness, energy, and ability to concentrate – occur after consumption of low to moderate doses (50-300 mg). Source: http://pubs.acs.org/hotartcl/chemtech/99/jul/negli.html Attention Deficit Disorder: http://www.merck.com/pubs/mmanual/section19/chapter262/262d.htm http://www.angelfire.com/biz/addsyndrome/index.html http://homepages.msn.com/RightWay/c_thomas_wild Domeena C. Renshaw, M.D., in The Hyperactive Child, reports a study by Schnackenberg, who substituted caffeine for methylphenidate (Ritalin) in eleven children who were on the latter medication for their hyperkinetic symptoms. She reports that his results with two cups of coffee (equivalent to 200-300 mg. caffeine) per day were as satisfactory as the amphetamines, at one tenth of the cost. There are a number of FDA approved medicines such as NoDoz which list caffeine as the active ingredient. Often there are cautions such as too much caffeine may cause nervousness, irritability, sleeplessness and, occasionally, rapid heart beat. The products are generally marketed for occasional use only and they are not intended for use as a substitute for sleep. If a person wants to find out more about the products, the person should consult their family doctor. That’s what I did. – Hide quoted text — Show quoted text – In the midst of my recent efforts to have my daughter and myself assessed for ADD, my new partner and I attended a CHADD meeting. There was a presentation given on diagnosing adults by the woman who had recently assessed me. My partner suddenly began to wonder if he might have it and said he should get assessed. As the meeting was breaking up and right in front of the presenter I asked him, "So you really think you may have ADD?" "Well, not as bad as you do." he said. "Perhaps if you didn’t drink so much coffee, you might think differently." The presenter pointed out, as I already knew, that some people self-medicate with caffeine. Then a couple of days later I asked my partner just how much coffee he consumes in a average day, because I knew he drank a lot, but I had no idea how much. He told me that he drinks an average of 20-22 mugs of coffee each day! I was shocked! I have scoured the net for info on long-term health effects of consuming that much caffeine and there is none. I don’t think anyone else drinks that much coffee…certainly no one that has been part of any study, Excessive intake is said to be about 10 cups and he drinks twice that! There are only long-term studies on people consuming up to 650 mg of caffeine per day (about 6 cups) and there are potential serious effects on that. The so-called toxic dose is 10,000 mg (about 100 cups of coffee). Even so, my partner is consuming what would be considered an "overdose"…and then some! His hands tremor, but otherwise, he is suffering no apparent ill effects. I worry about ulcers and heart irregularities. He has only been drinking this much for about the last year, since he quit drinking alcohol. I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

Before you buy.

Response:

Years ago, I came back from shore leave and discovered that the the hospital corpsman had hooked up an IV tube at my bunk–substituting a Coke bottle for the plasma. His explanation: You drink so much of the stuff, you might as well main-line it. Paul

Response:

My wife is a nurse, and I keep asking her to give me IV coffee.

Response:

You mean you have blood in your coffee stream? — Nessa — does fuzzy logic tickle

Response:

- Hide quoted text — Show quoted text – Years ago, I came back from shore leave and discovered that the the hospital corpsman had hooked up an IV tube at my bunk–substituting a Coke bottle for the plasma. His explanation: You drink so much of the stuff, you might as well main-line it. Paul My wife is a nurse, and I keep asking her to give me IV coffee. You mean you have blood in your coffee stream?

ROLF, or ROFL, or ROFLMAO or MFOSPALROFL err, shanks shor she shjoke, shbut shi shave shoo shlean she shreen shoff. – Hide quoted text — Show quoted text – — Nessa — does fuzzy logic tickle

Response:

I’ve got you all beat.. at work we make a POT of coffee using THREE scoops of CAFE BUSTELLO (expresso coffee)

What? You work at *my* office? That super-strong stuff smells good, but… ICK!!! But then, I’ve never been much of a coffee drinker, unless it’s mocha. Chewy, whose coffee you can float a horse shoe in, harasses me for liking a little coffee with my milk and sugar. — Light, Love, & Laughter, Kitten, Goddess of Mischief "Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this." – Anonymous "Just for today, do not worry; Just for today, do not anger; Earn your living honestly; Honor your parents, teachers and elders; Show gratitude for every living thing."- Dr. Mikao Usui Before you buy.

Response:

I’ve got you all beat.. at work we make a POT of coffee using THREE scoops of CAFE BUSTELLO (expresso coffee) at home I make A CUP of coffee using TWO SCOOPS (yes two scoops per cup) of the same coffee. (a scoop is 1/8 of a cup) – Hide quoted text — Show quoted text – When I was finally diagnosed at age 40 I was drinking between ten and fifteen pints of coffee per day … often instant coffee with a TABLESPOON of granules per cup. I find the International Coffees** make a wonderful creamer, especially with espresso…. AmMen **International Coffees are a line of instant coffee mixed with flavorings, sugar, and HeavenKnowsWhat. Before you buy.

– Nessa — does fuzzy logic tickle

Response:

Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

I drank coffee from the age of about eight or nine … as a kid I would take a 30 oz flask of black coffee to school. In those days we had free school milk, so I would have half the coffee at morning break with the milk, and keep the rest for lunch. When I was finally diagnosed at age 40 I was drinking between ten and fifteen pints of coffee per day … often instant coffee with a TABLESPOON of granules per cup. What was interesting was that I didn’t get any sort of buzz, and could stop for a few days without any withdrawal symptoms apart from feeling more " unfocussed " Ian Ford

Response:

When I was finally diagnosed at age 40 I was drinking between ten and fifteen pints of coffee per day … often instant coffee with a TABLESPOON of granules per cup.

I find the International Coffees** make a wonderful creamer, especially with espresso…. AmMen **International Coffees are a line of instant coffee mixed with flavorings, sugar, and HeavenKnowsWhat. Before you buy.

Response:

Curious…. I remember hearing about a kind of bottled water with caffeine added to it(don’t remember brand name, tho). Anyone try to make coffee with *that*? Buny

Response:

His hands tremor, but otherwise, he is suffering no apparent ill effects.

It is possible that the tremors in the hands could be the result od something besides the caffeine (*could*). My famyl has a history of hand tremors, which is a benign condition called "familial tremor" or "essential tremor". It has to do with overcompensating for fine motor skills. http://www.parkinsonsinstitute.org/tremor.html Even though this says "parkinson’s", ET is *not* parkinson’s syndrome. Some things can make my hands tremor more-caffeine is one of them. Fatigue, stress(physical or emotional) can do it. So are certain medications, such as my asthma meds. But even when not on these meds, or when I got "off" of caffeine, my hands still tremor to some degree. Then again, his tremors can be something else entirely. Like ADHD, it is a matter of finding out what it is *not* before one discovers what it *is*. Buny

Response:

[...] I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

ADDers do not measure coffee consumption in cups; the pot is the standard measure. Cutting back to 5 is good for your health. I might be exaggerating slightly, but perhaps the answer to your question is ‘yes’?

Response:

– Hide quoted text — Show quoted text – [...] I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently? ADDers do not measure coffee consumption in cups; the pot is the standard measure. Cutting back to 5 is good for your health.

Yup…5 pots George I might be exaggerating slightly, but perhaps the answer to your question is ‘yes’?

Before you buy.

Response:

In the midst of my recent efforts to have my daughter and myself assessed for ADD, my new partner and I attended a CHADD meeting. There was a presentation given on diagnosing adults by the woman who had recently assessed me. My partner suddenly began to wonder if he might have it and said he should get assessed. As the meeting was breaking up and right in front of the presenter I asked him, "So you really think you may have ADD?" "Well, not as bad as you do." he said. "Perhaps if you didn’t drink so much coffee, you might think differently." The presenter pointed out, as I already knew, that some people self-medicate with caffeine. Then a couple of days later I asked my partner just how much coffee he consumes in a average day, because I knew he drank a lot, but I had no idea how much. He told me that he drinks an average of 20-22 mugs of coffee each day! I was shocked! I have scoured the net for info on long-term health effects of consuming that much caffeine and there is none. I don’t think anyone else drinks that much coffee…certainly no one that has been part of any study, Excessive intake is said to be about 10 cups and he drinks twice that! There are only long-term studies on people consuming up to 650 mg of caffeine per day (about 6 cups) and there are potential serious effects on that. The so-called toxic dose is 10,000 mg (about 100 cups of coffee). Even so, my partner is consuming what would be considered an "overdose"…and then some! His hands tremor, but otherwise, he is suffering no apparent ill effects. I worry about ulcers and heart irregularities. He has only been drinking this much for about the last year, since he quit drinking alcohol. I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

Response:

snip His hands tremor, but otherwise, he is suffering no apparent ill effects. I worry about ulcers and heart irregularities.

I did that once in grad school. Ulcers are generally caused by bacteria or non-steroidal anti-inflamatory drugs. High coffee intake can cause cardiac arrhythmias. It’s pretty spooky but it goes away. He has only been drinking this much for about the last year, since he quit drinking alcohol. I now have no doubts that he’s self-medicating undiagnosed ADD and I want him to get assessed. I managed to convince him to cut back to 10 cups a day and gradually to 5 for the sake of his health. So far, so good. Has anyone else here tried to unknowingly self-medicate with caffeine to that extreme? Does anyone here even know someone who drinks that much coffee consistently?

It’s pretty hard to figure caffeine levels because it’s quite easy to make a cup of coffee four times as strong as the average weak North American coffee. I could fix 5 cups that would have as much caffeine as 20 restaurant cups. – George Before you buy.

Response:

Author: admin on
Category: Eessential Tremor Effexor
Tags: Eessential Tremor Effexor

Prescription Medication Knowledge Base » Venlafaxine Effexor » Chronic Neuropathic Pain etc.

Chronic Neuropathic Pain etc.

Question:

"Edee Roche" <Roche…@AOL.COM

wrote in message

news:39.80b5c24.26b3c117@aol.com…

I’m on prozac, which costs between $140 and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada?

1) You bet your *ass* prozac is cheaper here, Edee. It would run $90-120CDN ($60-80US) for your scrip. 2) Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here. :-( — (((((((((((((U))))))))))))) Michael <muirh…@island.net

-=[ Livin' on Island Time ]=-

Response:

In a message dated 07/27/2000 11:57:35 PM Central Daylight Time, ta…@TNS.NET writes:

<< I just downloaded a huge list of pharmacies in Mexico and that’s my next step.

I’m on prozac, which costs between $140 and $156 for 60 caps. I take Miacalcin to rebuild and strengthen my bones @ about $66 a month. These are two of the 10 meds I take, and the most expensive. Tammy mentioned Mexico. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? Edee

Response:

Shell, I can increase my neurontin if I want too (more $$$$) – I don’t want to go back on morphine as I do travel – it is very difficult to go out of this country with morphine – I went to Tel Aviv (Israel trip) – found out after that if my meds were inspected I dould have been arrested even with Neuro’s lettters etc. That scared me. Be well Shell Love Barbxx. "Shell" <smin…@epix.com

wrote in message

news:397B4595.FA1F6D1B@epix.com… – Hide quoted text — Show quoted text -

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never

even

ask for morphine and that is why I put up with the awful neuro I currently

see

because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give

you some

for break thru pain? I never sleep thru the night. I hate this nasty pain

and I

feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their

jobs.

Take Care Shell Barb Edmiston wrote: Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise

I

get into this ‘overdrive’ like tremors and weakness + pain but fast

heart

and nightmares.(Neurontin relief is reduced by eating high protein =

steak

or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering

what

the ****** is going on in my body. Got my first wheelchair last week –

for > > home – but failing badly at everything else. Hey – xx be well on both > > meds!! OK? > > "joannek4" <joann…@email.msn.com

wrote in message

> > news:ePKwXo58$GA.420@cpmsnbbsa08… > > > Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> > > news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > > > Shell – I thought morphine worked really well for me – it changed my > > life! > > > > But the Docs are dead against it now as some folk have discovered ho w to

change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro

sent

me to a Pain Clinic because he tried everything he could and didn’t work.

I

deal with nerve pain which in my opinion only Morphine can help calm

the

pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

On 29 Jul 2000 08:14:03 +0300, Roche…@AOL.COM (Edee Roche) wrote: }and if so, }what iis the procedure to follow to get my meds from Canada?

I just did a search for any outlets that sold prescription drugs on-line. The only one I found was Guardian Drugs, but you must have a prescription from a physician licensed to practice in the Province of Ontario. If you want to search further then I suggest http://www.canada.com — jcarter at superaje dot com The next century and the next millennium begin at midnight on December 31,2000.

Response:

Here are some drug comparisons from an article in the OREGONIAN newspaper. The U.S. insured price is the cost negotiated & paid by the insurance company. Drug U.S. insured Canada Mexico U.S. uninsured Prilosec $58.73 $49.80 $37.50 $117.56 Zoloft 115.70 125.00 133.00 223.61 One of the tv stations did a cost comparison between Portland, OR pharmacies and found some of the best prices at small pharmacies. Carole – Hide quoted text — Show quoted text -Michael Muirhead wrote:

"Edee Roche" <Roche…@AOL.COM wrote in message news:39.80b5c24.26b3c117@aol.com… I’m on prozac, which costs between $140 and $156 for 60 caps. Does anyone out there know if meds would be cheaper in Canada? and if so, what iis the procedure to follow to get my meds from Canada? 1) You bet your *ass* prozac is cheaper here, Edee. It would run $90-120CDN ($60-80US) for your scrip. 2) Other than showing up here to buy ‘em, I have no idea how you’d get ‘em from here. :-( — (((((((((((((U))))))))))))) Michael <muirh…@island.net -=[ Livin' on Island Time ]=-

Response:

In a message dated 07/23/2000 3:34:30 PM Central Daylight Time, ms150…@MINDSPRING.COM writes:

<< He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though my actions show otherwise. Isn’t it frustrating? Really tough when we have this pain and can barely function, and to add to it, we have to fight the doctors to get what we need.

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee

Response:

Joanne, You SAID it girl! Power to the patient! Susan E

Response:

John P. Husvar <jhus…@apk.net

wrote in message

news:8lhabj$1rh$1@plonk.apk.net…

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement.

I agree…this has been an ongoing issue for me. With sufficient pain meds, I’m up and around, active, working, eating better, and less tired. Funny how my non-MS friends can take a Vicodin and it wipes them out…for me it’s a few hours of respite on bad days and it gets me up and functioning. My HMO disagrees. MS is officially a "painless" disease. I am hoping the MS Society will come out with some official statement at some point that will allow some of the stricter HMO’s (I have Kaiser) to prescribe adequate pain relief. We’re actually looking into going down to Mexico for meds at this point. I spoke to a therapist about meds – she specializes in illness with chronic pain. The whole addiction question. Her questions were "Have you increased your dosage or frequency?" No. "What do you do when you take a pain reliever?" Laundry, play with my child, cook, work, and sleep restfully. Her response made sense to me….that if we are addicted to anything it’s the relief from pain, and that if monitored carefully, the improvement in quality of life far outweighs the risks. Unfortunately, she can’t write prescriptions Tammy —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM

wrote in message

news:44.5bbe4f0.26ade33a@aol.com… – Hide quoted text — Show quoted text -

I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain

and

can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is

the

pain and that was a right I was entitled to. Edee

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I just spoke with my Kaiser pharmacy and my doc (and he IS a specialist) hasn’t gotten around to this month’s refill approval yet (I have to get a new one every month, and it’s about half of what I actually need). It makes me sick. I just downloaded a huge list of pharmacies in Mexico and that’s my next step. This is a huge waste of energy. I though the National MS Society was considering a statement on pain management and MS? Their stance on the ABC drugs is the one and only reason I got approved for Copaxone after a 3-month fight. (I wasn’t "sick enough". For a prophylactic drug.) Tammy <ms150…@mindspring.com

wrote in message

news:8lopl0$r75$1@slb0.atl.mindspring.net… – Hide quoted text — Show quoted text -

I am going through the exact same thing myself! I take hydrocodone and my neuro is afraid of addiction!!! :O I too cut them in half and wait as

long

as I possibly can between pills. My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled. He gave me one more and said ‘no more’! I am switching to a specialist and hoping that he can help with something else that will work as well. No one can imagine this pain that

we

go through. NOT the pain of the occasional spasm! But feels like being

in

labor 24/7! Karlyn Shell wrote in message <397F4EA9.2E732…@epix.com… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making

it

up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when no patient should have to

worry

about living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give

you > to > >> parcel them out over a month’s time to make them last. It’s ridiculous, > and > >> does increase stress – something none of us need. It feels like a > >> never-ending battle. > >> Tammy > >> Edee Roche <Roche…@AOL.COM

wrote in message

> >> news:44.5bbe4f0.26ade33a@aol.com… > >> > I cut mine in half also. I have been taking oxycodone since 1980, about

20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for

its

intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

—–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

I am going through the exact same thing myself! I take hydrocodone and my neuro is afraid of addiction!!! :O I too cut them in half and wait as long as I possibly can between pills. My husband told the doc, that stress is our worst enemy and there is not stress to compare with what we go through trying to get our pain pills refilled. He gave me one more and said ‘no more’! I am switching to a specialist and hoping that he can help with something else that will work as well. No one can imagine this pain that we go through. NOT the pain of the occasional spasm! But feels like being in labor 24/7! Karlyn – Hide quoted text — Show quoted text -Shell wrote in message <397F4EA9.2E732…@epix.com

… It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do

as I

cannot take aspirin or ibuprofen and of course the docs think I’m making it

up

like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go

through

their little phase and end up at Betty Ford. I’m sorry just having a bad

pain

day and so tired of playing the game when no patient should have to worry

about

living with this awful pain. Take Care Shell Tammy wrote: That is such an encouraging attitude, Edee…I so know that horrible

feeling

of no refills and no help in sight. Or counting out what they do give you

to

parcel them out over a month’s time to make them last. It’s ridiculous,

and

does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about

20

years. I use less now than ever and have had now problems with it at

all.

Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found

that

stress increases pain, including stress caused by knowing you are in

pain

and can’t do anything about it or are running low on pain medication with

no

refills. I told my GP and my neuro both that the only part of MS I can control

is

the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

It is awful having to worry about the next refill. My spouse and I are constantly wondering whether the cessation will occur and what we will do as I cannot take aspirin or ibuprofen and of course the docs think I’m making it up like the one episode of ER where the old lady says she has a migraine and aspirin hurts her ‘tummy’. Then of course, you have the actors who go through their little phase and end up at Betty Ford. I’m sorry just having a bad pain day and so tired of playing the game when no patient should have to worry about living with this awful pain. Take Care Shell – Hide quoted text — Show quoted text -Tammy wrote:

That is such an encouraging attitude, Edee…I so know that horrible feeling of no refills and no help in sight. Or counting out what they do give you to parcel them out over a month’s time to make them last. It’s ridiculous, and does increase stress – something none of us need. It feels like a never-ending battle. Tammy Edee Roche <Roche…@AOL.COM wrote in message news:44.5bbe4f0.26ade33a@aol.com… I cut mine in half also. I have been taking oxycodone since 1980, about 20 years. I use less now than ever and have had now problems with it at all. Many in the medical field believe that if a medication is used for its intended purpose, addiction is very rare.and unlikely. I have found that stress increases pain, including stress caused by knowing you are in pain and can’t do anything about it or are running low on pain medication with no refills. I told my GP and my neuro both that the only part of MS I can control is the pain and that was a right I was entitled to. Edee —–= Posted via Newsfeeds.Com, Uncensored Usenet News =—– http://www.newsfeeds.com – The #1 Newsgroup Service in the World! —–== Over 80,000 Newsgroups – 16 Different Servers! =—–

Response:

Here in NY- this is a problem as well. Drs. here are paranoid about any pain meds. Their fear is addiction. This is insanity-I know so many are suffering with tremendous pain on a daily basis, but Drs. here refuse to Rx. I guess they are more concerned with how they appear to the HMOs than with the welfare of their patients. Its called CYA.!! Dianne-NY – Hide quoted text — Show quoted text -

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com wrote in message news:ea5v0lT9$GA.64@cpmsnbbsa07… Hi Michael, I have to agree with you on getting addicted to whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Hi Michael, I have to agree with you on getting addicted to whatever a person takes for pain and it works. We are talking about MS and the severe pain that comes with it. What is more important stopping the pain enough to deal with it or becoming addicted. It is ridiculous for a Doctor to even bring this up to a patient but if it’s a must,well I feel it’s our choice to continue to take it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

While addiction can generate its own set of problems additional to the condition causing the pain; which is better, a happy, productive, self-supporting addict or a miserable dependent, but "clean" victim? Is a puzzlement. joannek4 <joann…@email.msn.com

wrote in message

news:ea5v0lT9$GA.64@cpmsnbbsa07… – Hide quoted text — Show quoted text -

Hi Michael, I have to agree with you on getting addicted to whatever a person

takes for

pain and it works. We are talking about MS and the severe pain that

comes

with it. What is more important stopping the pain enough to deal with

it or

becoming addicted. It is ridiculous for a Doctor to even bring this up

to a

patient but if it’s a must,well I feel it’s our choice to continue to

take

it not the Doc. We are the ones in pain not him. Take Care, Joanne

Response:

Barb, Won’t your doc give you both (neruontin and morphine) I know I could never even ask for morphine and that is why I put up with the awful neuro I currently see because I’m scared I will lose my current pain meds. Anyway….. If you have already used Morphine and it helped, wouldn’t your doc give you some for break thru pain? I never sleep thru the night. I hate this nasty pain and I feel for all of us that have to put up with it ecspecially when there is something that helps. Our only obstacle are getting the docs to do their jobs. Take Care Shell – Hide quoted text — Show quoted text -Barb Edmiston wrote:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else. Hey – xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com wrote in message news:ePKwXo58$GA.420@cpmsnbbsa08… Barb Edmiston <barbedmis…@dingoblue.net.au wrote in message news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

I have this pain and my neuro prescribed Hydrocodone and it works! Doesn’t take the pain away completely, but leaves you with a feeling of pressure instead of PAIN. But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top of not taking away the pain. I have some of the hydrocodone left and as this exacerbation has started subsiding, I have been cutting my 10mg tablets in half and that seems to be doing the job…at least now. I have an appointment with a new neurologist Aug. 1st who specializes in MS and we will see what he has to say. Only problem is that I have pain meds to last only until the 28th and my current neuro, will not prescribe any more. He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though my actions show otherwise. Isn’t it frustrating? Really tough when we have this pain and can barely function, and to add to it, we have to fight the doctors to get what we need. Karlyn "Laura K." wrote in message <8e.7f85b88.26a64…@aol.com

… Hello Group: For all interested, another prospective on MS pain. use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

Response:

Karlyn wrote…

I have this pain and my neuro prescribed Hydrocodone and it works!

Doesn’t

take the pain away completely, but leaves you with a feeling of pressure instead of PAIN. But now he fears that I will become ‘addicted’ and has tried other things that have not worked and made me violently ill on top

of

not taking away the pain.

Gimme a break. Your doctor is an idiot. Don’t fault him too harshly for that, most of them are in this regard. Of *course* you’ll become addicted ("tolerant" and "dependant", to name it properly) if you take any opiate for long enough… so WHAT? It’s not that hard to become UN-addicted when the time comes to stop taking the stuff. What he’s *really* afraid of is that you’ll become the stereotypical poster-campaign drug fiend that the world has come to know and fear. Doctors aren’t granted some special immunity to social pressure, you know.

He is aware that I cut the pills in half and on good days, have gone up to 11 hours without one…but still afraid that I will get addicted, though

my

actions show otherwise. Isn’t it frustrating?

Yup. You’ve given him ample evidence that even if you *did* become addicted, you’re prepared to end your addiction as soon as it’s appropriate. Model behaviour, I’d say. Tell your new neuro about all this, will you? It might be a good litmus test of how commited he/she is to helping you, rahter than merely *treating* you. — (((((((((((((U))))))))))))) Michael <muirh…@island.net

-=[ Livin' on Island Time ]=-

Response:

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing that works for me are narcotics. This is one whacky disease, what works for one of us doesn’t work for another. I’m glad you have found relief with the Neurontin but I never ever want to see it again. Take Care Shell – Hide quoted text — Show quoted text -Barb wrote:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price) thank you for your info! Barb. In respite I think - I hope………. xxx

Response:

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. :0( So glad it works for you – keep eating the tinned pears beats prunes….(good for the bowel!!) Barb..(on Neurontin now)…. Be Well x. "Shell" <smin…@epix.com

wrote in message

news:3975F006.9B920A51@epix.com… – Hide quoted text — Show quoted text -

Barb, I found Neurontin exacerbated all my symptoms. I hated it. The only thing

that

works for me are narcotics. This is one whacky disease, what works for one

of us

doesn’t work for another. I’m glad you have found relief with the

Neurontin but

I never ever want to see it again. Take Care Shell

Response:

Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au…

Shell – I thought morphine worked really well for me – it changed my life! But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it.

Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent me to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Hi Joanne I still get break through pain at times on Neurontin. At the moment I am in a real mess. I can’t sleep – if I try to exercise I get into this ‘overdrive’ like tremors and weakness + pain but fast heart and nightmares.(Neurontin relief is reduced by eating high protein = steak or lean chicken etc.) BUT I need to try to keep fit. Barb – wondering what the ****** is going on in my body. Got my first wheelchair last week – for home – but failing badly at everything else. Hey – xx be well on both meds!! OK? "joannek4" <joann…@email.msn.com

wrote in message

news:ePKwXo58$GA.420@cpmsnbbsa08… – Hide quoted text — Show quoted text -> Barb Edmiston <barbedmis…@dingoblue.net.au

wrote in message

> news:3977da87$0$11187$7f31c96c@news01.syd.optusnet.com.au… > > Shell – I thought morphine worked really well for me – it changed my life!

But the Docs are dead against it now as some folk have discovered how to change the content of the capsule and sell it. Hi Barb & Shell, I take Neurontin and Morphine (MS Contin) for severe pain. My Neuro sent

me

to a Pain Clinic because he tried everything he could and didn’t work. I deal with nerve pain which in my opinion only Morphine can help calm the pain. I well understand anyone dealing with pain its devastating! Take Care, Joanne

Response:

Thank you – I have only one word to say NEURONTIN beats MORPHINE!!!!!!!! AMEN. Works for me thank goodness – even though the dose goes up – (and price) thank you for your info! Barb. In respite I think - I hope………. xxx "Laura K."" <Nygab…@AOL.COM

wrote in message

news:8e.7f85b88.26a6439f@aol.com… – Hide quoted text — Show quoted text -

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute

of=20

Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of

neurolog=

y=20 at Thomas Jefferson University. Dr. Knobler has basic science and

clinical=20

research expertise in multiple sclerosis, viral immunology and the

managemen=

t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with

multiple=20

sclerosis and chronic pain disorders. About half of the patients I see

with=20

multiple sclerosis are also affected by chronic neuropathic pain.

Therefore,=

=20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and

interrupt=

s=20 the patients’ activities of daily living. The pain may be a result of

trauma=

=20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a

bur=

ning=20 dysesthetic sensation. Many of the newer anticonvulsants work

particularly=20

well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an

effort=20

directed at pushing this class of medication to its limit before

considering=

=20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400

milligrams=20

total). The patient is still experiencing sensory dysesthesia as well

as=20

having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by

starting=

=20 at a lower dose of 100 milligrams to start, and then titrating upward to

a=20

higher dose. I start the patient on the medication at bedtime initially,

to=20

be certain that the patient gets to sleep, and then add additional

doses=20

during the daytime, as needed, to get maximal relief. Recognizing that

this=20

is an educational process for the patient, I explain that it will take

time=20

to get the maximum benefit from the medicine, and encourage the patient

to=20

work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to

start,=20

and have the patient titrate up to as much as 40 milligrams at bedtime,

if=20

that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact

on=20

improving mood, slowing the urgent bladder, reducing burning pain and

helpin=

g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for

this=

=20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It

is=20

far more difficult to get a patient to continue a medication that they

have=20

had an adverse reaction to caused from taking too much of the drug, than

to=20

have the patient gradually increase the dose and tolerate the side effects

a=

=20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose

i=

n=20 100-milligram increments, generally until reaching three tablets at

bedtime.=

=20 I may then begin to spread the medication throughout the day as needed.

For=20

tiagabine, I start patients with 4 milligrams and escalate at

4-milligram=20

increments to reach a dosing schedule of two 4-milligram tablets four

times=20

per day. This can be reduced to twice daily dosing if needed for

convenience=

.=20 For topiramate, I start patients with 25 milligrams at bedtime and

escalate=20

to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at

the=20

same time. I have observed that I can continue to use lower doses of

each=20

type of medication effectively and keep the side effects low while

improving=

=20 efficacy since their mechanisms of action are different (which is beyond

the=

=20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also

be=

=20 addressed to provide effective care and management. These symptoms

include=20

aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory

problem=

s. I have noted that medication and lack of sleep can contribute to the

combine=

d=20 symptoms of sleep disruption, confusion, muscle spasms and memory

problems.=20

To address these issues effectively, I have found that a certain degree

of=20

pain relief is needed for quality sleep to take place. Pain is an

alerting=20

response that will effectively prevent sleep, and lack of sleep can lead

to=20

confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with

th=

e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn

patient=

s=20 of possible side effects such as nausea, vomiting, delayed swallowing

or=20

delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in

patients=20

treated with opioids. However, some patients indicate higher pain levels

at=20

their follow-up appointments for several reasons: (1) they have not

taken=20

their medication in order to drive to their appointment; (2) they

over-repor=

t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in

or=

der to=20 look as if they need more pain medication, or to ensure continuation of

thei=

r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement

as=20

well. I caution them about the use of magnesium citrate if they are at

risk=20

of developing fecal impaction because of the potential danger of

perforation=

.=20 Patients usually don=E2=80=99t like to hear that, but they have to know.

If=20=

they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an

antidepressant.=

=20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note

that=20

they have been of some use in both relief of depression and treatment

of=20

migraine. This is helpful since there is an element of migraine-like

headach=

e=20 in many of the patients that develop upper extremity pain problems.

Migraine=

=20 may be the response that any of several stimuli yields when triggered,

but=20

whatever the explanation the depression must be treated. Fluoxetine

(Prozac)=

,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records

of=20

effectiveness. When an SSRI cannot be used because of a potential

conflict=20

due to simultaneous use with an anti-migraine triptan (Serotonin

Syndrome),=20

bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5

t=

o=20 10 milligrams per day, with some improvement. Confusion should subside

as=20

sleep improves and the dose of anticonvulsant adjuvant is reduced.

Improved=20

pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control

is=20

that associated with the control of movement-related muscle spasms.

Muscle=20

spasms are made worse by physical activity of even the mildest variety,

a=20

dependent posture and cold ambient temperature. This is important

because=20

treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of

the=20

pain, before it has had a chance to become "centralized" pain due to

changes=

=20 secondary to the release of excitatory neurotransmitters within the

dorsal=20

root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of

1mg=20

at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so

needed=

,=20 with a maximum of eight full 4-milligram tablets per day (32

milligrams).=20

Tizanidine reduces the spasm of movement and the pain associated with

that=20

spasm,

… read more »

Response:

I hated Neurontin. It exacerbated all my symptoms and I will never take it again. I know it has helped a lot of patients but not me….yuk. As for Zoloft……To each their own. Take Care Shell – Hide quoted text — Show quoted text -"Laura K." wrote:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as

… read more »

Response:

Hello Group: For all interested, another prospective on MS pain. Intelihealth Rational Polypharmacy In The Treatment Of Chronic Neuropathic Pain Robert L. Knobler, M.D., Ph.D., is the director of the Knobler Institute of=20 Neurologic Disease, PC, and the K.I.N.D. Clinic. He is professor of neurolog= y=20 at Thomas Jefferson University. Dr. Knobler has basic science and clinical=20 research expertise in multiple sclerosis, viral immunology and the managemen= t=20 of chronic pain disorders.=20 =20 In my adult neurology practice, I see many referred patients with multiple=20 sclerosis and chronic pain disorders. About half of the patients I see with=20 multiple sclerosis are also affected by chronic neuropathic pain. Therefore,= =20 I thought I would discuss some of the clinical issues in the day-to-day=20 management of chronic neuropathic pain. The patients I see have various forms of pain, but their pain is almost=20 always severe. The pain is often rated 7-9/10 before treatment and interrupt= s=20 the patients’ activities of daily living. The pain may be a result of trauma= =20 or the lesions of multiple sclerosis. The most common component of my patients=E2=80=99 complaint is that of a bur= ning=20 dysesthetic sensation. Many of the newer anticonvulsants work particularly=20 well for this symptom, particularly gabapentin (Neurontin), tiagabine=20 (Gabitril) and topiramate (Topamax). It has been my perception, perhaps influenced by the information I am=20 provided in the history I elicit from the patient, that there is an effort=20 directed at pushing this class of medication to its limit before considering= =20 other medications. Typically, a patient will see me who has been given=20 gabapentin at a dose of 800 milligrams four times daily (2400 milligrams=20 total). The patient is still experiencing sensory dysesthesia as well as=20 having some confusion and dizziness from the high dose of gabapentin.=20 I have found that patients get the best response from gabapentin by starting= =20 at a lower dose of 100 milligrams to start, and then titrating upward to a=20 higher dose. I start the patient on the medication at bedtime initially, to=20 be certain that the patient gets to sleep, and then add additional doses=20 during the daytime, as needed, to get maximal relief. Recognizing that this=20 is an educational process for the patient, I explain that it will take time=20 to get the maximum benefit from the medicine, and encourage the patient to=20 work with me to help find the best dose for them.=20 Older drugs, such as the tricyclics, still will work best in some=20 circumstances. I may choose to use 10 milligrams of amitriptyline to start,=20 and have the patient titrate up to as much as 40 milligrams at bedtime, if=20 that much is actually needed. The reasons for using tricyclics such as=20 amitriptyline for the treatment of neuropathic pain include its impact on=20 improving mood, slowing the urgent bladder, reducing burning pain and helpin= g=20 patients get to sleep. Caution is advised in patients with a history of=20 palpitations. Dry mouth and urinary retention can present drawbacks for this= =20 class of medication, so I tend to use the newer medications with more=20 specific effectiveness. However, tricyclics sometimes still have great=20 utility and have the added benefit of being relatively inexpensive. With all of these medications, the starting dose is always low, and the=20 titration is always slow. The titration can be accelerated as needed. It is=20 far more difficult to get a patient to continue a medication that they have=20 had an adverse reaction to caused from taking too much of the drug, than to=20 have the patient gradually increase the dose and tolerate the side effects a= =20 bit longer until they are adequately treated by the drug. For gabapentin, I start patients with 100 milligrams and increase the dose i= n=20 100-milligram increments, generally until reaching three tablets at bedtime.= =20 I may then begin to spread the medication throughout the day as needed. For=20 tiagabine, I start patients with 4 milligrams and escalate at 4-milligram=20 increments to reach a dosing schedule of two 4-milligram tablets four times=20 per day. This can be reduced to twice daily dosing if needed for convenience= .=20 For topiramate, I start patients with 25 milligrams at bedtime and escalate=20 to two 25-milligram tablets or capsules four times per day. I may have some patients taking more than one type of anticonvulsant at the=20 same time. I have observed that I can continue to use lower doses of each=20 type of medication effectively and keep the side effects low while improving= =20 efficacy since their mechanisms of action are different (which is beyond the= =20 scope of the present discussion, but which is the scientific basis for=20 rational polypharmacy). Other symptoms and side effects may occur in patients and these must also be= =20 addressed to provide effective care and management. These symptoms include=20 aching pain, unresponsiveness to these newer anticonvulsants, reactive=20 depression, muscle spasms, difficulty sleeping, confusion and memory problem= s. I have noted that medication and lack of sleep can contribute to the combine= d=20 symptoms of sleep disruption, confusion, muscle spasms and memory problems.=20 To address these issues effectively, I have found that a certain degree of=20 pain relief is needed for quality sleep to take place. Pain is an alerting=20 response that will effectively prevent sleep, and lack of sleep can lead to=20 confusion and memory disturbances. To treat pain, I often prescribe opioids as they are needed. I begin with th= e=20 use of milder medications containing codeine, if tolerated. I then use=20 hydrocodone, long-acting oxycodone, long-acting morphine, methadone,=20 hydromorphone, meperidine, fentanyl patches or oral fentanyl. I warn patient= s=20 of possible side effects such as nausea, vomiting, delayed swallowing or=20 delayed gastric emptying, and constipation. I have noted a reduction of pain intensity to the 4-5/10 range in patients=20 treated with opioids. However, some patients indicate higher pain levels at=20 their follow-up appointments for several reasons: (1) they have not taken=20 their medication in order to drive to their appointment; (2) they over-repor= t=20 pain in an attempt to ensure continuation of their medication; (3) they=20 purposely don=E2=80=99t take their medication before their appointment in or= der to=20 look as if they need more pain medication, or to ensure continuation of thei= r=20 pain medication. I put patients taking opioids on a stool softener and a fiber supplement as=20 well. I caution them about the use of magnesium citrate if they are at risk=20 of developing fecal impaction because of the potential danger of perforation= .=20 Patients usually don=E2=80=99t like to hear that, but they have to know. If=20= they=20 develop gastrointestinal pain or rectal bleeding, I send them for an=20 appropriate endoscopic or colonoscopic evaluation. If patients have reactive depression develop, I prescribe an antidepressant.= =20 I favor the selective serotonin reuptake inhibitors (SSRIs), and note that=20 they have been of some use in both relief of depression and treatment of=20 migraine. This is helpful since there is an element of migraine-like headach= e=20 in many of the patients that develop upper extremity pain problems. Migraine= =20 may be the response that any of several stimuli yields when triggered, but=20 whatever the explanation the depression must be treated. Fluoxetine (Prozac)= ,=20 sertraline (Zoloft) and venlafaxine (Effexor) all have excellent records of=20 effectiveness. When an SSRI cannot be used because of a potential conflict=20 due to simultaneous use with an anti-migraine triptan (Serotonin Syndrome),=20 bupropion (Wellbutrin) can be used effectively. If memory problems persist, donepezil (Aricept) can be used at a dose of 5 t= o=20 10 milligrams per day, with some improvement. Confusion should subside as=20 sleep improves and the dose of anticonvulsant adjuvant is reduced. Improved=20 pain control will also help improve cognition. Finally, perhaps the most important aspect of neuropathic pain control is=20 that associated with the control of movement-related muscle spasms. Muscle=20 spasms are made worse by physical activity of even the mildest variety, a=20 dependent posture and cold ambient temperature. This is important because=20 treating movement-related spasms is one of the principal ways by which=20 neuropathic pain may be resolved, particularly early after the onset of the=20 pain, before it has had a chance to become "centralized" pain due to changes= =20 secondary to the release of excitatory neurotransmitters within the dorsal=20 root entry zone. I most often will use tizanidine (Zanaflex) to treat neuropathic pain=20 associated with movement-related muscle spams, beginning with a dose of 1mg=20 at bedtime. I have the patient titrate up to as much as 8 milligrams at=20 bedtime, if needed, and 1 to 4 milligrams at two-hour intervals if so needed= ,=20 with a maximum of eight full 4-milligram tablets per day (32 milligrams).=20 Tizanidine reduces the spasm of movement and the pain associated with that=20 spasm, thus allowing the patient to move more freely. Tizanidine may be used= =20 strictly on an as needed basis during the day or night. Taken together, the use of medications for the burning pain/allodynia=20 (anticonvulsants); aching pain (analgesic/narcotics); bowel regimen (stool=20 softener/fiber); reactive depression (antidepressants); disturbed memory=20 (memory enhancer); muscle spasm (antispasticity agents) provides the basis=20 for a plan of rational polypharmacy in the clinical management of the patien= t=20 with chronic neuropathic pain. Nygabnet

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Category: Venlafaxine Effexor
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Prescription Medication Knowledge Base » Zoloft Effexor » BUSPAR-help anyone?

BUSPAR-help anyone?

Question:

I was put on Buspar (worked up to 30mg/day) in March of this year. I never saw any significant change in my anxiety or PAs since so in Sept. I decided to ween myself off (my doctor said okay) of it. Has Buspar helped anyone in any way? The only thing I found that it helped was my migraine headaches. They seemed to decline amazingly while on it, but I really can’t be sure that it wasn’t related to something else. Thanks!

Response:

I recently started taking Buspar after a very bad experience with Prozac. I’ve tried other meds like Paxil, Zoloft, Effexor, and even St. John’s Wort. Nothing worked to get rid of my headaches or took me out of a withdrawn state (if anyone reads this, have you ever felt like you were in a fog, couldn’t concentrate, and just lost the "zest", if so, tell me about it.) So far my 10mgs/day of Buspar seems to be helping but it really has only been less than a week…any advice?

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Category: Zoloft Effexor
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Prescription Medication Knowledge Base » Side Effects Of Zoloft » zoloft and jumpiness

zoloft and jumpiness

Question:

ok, i’m back on zoloft and waiting for the effects to kick in. the last time around, i think it actually precipitated something close to a panic attack. i’m not so sure i’m looking forward to the other side of the pendulum either. anyone else get this? Dawn. International student Second year Media Studies RMIT University, Australia (Melbourne) "Maybe I -will- become a writer, and maybe I won’t. I don’t know. I haven’t read the last page yet." - Julia Salinger, Party of Five

Response:

Dawn, Several SSRIs cause a feeling of panic, jumpiness, and impending doom until they "kick" in. Paxil nearly wiped me out when I went on it. Luckily (?) I was in the hospital when I was put on Zoloft a few years ago. Anyhow, after about 3 weeks of feeling like shit, the drug kicked in and I did feel a bit better. My Best, ~Robbi~ "oo" http://www.geocities.com/SoHo/7160 for all of your bipolar needs. Serving bipolars since 1996! The sex organ is a terrible thing to waste! P.S. The last remark on my sig line is dedicated to the sexual dysfunction that occurs in 25% of people taking antidepressants. The 25% figure is based on medical information which is suspect.

Response:

What are the side effects of Zoloft? Guess I should be prepared for them Kimber

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Category: Side Effects Of Zoloft
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Prescription Medication Knowledge Base » Do Xanax And Zoloft Hinder Libido » My Story and The American Tinnitus Association

My Story and The American Tinnitus Association

Question:

Hello to everyone. I am new to this and am so glad to find support from many others suffering from tinnitus. It seems that nobody in my family or any of my friends understand just how troublesome tinnitus can be. I only have T in my left ear and it absolutely drives me crazy! Sometimes I think that my sinuses cause the T to be worse (like today for instance – I live in Michigan and the humidity is 100% – YUCK!) Other times I think that my TMJ is causing the T since it is only on the left side of my jaw. And then I wonder if some of the medications that I am taking could be attributing to my T. I take zoloft and xanax for anxiety. I know that zoloft can cause tinnitus, but I have been taking it for a year now and I can’t just stop taking it. I have to taper myself off of the medicine. I also take two different medications for sinuses (claritin and rutuss) and high blood pressure medicine (atenelol). Yes, I know, I sound like a real mess! And I’m only 27 years old! I just recently went to a health food store and purchased some herbs to try to help some of my problems. I HATE being dependant on drugs! Not only that, but most of them don’t even seem to work! The sad thing is, I know that I am grasping at straws to try and find the answer to where my T is coming from. Some people seem to know exactly when their T started, but I can’t attribute the start of my tinnitus to an illness, taking aspirin, or anything else. I have read a lot of messages from people who are wondering if xanax is a good medication to take for T. If I may be blunt – PLEASE do not try xanax if you don’t absolutely have to. I have been on it for a little over a year for anxiety and my body has become chemically dependant upon it. My doctor is trying to slowly wean me off of it, but it is VERY DIFFICULT! Every day I tell myself that this is the day that I am just going to stop taking my xanax! But every day I end up taking 1 or 2, especially before I go to bed at night! Anyway, not only is my body chemically dependant on xanax, but it doesn’t help my T AT ALL! Just recently I called the American Tinnitus Association to order the publication of the International Tinnitus Seminar which occured on July 12-15th, 1995. The seminar was held in Portland and many tinnitus specialists attended, contributing their findings and treatments regarding tinnitus. The publication costs $25.00 plus Shipping and Handling. While I was on the phone, I was asked if I would like to subscribe to the American Tinnitus Association. This includes Tinnitus magazines that come out 4 times a year and all sorts of information, books, an audio tape, and other things that come up throughout the year. This was also $25.00. I just thought that I would share this information. It is about 1:20 A.M. and I couldn’t sleep due to a strange pulsing ringing in my ear. Gee, I wonder what that could be? If anyone would like the address, it is: American Tinnitus Association P.O. Box 5 Portland, OR 97207-0005 Or you can call and charge by phone at (503) 248-9985. If anyone else can’t sleep due to ringing in their ears, feel free to e-mail me anytime – I’ll probably be up and I love getting email! Leslie Grobbel

Response:

I too take Xanax and Zoloft. I too only have T on my left side. I too had not been bothered by T until about 4 months ago. It just started….no reason I can think of. ENT did a work up and said it is due to hearing loss and will probably get worse. I am not buying his explanation for a few reasons, one of which is that I felt the "brush off" cuz T isn’t that exciting to an ENT. I am trying Zinc and B12 sublingual. No noticable difference. My computer seems to make the T worse and I have taken to wearing earplugs when working on the computer. My T sort of "comes and goes"….silent (or barely audible) for a few days….loud as heck for a few more. You are correct about Xanax…very hard to get off once you start and I have been taking it for 3 years, so obviously if it was gonna work for T, it would have. I plan on just checking in periodically and dealing with this thing best I can. Good Luck Steve

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