Question:

I have had asthma since birth, and it was primarily caused by seasonal allergies. ….. in the past year have virtually eliminated my asthma and use of all prescription drugs by using some mega-quality supplements, followed by huge doses of vitamin C and anti-oxidants and grape seed extract……

That sounds like me except I’ve kept a pretty serious regimen of vitamins and exercise without the same auspicious results. I was able to quit taking prescription drugs and inhalers due to a certain non-prescription medication called Haysma. That is until it suddenly dissapeared completely from the shelves of every store (it was sold in most regular grocery stores as well as drug stores) in Salt Lake City. From what I’ve been unofficially informed, it was banned in S.L. & maybe all of Utah because somebody in our LDS-influenced legislature thought it contained harmful substances, esp. caffeine. This isn’t the first time something that is practically benign in the "real" world was 86′d by our gov. Except this time it has caused me to either put up with attacks or go back to the horrible prescription drugs and/or inhalers I thought I was free from. I’m quite sure  that Haysma–there’s probably other comparable products, but this is the only one ever sold around here; because it was supposed to be harmless–is not banned anywhere else. The company, also called Haysma Inc, is still going strong according to the stock market reports. So if anyone out there in non-Mormon land knows where or how I can find it, I’d greatly appreciate an e-mail. Thanks, Mike S.W.

Response:

That sounds like me except I’ve kept a pretty serious regimen of vitamins and exercise without the same auspicious results. I was able to quit taking prescription drugs and inhalers due to a certain non-prescription medication called Haysma. That is until it suddenly dissapeared completely from the shelves of every store (it was sold in most regular grocery stores as well as drug stores) in Salt Lake City. From what I’ve been unofficially informed, it was banned in S.L. & maybe all of Utah because somebody in our LDS-influenced legislature thought it contained harmful substances, esp. caffeine.

According to a quick search I did haysma is listed as containing ephedrine.  The drug ephedrine has been associated with so many serious and fatal reactions that the FDA proposed strict limits on its usage.  These limits would have effectively banned many OTC and ‘alternative’ remedies. (These limits were dropped by the FDA after Congressional pressure.) Due to the presence of known dangers and the ability of lobbyists to prevent federal safety standards, many states have adopted the proposed FDA safety standards on their own. BTW, mixing ephedrine and caffeine is a very, very bad idea.  If haysma does in fact contain both then it is a good thing it was removed from the shelves. "Usenet is like a herd of performing elephants with diarrhea — massive, diffucult to redirect, awe-inspiring, entertaining, and a source of mind boggling amounts of excrement when you least expect it." Gene Spafford 1992

Response:

Another option for manufacturers is to petition FDA, asking the agency to establish the conditions under which the new dietary ingredient would reasonably be expected to be safe. To date, FDA’s Center for Food Safety and Applied Nutrition has received no such petitions. Under DSHEA, once a dietary supplement is marketed, FDA has the responsibility for showing that a dietary supplement is unsafe before it can take action to restrict the product’s use. This was the case when, in June 1997, FDA proposed, among other things, to limit the amount of ephedrine alkaloids in dietary supplements (marketed as ephedra, Ma huang, Chinese ephedra, and epitonin, for example) and provide warnings to consumers about hazards associated with use of dietary supplements containing the ingredients. The hazards ranged from nervousness, dizziness, and changes in blood pressure and heart rate to chest pain, heart attack, hepatitis, stroke, seizures, psychosis, and death. The proposal stemmed from FDA’s review of adverse event reports it had received, scientific literature, and public comments. FDA has received many comments on the 1997 proposal and was reviewing them at press time. Besides FDA, individual states can take steps to restrict or stop the sale of potentially harmful dietary supplements within their jurisdictions. For example, Florida has banned some ephedra-containing products, and other states have said they are considering similar action. Also, the industry strives to regulate itself, the Council for Responsible Nutrition’s Cordaro says. He cites the GMPs that his trade group and others developed for their member companies. FDA is reviewing these GMPs as it considers whether to pursue mandatory industry-wide GMPs. Another example of self-regulation, Cordaro says, is the voluntary use of a warning about ephedra products that his organization drafted. He says that about 90 percent of U.S. manufacturers of products containing ephedra alkaloids now use this warning label. http://www.fda.gov/fdac/features/1998/598_guid.html Ephedra As you know, on June 4, 1997, FDA published in the Federal Register a proposed rule on Dietary Supplements Containing Ephedrine Alkaloids (62 FR 30678). There are a variety of opinions about the proposed rule and the direction the Agency should take. One cannot dispute, however, the shear volume of the reports of illness and injuries that FDA received reported to be associated with the use of dietary supplements suspected to contain ephedrine alkaloids. Between 1993 and mid-1996, FDA received about 1,600 AER’s reported to be associated with the use of dietary supplement products in general. Of these, over half of the AER’s were reported to be associated with the use of dietary supplements that contained, or were suspected to contain, ephedrine alkaloids. These adverse events tended to involve cardiovascular system effects and nervous system effects. FDA evaluated these reports and found that the single most common element was that the products contained, or were thought to contain, a source of ephedrine alkaloids (62 FR 30679). FDA used the information available in the approximately 600 AER’s that were in the Agency’s possession as of June 7, 1996, to describe patterns associated with these reports. A review of the demographic information showed that in over half of the reported adverse events, the injured party was under 40 years of age. Almost 75 percent of the adverse events were reported to occur in females, often using products promoted for weight loss (62 FR 30683). About 59 percent of the adverse events were reported to occur within 4 weeks of starting to use the product. About 14 percent of the reported adverse events occurred on the first day of using the dietary supplement and, in a few cases, on the initial use (62 FR 30684). Overall, the reported signs and symptoms associated with these AER’s included those in which clinically serious events occurred, including heart attack, stroke, psychoses, seizure, and in a few cases, death, as well as those with less clinical significance, including rapid and irregular heart rhythms, increased blood pressure, anxiety, nervousness, tremor, hyperactivity, and insomnia (62 FR 30683). The Agency recognized that these reports could be indicative of early warnings of serious cardiovascular or nervous system risks if product use were to continue. Notably, the information from these adverse events revealed consistent patterns of signs and symptoms in both healthy individuals and in those with underlying diseases or conditions. Many of these reported signs and symptoms occurred in young adults who generally would not have been expected to be at high risk for such conditions (e.g., heart attack and stroke). Included were the deaths of two young adult males in which the medical examiners attributed the cause of death to ephedrine toxicity (ARMS Nos. 10862 and 11134 at 62 FR 30720 and 30722, respectively). In some cases, particular events appeared to reflect individual sensitivities related to dose levels, frequency, or duration of use of ephedrine alkaloids (62 FR 30684). As depicted in Chart C, the ephedra AER’s generated an important "signal", but were just one small component (the "tip of the iceberg") of FDA’s overall analysis of the potential public health risk associated with this product. To better understand the nature and types of products associated with these AER’s, FDA conducted a review of the marketplace (62 FR 30679). Over a two-year period, FDA collected and analyzed over 25 dietary supplement products labeled as containing a known source of ephedrine alkaloids. FDA also searched the scientific literature for relevant clinical studies, case reports, and the expected physiologic and pharmacologic effects. In addition, FDA also convened an ad hoc working group of its Food Advisory Committee (Working Group) and its Food Advisory Committee to consider the public health problems associated with the use of ephedrine alkaloid-containing dietary supplements (62 FR 30680). In the proposed rule, FDA requested comments containing data, particularly clinical data, on the safety of the use of ephedrine alkaloids in dietary supplements. (62 FR 30694). As noted above, while the AER’s served as the warning signal of potential hazard associated with the use of dietary supplements containing ephedrine alkaloids, the Agency’s evaluation of those hazards was comprised of multiple sources of scientific information. This evaluation included the AER’s, a search of the scientific literature, published case reports, controlled clinical studies, and published reports of adverse events associated with traditional uses of ephedrine alkaloids. All of these sources of scientific information revealed a consistent pattern of cardiovascular and nervous system effects associated with ephedrine alkaloids. That view was affirmed by FDA’s Food Advisory Committee. http://www.fda.gov/ola/aems599.html

Response:

I have had asthma since birth, and it was primarily caused by seasonal allergies. It did however flare up at any time, often linked to strenuous exertion, temperature changes and stress. I have been on Tedral, Beclovent, Salbutamol, Ventolin and Flovent. I am now 40, and in the past year have virtually eliminated my asthma and use of all prescription drugs by using some mega-quality supplements, followed by huge doses of vitamin C and anti-oxidants and grape seed extract. The daily vitamin C doses for me (that my body can tolerate without any effects) are around 5000 milligrams. That can vary from person to person. I also made some minor diet changes in cutting back on dairy products and red meat. Hope this information helps. Eric

Response:

Question:

Just wondering if anyone has tried taking Singulair to treat allergy related sinus congestion.

Response:

I read that it was FDA approved for allergic rhinitis very recently. "Steven Balough" <sbalo…@mail.utexas.edu

wrote in message

news:avlc9n$2kp$1@geraldo.cc.utexas.edu… – Hide quoted text — Show quoted text -

Just wondering if anyone has tried taking Singulair to treat allergy

related

sinus congestion.

Response:

Many allergists and ENTs have prescribed it for that for years, even without FDA approval for it ("off-label"). I’ve been prescribed it several times, for rhinitis. Recently I started taking it again. To tell the truth, I’m really not sure if it is helping me at all or not. (Sometimes it’s hard to know. You think–"I might be worse if I wasn’t taking this".) Anyone here noticed definitive results from it? Are there any published controlled double-blind studies on using it for rhinitis? (I guess there would have to be, if in fact the FDA has approved it for that purpose.) Anyone know where one can read the studies? Can’t regular Singulair use over years have negative effects on the liver? What if one takes both Singulair and acetaminophen regularly? "Joy" <n…@nospam.com

wrote in message

news:cy5U9.5794$Qr4.558783@newsread1.prod.itd.earthlink.net… – Hide quoted text — Show quoted text -> I read that it was FDA approved for allergic rhinitis very recently. > "Steven Balough" <sbalo…@mail.utexas.edu

wrote in message

> news:avlc9n$2kp$1@geraldo.cc.utexas.edu… > > Just wondering if anyone has tried taking Singulair to treat allergy > related > > sinus congestion.

Response:

Question:

::I went to Roel this morning, and I have still the zoloft. ::But I take now 2x 50mg, first I had 3x 50mg. ::I will see him back in 14 days, and than we will talk again abaut the med. ::And we will than talk also abaut the problems I have, ::with the deadt of my sister, and why it is so difficult for me. Dear Diana, I hope the Zoloft reduction helps. I agree with Philip in that I don’t understand why nothing more was done at this appt.  You’ve been suffering long enough. (((((Diana))))) Jackie ~*~Life was so much easier when your clothes didn’t match and boys had cooties~*~ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

My dear Family . I went to Roel this morning, and I have still the zoloft. But I take now 2x 50mg, first I had 3x 50mg. I will see him back in 14 days, and than we will talk again abaut the med. And we will than talk also abaut the problems I have, with the deadt of my sister, and why it is so difficult for me. I will let you know how things are going. Love Diana — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi, Diana, I hope this med adjustment is successful for you. Dealing with the death of a loved one takes time.  Your sister was a valuable piece of your life but you will make it through this… smiles, Elise

– Hide quoted text — Show quoted text – My dear Family . I went to Roel this morning, and I have still the zoloft. But I take now 2x 50mg, first I had 3x 50mg. I will see him back in 14 days, and than we will talk again abaut the med. And we will than talk also abaut the problems I have, with the deadt of my sister, and why it is so difficult for me. I will let you know how things are going. Love Diana — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

I wish you the very best with this med change, Diana.  I hope you can, somehow, deal with the death of your sister.  I know how close you were and I would feel the same.  Thinking of you.  {{{{{Diana}}}}} Love, Di

My dear Family . I went to Roel this morning, and I have still the zoloft. But I take now 2x 50mg, first I had 3x 50mg. I will see him back in 14 days, and than we will talk again abaut the med. And we will than talk also abaut the problems I have, with the deadt of my sister, and why it is so difficult for me. I will let you know how things are going. Love Diana

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Diana schreef: My dear Family . I went to Roel this morning, and I have still the zoloft. But I take now 2x 50mg, first I had 3x 50mg. I will see him back in 14 days, and than we will talk again abaut the med. And we will than talk also abaut the problems I have, with the deadt of my sister, and why it is so difficult for me.

I wonder why he didn’t talk with you about your medication now instead of postponing it. The same goes for talking about your sister’s death. You were scheduled for aan appointment, weren’t you? Or didn’t he have enough time? Well, you will survive another two weeks but it’s a bit disappointing that nothing was talked about. Maybe lowering ther Zoloft dose is a good idea. Philip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Question:

Hi, My neurologist (I’ve been diagnosed with a movement disorder — most likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to combat associated feelings of depression and anxiety. Unfortunately, it has made my essential tremor much worse.  Has anyone had a similar problem?  Any ideas for combatting this side effect? Thanks, Matt

SSRI’s can exacerbate movement disorders and even cause some (in rare cases). You might be better off with an antidepressant from the TCA group: imipramine ("Tofranil"), nortriptyline, amitryptyline, doxepin, clomipramine etc. Philip — The charter is available at:  http://readystump.algebra.com/~asapm

– The charter is available at:  http://readystump.algebra.com/~asapm

Response:

- Hide quoted text — Show quoted text – Hi, My neurologist (I’ve been diagnosed with a movement disorder — most likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to combat associated feelings of depression and anxiety. Unfortunately, it has made my essential tremor much worse.  Has anyone had a similar problem?  Any ideas for combatting this side effect? Thanks, Matt SSRI’s can exacerbate movement disorders and even cause some (in rare cases). You might be better off with an antidepressant from the TCA group: imipramine ("Tofranil"), nortriptyline, amitryptyline, doxepin, clomipramine etc. Philip — The charter is available at:  http://readystump.algebra.com/~asapm

I want to thank all of you for your responses.  I talked to my neurologist and she switched me to Paxil.  My tremor is much better (very close to its pre Lexapro level).  Should things get worse, I have several strategies to try (beta blockers, TCA AD) thanks to this group! Matt — The charter is available at:  http://readystump.algebra.com/~asapm

Response:

Hi, My neurologist (I’ve been diagnosed with a movement disorder — most likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to combat associated feelings of depression and anxiety. Unfortunately, it has made my essential tremor much worse.  Has anyone had a similar problem?  Any ideas for combatting this side effect? Thanks, Matt — The charter is available at:  http://readystump.algebra.com/~asapm

Response:

Hi, My neurologist (I’ve been diagnosed with a movement disorder — most likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to combat associated feelings of depression and anxiety. Unfortunately, it has made my essential tremor much worse.  Has anyone had a similar problem?  Any ideas for combatting this side effect?

Start at Lexapro 5 mg/day for awhile before you go up to 10 mg/day. Add a beta blocker such as Inderal or Tenormin for the essential tremor. Chip — The charter is available at:  http://readystump.algebra.com/~asapm

Response:

:My neurologist (I’ve been diagnosed with a movement disorder — most :likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to :combat associated feelings of depression and anxiety. : :Unfortunately, it has made my essential tremor much worse.  Has anyone :had a similar problem?  Any ideas for combatting this side effect? Dear Matt, Antidepressants "can" exacerbate movement disorders. This side-effect may pass, or it may not. I suggest you make your doctor aware of this problem. Jackie ~*~Instead of a turkey, we’re having a swan. You get more stuffing~*~ — The charter is available at:  http://readystump.algebra.com/~asapm

Response:

as chip said a beta blocker. Or you could also use primedone or valium, that has helped me with my tremors. the primedone, i think the brand name is mysoline is good but it was rather strong for me. it stopped the tremors to 0 but all i would do is sleep. brian s.

– Hide quoted text — Show quoted text – Hi, My neurologist (I’ve been diagnosed with a movement disorder — most likely a form of spinocerebellar ataxia) prescribed 10mg Lexapro to combat associated feelings of depression and anxiety. Unfortunately, it has made my essential tremor much worse.  Has anyone had a similar problem?  Any ideas for combatting this side effect? Start at Lexapro 5 mg/day for awhile before you go up to 10 mg/day. Add a beta blocker such as Inderal or Tenormin for the essential tremor. Chip — The charter is available at:  http://readystump.algebra.com/~asapm

– The charter is available at:  http://readystump.algebra.com/~asapm

Response:

Question:

I have tappered down my Effexor dose (with Doctor supervision, over ~ 2 months, from 75 mg XR, once daily) to the lowest I can get, which is 37.5 mg, which I take in the morning.  Suprisinlgy with it’s short half life, I seem to feel no withdrawl effects by the end of the day. However, now my dose is zero, and I think, after 24 hours, I began to feel some withdrawl effects.  It’s best described (by others) as a brain zap (a bit like vertigo).  It seems not an uncommon effect.  I have s light headache, some fatigue, but certianly not incapacitating.  But it does freak me out and I am battling not to take a tablet to make it go away.  I went on AD when I had some health issues.  Freaky things happening to my body don’t help me very much. I have only been Effexor free for 48 h, it does seem to be getting a little worse.  Can anyone suggest how long I need to stick it out  ? One week ?  One month ?  It seems to vary person to person, but a guide would be good. My Doc has no advice on this. Appreciated, RDJ

Response:

You did a good taper-down, but effexor is notoriously hell to wash-out. 10 days to 2 weeks is the norm. This is a stupid suggestion, but I was helped by using Thera-flu (or the generic versions)…you know, those hot lemon-flavored antihistamine thingies? Jim M.

– Hide quoted text — Show quoted text – I have tappered down my Effexor dose (with Doctor supervision, over ~ 2 months, from 75 mg XR, once daily) to the lowest I can get, which is 37.5 mg, which I take in the morning.  Suprisinlgy with it’s short half life, I seem to feel no withdrawl effects by the end of the day. However, now my dose is zero, and I think, after 24 hours, I began to feel some withdrawl effects.  It’s best described (by others) as a brain zap (a bit like vertigo).  It seems not an uncommon effect.  I have s light headache, some fatigue, but certianly not incapacitating.  But it does freak me out and I am battling not to take a tablet to make it go away.  I went on AD when I had some health issues.  Freaky things happening to my body don’t help me very much. I have only been Effexor free for 48 h, it does seem to be getting a little worse.  Can anyone suggest how long I need to stick it out  ? One week ?  One month ?  It seems to vary person to person, but a guide would be good. My Doc has no advice on this. Appreciated, RDJ

Response:

Thanks for the reply.  Unfortunately, I couldn’t hack the withdrawl and took a tab.  Bad thing is, I felt better within an hour.  I was hoping waht I was feeling was unrelated to withdrawl, maybe juat a vrius or something.  I am now taking 37.5 mg every second day.  By the end of the second day, I start to feel the withdrawl.  I intend to do this for a week or so to get to know what thw withdrawl feels like, so I am less freaked out by it. In Australia, 37.5 mg seems to be the lowest dose available, according to my Doc.  I am not confident of tablet splitting. The lemon things are around.   Do you think it’s the anti-histamnine that does the job ? You did a good taper-down, but effexor is notoriously hell to wash-out. 10 days to 2 weeks is the norm. This is a stupid suggestion, but I was helped by using Thera-flu (or the generic versions)…you know, those hot lemon-flavored antihistamine thingies? Jim M.

[snip]

Response:

6 months or so ago my pdoc tried weaning me off effexor. From 150mg on down…when I hit 37.5 I started withrawal. Dizzy, headache, felt like I was walkin sidewys, brain zaps, nausea. I was put on Wellbuterin. I eventually got  totally off. AAAHHHH I called my pdoc crying just having a fit becase I vomited twice. The depression was awaful. I had forgotten how disgusting depression was. Waves of major depression. I did use some benedryl which did help some. So he put me back on Effexor. I am on lithium, lamictal, effexor, ativan and restoril. In my out of mind state I was crying, "with all the drugs I am on how can this happen??!" just crying a way. First he tried clinical terms….forget it, I barely knew where I was. So he put it to me like this, " You have a car, it has a body, wheels and an engine also a steering wheel. You can have all that but, if you do not have the  key you cannot start the car you aren’t going anywhere. Effexor is one of your keys. If you do not have it with your other meds you do not receive what your brain needs." Good luck with your effexor. When I was put back on I felt so much better. maridee

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Response:

Question:

Thank you for the ideas. I’ll be working on them tomorrow and will post the newer version. I appreciate all the suggestions. When this is finished I’ll have said what I want to say and be able to walk away knowing he understands. I couldn’t have made these improvements without all of your help. Thank you! Theresa

– Hide quoted text — Show quoted text – Jan 2001 Dec 2000 etc tends to learn on "topics" rather than as a general melee of info — k t1 13 yr What about this? Still too long? Diabetes dx 1996 Panic disorder/depression/PTSD dx 1985. (I see Dr. Strgar for this). A history of the treatment for my diabetes is as follows: 1984 dx gestational diabetes controlled with diet and exercise. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. 1996-1997 semi-controlled with diet 1997-1998 uncontrolled. 1998-1999 tried Gluophage then switched to gluotrol semi-controlled August 1999 70/30 insulin therapy began About 6 weeks ago Leslie, the diabetic counselor, left the doctors office due to health issues. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. January 2000 switched to Humalog and NPH The way that I take my insulin is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1u to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to help me make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor.

Response:

Thank you for the ideas. I’ll be working on them tomorrow and will post the newer version. I appreciate all the suggestions. When this is finished I’ll have said what I want to say and be able to walk away knowing he understands. I couldn’t have made these improvements without all of your help. Thank you!

I don’t think the Dr. will read it. I would suggest taking a list of your concerns and questions with you and use them as a reference during the consultation. — pianoguy return email disabled

Response:

I don’t think the Dr. will read it. I would suggest taking a list of your concerns and questions with you and use them as a reference during the consultation.

there is a very high risk that the Dr won’t read……. that’s why i over….. the expectations may be, but who knows……. the medical history will be important and read……. Theresa can quickly read the expectations part to her Dr during their visit to ensure it will be heard your suggestion of a list of concerns/questions to reference is critical to any well-spent Dr’s visit (at least it is for myself ’cause i forget what i wanted to ask, and i forget my symptoms in the Dr’s office) — k t1 13 yr

Response:

It’s a good thing I’ve done this. I called past doctors and got the dates right. I am just going to memorize the expactations and say them. The thank you will be said and I don’t need to memorize it. So this, and the 3 lab reports I have, will be what I take in. Diabetes dx March 1998 Panic disorder/depression/PTSD dx 1985. (I see Dr. Strgar for this). A history of the treatment for my diabetes is as follows: January 2001 switched to Humalog and NPH .            Humalog: ratio of 1u to 8 breakfast/1u to 10 lunch and dinner .            1u to 50 mg/dl when above 140 NPH 10u bedtime August 2000 70/30 insulin therapy began January 2000 tried Gluophage then switched to Gluotrol 1999 semi-controlled with diet March 1998 untreated/uncontrolled 1984 dx gestational diabetes controlled with diet and exercise Medications Daily: Effexor XR 150 mg bedtime Risperdal 1 mg bedtime Alesse 28 bedtime/Estradiol 1mg (when not taking the Alesse) Humalog 1u to 8 carbs Breakfast 1u to 10 carbs Lunch/Dinner NPH 10u bedtime As Needed: Propo-N/APAP 100-650 Xanax Diphenox/Atropine Albuterol, USP Zomig 5 mg (new: have never used this one) — Theresa dx ‘98 t2 humalog & N, diet & exercise Being happy doesn’t mean everything’s perfect, it just means you’ve decided to see beyond the imperfections.

Response:

a Dr usually wants only the salient details……. try a bullet format on a time line (if necessary)……. avoid any details that aren’t applicable in todays terms (or shorten them to….. history of glucophage, glycet, yada meds as just a point) i do hope you repost your next version so that further critique can be done an aside……. put the Thank you letter separate from the "salient details" letter……. two different messages you want to send, so make it easier for the Dr to sort out the messages — k t1 13 yr – Hide quoted text — Show quoted text – Theresa, too long.  Most people lose interest after a few paragraphs. If you can condense all the important stuff into less paragraphs then you have more chance of the whole letter being read. This is very true. If this was me writing it or reading it I would cut the first paragraph to the first sentence. paragraph 2 is fine, I would scrap para 3. I can cut the first paragraph. The third paragraph is very important to me and so I want to at least say working is very important because if I don’t feel well, than I can’t work. Maybe there is a more consise way to say this. The diabetes stuff is way too long and flowery. At this point I would do a sort of time line. Diagnosed GD 19XX – diet and exercise controlled. Diabetes dx 19XX – Glucotrol fair results. 19XX insulin regimen begun. This is very good! I can do this easily and it will cut tons of fluff! Thanks! The aim is for the doctor to read the lot plus get an overview of your history. Hope I haven’t offended. Not at all, I wanted brutal for a purpose. This is going to be the most important visit. He’ll need to get to know me and I’ll need to get to know him. I don’t want him spending the whole time reading. : ) I want to have him talk so I can judge him as well.  Thank you for the suggestions. Theresa

Response:

Lot better hope the visit works out for you Theresa.

Thanks for the imput, Ozgirl. : ) Much appreciated. Theresa

Response:

Jan 2001 Dec 2000 etc tends to learn on "topics" rather than as a general melee of info — k t1 13 yr – Hide quoted text — Show quoted text – What about this? Still too long? Diabetes dx 1996 Panic disorder/depression/PTSD dx 1985. (I see Dr. Strgar for this). A history of the treatment for my diabetes is as follows: 1984 dx gestational diabetes controlled with diet and exercise. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. 1996-1997 semi-controlled with diet 1997-1998 uncontrolled. 1998-1999 tried Gluophage then switched to gluotrol semi-controlled August 1999 70/30 insulin therapy began About 6 weeks ago Leslie, the diabetic counselor, left the doctors office due to health issues. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. January 2000 switched to Humalog and NPH The way that I take my insulin is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1u to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to help me make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor.

Response:

Theresa, Heres some more feedback that I hope to be useful. My wife has multiple medical issues that has required that we seek out various new doctors. We had a list of her medical history and prescriptions and began handing these to the doctors, and found they simply didn’t use it. In fact one doctor told us they were taught in medical school to ignore this type of thing. Their are two reasons they do this, one is to ask the patient the questions you need answers to in order to better analyze the patients current condition. The other reason is they suspect the patient to be a hypochondriac. The thing that works for us is to bring the list as a reminder, give the doctor the information as they ask for it, and fill them in on the rest when they are done asking questions. Just some ideas….. — John M.

– Hide quoted text — Show quoted text – Theresa, too long.  Most people lose interest after a few paragraphs. If you can condense all the important stuff into less paragraphs then you have more chance of the whole letter being read. This is very true. If this was me writing it or reading it I would cut the first paragraph to the first sentence. paragraph 2 is fine, I would scrap para 3. I can cut the first paragraph. The third paragraph is very important to me and so I want to at least say working is very important because if I don’t feel well, than I can’t work. Maybe there is a more consise way to say this. The diabetes stuff is way too long and flowery. At this point I would do a sort of time line. Diagnosed GD 19XX – diet and exercise controlled. Diabetes dx 19XX – Glucotrol fair results. 19XX insulin regimen begun. This is very good! I can do this easily and it will cut tons of fluff! Thanks! The aim is for the doctor to read the lot plus get an overview of your history. Hope I haven’t offended. Not at all, I wanted brutal for a purpose. This is going to be the most important visit. He’ll need to get to know me and I’ll need to get to know him. I don’t want him spending the whole time reading. : ) I want to have him talk so I can judge him as well.  Thank you for the suggestions. Theresa

Response:

Lot better hope the visit works out for you Theresa.

– Hide quoted text — Show quoted text – What about this? Still too long? Diabetes dx 1996 Panic disorder/depression/PTSD dx 1985. (I see Dr. Strgar for this). A history of the treatment for my diabetes is as follows: 1984 dx gestational diabetes controlled with diet and exercise. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. 1996-1997 semi-controlled with diet 1997-1998 uncontrolled. 1998-1999 tried Gluophage then switched to gluotrol semi-controlled August 1999 70/30 insulin therapy began About 6 weeks ago Leslie, the diabetic counselor, left the doctors office due to health issues. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. January 2000 switched to Humalog and NPH The way that I take my insulin is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1u to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to help me make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor.

Response:

Theresa, too long.  Most people lose interest after a few paragraphs. If you can condense all the important stuff into less paragraphs then you have more chance of the whole letter being read.

This is very true. If this was me writing it or reading it I would cut the first paragraph to the first sentence. paragraph 2 is fine, I would scrap para 3.

I can cut the first paragraph. The third paragraph is very important to me and so I want to at least say working is very important because if I don’t feel well, than I can’t work. Maybe there is a more consise way to say this. The diabetes stuff is way too long and flowery. At this point I would do a sort of time line. Diagnosed GD 19XX – diet and exercise controlled. Diabetes dx 19XX – Glucotrol fair results. 19XX insulin regimen begun.

This is very good! I can do this easily and it will cut tons of fluff! Thanks! The aim is for the doctor to read the lot plus get an overview of your history. Hope I haven’t offended.

Not at all, I wanted brutal for a purpose. This is going to be the most important visit. He’ll need to get to know me and I’ll need to get to know him. I don’t want him spending the whole time reading. : ) I want to have him talk so I can judge him as well.  Thank you for the suggestions. Theresa

Response:

What about this? Still too long? Diabetes dx 1996 Panic disorder/depression/PTSD dx 1985. (I see Dr. Strgar for this). A history of the treatment for my diabetes is as follows: 1984 dx gestational diabetes controlled with diet and exercise. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. 1996-1997 semi-controlled with diet 1997-1998 uncontrolled. 1998-1999 tried Gluophage then switched to gluotrol semi-controlled August 1999 70/30 insulin therapy began About 6 weeks ago Leslie, the diabetic counselor, left the doctors office due to health issues. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. January 2000 switched to Humalog and NPH The way that I take my insulin is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1u to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to help me make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor.

Response:

Theresa, too long.  Most people lose interest after a few paragraphs. If you can condense all the important stuff into less paragraphs then you have more chance of the whole letter being read. If this was me writing it or reading it I would cut the first paragraph to the first sentence. paragraph 2 is fine, I would scrap para 3. The diabetes stuff is way too long and flowery. At this point I would do a sort of time line. Diagnosed GD 19XX – diet and exercise controlled. Diabetes dx 19XX – Glucotrol fair results. 19XX insulin regimen begun. The aim is for the doctor to read the lot plus get an overview of your history. Hope I haven’t offended.

– Hide quoted text — Show quoted text – Because this appointment will be our first I need advice in getting my letter fine-tuned. Any help would be appreciated. Help me get rid of the fluff and be as concise as possible as well as state my needs with clarity. tia Dr. **** Thank you for accepting me as a patient. I sought referrals and followed up on them trying to find an Internist, but was unable to locate any that would accept my insurance. This was very frustrating. When I finally got to your number I was overjoyed to find someone who cares about people more than their insurance. So this is a heartfelt thank you! Though I don’t know you I do want to introduce myself. The appointment will go fast so I am going to put things in writing so you’ll get a good picture of who I am and the sort of care I’ll need. I have diabetes, which is the primary care I’ll need from you. I also have panic disorder/depression/PTSD. I see Dr. Strgar for the latter. All of these conditions are under control with the use of medications, exercise, education, and determination. I own a small desktop publishing business. I work few hours but would like to work more. I struggle with my business. I sometimes have difficulty concentrating and tire quickly. Working is very important to me and as such has "pushed" me to get my medical conditions under control. I want to work. I’d like it if I could work full-time. For now I do what I can and strive to improve my condition. I have a teenaged daughter who is a delight. She is very helpful and a good student. I love being her mother and we get along very well. She also suffers from depression; it is also under control with medications. A history of the treatment for my diabetes is as follows: In 1984 I had gestational diabetes. I controlled it with diet and exercise. My daughter was born and weighed 7′10. She was healthy and bright. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. Although I had had gestational diabetes and knew the diet/exercise regimen I was unable to get my bgs under control. With the help of Leslie Rohr-diabetic counselor-I was able to regain my control. This lasted for about a year. (diet and exercise only). My doctor had me fax her my logbook readings once a week, because my bgs were out of control. It didn’t seem to matter what I did. I was frustrated. I faxed the logbook but with nothing changing it seemed pointless. I finally gave up on testing. My numbers were not good. This went on for approximately another year. I felt terrible. I didn’t think about going back to Leslie. I don’t know why. Finally, after complaining and being in the office sick all the time the doctor started me on gluophage. I took this medication for 3 weeks, at a very low dose. It made me very ill, did not improve my numbers, nor did it seem as if the queasy feeling were going to dissipate with time. I finally called the nurse and asked to be switched to something else. The doctor prescribed gluotrol. I took glucotrol for approximately 9 months with fair results (readings under 160, but still feeling crummy). At one point I got the flu and the medication stopped working altogether, so the doctor increased it. This caused me to have what I experienced as panic attacks. I was having them 2-3 times a week. (Whereas before the increase in dosage I was having 2-3 panics a month). I say "experienced" these as panics because my symptoms were: shaking, sweating, inability to concentrate, feeling like I was going to die, feeling faint, etc. After much heated discussion, none of which contained hypos as the cause, my doctor suggested insulin. In August I started Insulin. With the change to insulin I saw Leslie Rohr again. Leslie got me started on the 70/30 insulin from Lilly. During a time when I was feeling panicy it was also time to test my bgs. Low and behold, I was near 50. This is when I realized the panics and hypos were similar. Since then before I assume I am having a panic I check my bgs. Because of the hypos I had while taking the 70/30 I checked my bgs before I would drive. I was having hypos partly because I was skipping snacks. I was eating 6 small meals a day, and at the end of the month I was having difficulty keeping enough snacks in the house. Sometimes my budget did not stretch far enough. About 6 weeks ago Leslie left the doctors office due to health issues of her own. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. This reduced the stress I felt when working with the doctor. I found that the doctor did not listen to me, but she would listen to Leslie. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. I read up on using insulin that was not pre-mixed and talked to my doctor several times about changing to the regular insulin. She wanted to wait until the Lantus came out on the market and then change me to the regular insulin. She wanted me to "play" with the "R" I used for highs. This was difficult with the pre-mix. I finally convinced her to let me use Humalog and Humilin N. I have been taking this for a month. In that time I have not had a single hypo. My numbers have been excellent and I feel great. This change has me very excited. The way that I take my insulin now is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1 U to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I would like to stay with the exchange diet, however I can’t always afford to eat as nutritiously as it recommends. I would also like to eat more of the lower glycemic foods, but the cost is prohibitive. I control portion size and hope for the best. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). I know this is not much, but I am working on increasing it. It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor. Again, thank you for accepting me as your patient.

Response:

Because this appointment will be our first I need advice in getting my letter fine-tuned. Any help would be appreciated. Help me get rid of the fluff and be as concise as possible as well as state my needs with clarity. tia Dr. **** Thank you for accepting me as a patient. I sought referrals and followed up on them trying to find an Internist, but was unable to locate any that would accept my insurance. This was very frustrating. When I finally got to your number I was overjoyed to find someone who cares about people more than their insurance. So this is a heartfelt thank you! Though I don’t know you I do want to introduce myself. The appointment will go fast so I am going to put things in writing so you’ll get a good picture of who I am and the sort of care I’ll need. I have diabetes, which is the primary care I’ll need from you. I also have panic disorder/depression/PTSD. I see Dr. Strgar for the latter. All of these conditions are under control with the use of medications, exercise, education, and determination. I own a small desktop publishing business. I work few hours but would like to work more. I struggle with my business. I sometimes have difficulty concentrating and tire quickly. Working is very important to me and as such has "pushed" me to get my medical conditions under control. I want to work. I’d like it if I could work full-time. For now I do what I can and strive to improve my condition. I have a teenaged daughter who is a delight. She is very helpful and a good student. I love being her mother and we get along very well. She also suffers from depression; it is also under control with medications. A history of the treatment for my diabetes is as follows: In 1984 I had gestational diabetes. I controlled it with diet and exercise. My daughter was born and weighed 7′10. She was healthy and bright. Every year after that I was checked for diabetes during the yearly lab work. I’m not exactly sure of the year, but in approximately 1996, my medications for depression were not working well and my psychiatrist (Irwin Noparstak at the time) told me to have a check up with my GP and to have lab work done. The lab work came back with the news I was diabetic. Although I had had gestational diabetes and knew the diet/exercise regimen I was unable to get my bgs under control. With the help of Leslie Rohr-diabetic counselor-I was able to regain my control. This lasted for about a year. (diet and exercise only). My doctor had me fax her my logbook readings once a week, because my bgs were out of control. It didn’t seem to matter what I did. I was frustrated. I faxed the logbook but with nothing changing it seemed pointless. I finally gave up on testing. My numbers were not good. This went on for approximately another year. I felt terrible. I didn’t think about going back to Leslie. I don’t know why. Finally, after complaining and being in the office sick all the time the doctor started me on gluophage. I took this medication for 3 weeks, at a very low dose. It made me very ill, did not improve my numbers, nor did it seem as if the queasy feeling were going to dissipate with time. I finally called the nurse and asked to be switched to something else. The doctor prescribed gluotrol. I took glucotrol for approximately 9 months with fair results (readings under 160, but still feeling crummy). At one point I got the flu and the medication stopped working altogether, so the doctor increased it. This caused me to have what I experienced as panic attacks. I was having them 2-3 times a week. (Whereas before the increase in dosage I was having 2-3 panics a month). I say "experienced" these as panics because my symptoms were: shaking, sweating, inability to concentrate, feeling like I was going to die, feeling faint, etc. After much heated discussion, none of which contained hypos as the cause, my doctor suggested insulin. In August I started Insulin. With the change to insulin I saw Leslie Rohr again. Leslie got me started on the 70/30 insulin from Lilly. During a time when I was feeling panicy it was also time to test my bgs. Low and behold, I was near 50. This is when I realized the panics and hypos were similar. Since then before I assume I am having a panic I check my bgs. Because of the hypos I had while taking the 70/30 I checked my bgs before I would drive. I was having hypos partly because I was skipping snacks. I was eating 6 small meals a day, and at the end of the month I was having difficulty keeping enough snacks in the house. Sometimes my budget did not stretch far enough. About 6 weeks ago Leslie left the doctors office due to health issues of her own. I had been going through Leslie in regards to my diabetes. She would explain things to me and if I had a concern she would listen and if warranted would talk to the doctor. This reduced the stress I felt when working with the doctor. I found that the doctor did not listen to me, but she would listen to Leslie. If I had a concern Leslie would explain things to me so that I knew how to manage. The relationship I had with Leslie was very important to my getting healthy. I consider this the point at which I made a turn-a-round in my therapy with the diabetes. It has been about 6 months that I have been getting the treatment I need. With Leslie’s leaving I tried to deal with the doctor, but was unable to and have made a change to your office. I read up on using insulin that was not pre-mixed and talked to my doctor several times about changing to the regular insulin. She wanted to wait until the Lantus came out on the market and then change me to the regular insulin. She wanted me to "play" with the "R" I used for highs. This was difficult with the pre-mix. I finally convinced her to let me use Humalog and Humilin N. I have been taking this for a month. In that time I have not had a single hypo. My numbers have been excellent and I feel great. This change has me very excited. The way that I take my insulin now is I use carb-counting. I base my Humalog on how many carbs I eat at a meal. I use the ratio of 1u to 8 Carbs for breakfast and 1u to 10 for lunch and dinner. If I my numbers are high, I have used the ratio of 1 U to 50 mg/dl to lower the high. I have not done this much since I can lower my bgs 15 mg/dl by walking 15 minutes, which is much faster than I can lower it with the insulin. My diet is a "low-income" carb-counting diet. I would like to stay with the exchange diet, however I can’t always afford to eat as nutritiously as it recommends. I would also like to eat more of the lower glycemic foods, but the cost is prohibitive. I control portion size and hope for the best. I exercise by walking on a treadmill 15-30 minutes daily. (.5 miles to 1 mile). I know this is not much, but I am working on increasing it. It is important to me that we work together in my treatment. I have to live with the decisions that we make. If you want me to do something that it isn’ t working then we need to discuss what is happening. I will question decisions. This is not to be taken as a question of your expertise but as a discussion so that I understand how to follow the treatment plan or make adjustments that help me to be healthy. You have the education and training to make the right decisions; I will provide you with my logbook and anything else you may need. In the end, I want to be able to function as well as is possible. I need you to assist me in that endeavor. I need to be monitored. I need to have someone who will answer questions; I need to have someone watch over my treatment so that I don’t get into trouble. I’m hoping you will be this kind of doctor. Again, thank you for accepting me as your patient.

Response:

Question:

I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

Response:

Hello, DGA – Have you ever been tested for a sleep disorder?  For years doctors tried to tell me that I was suffering from depression because I was sleepy all of the time.  Finally I was diagnosed first with sleep apnea and five years with narcolepsy.  I don’t know how long I had apnea before it was diagnosed, but I had had the narcolepsy for 37 years!  Having untreated sleep disorders can depress anyone! Kent Taylor (Mongo) – Hide quoted text — Show quoted text -DGA wrote in message …

I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

Response:

On Wed, 04 Aug 1999 19:16:58 GMT, "DGA" <davea…@flash.net

wrote: I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.  I’ve tried taking it at different times if the day, but still have problems.  One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  If I go ahead and go into the office to work super-early, my production is outstanding for about half the day. I get to feeling  very run down after lunch though.   If I go back to bed after waking up alert like this, I am usually able to drift off for another 1-2 hours of sleep.  Unfortunately, after sleeping an extra hour or two,  I FIND IT ALMOST IMPOSSIBLE TO GET UP. Even after loading up on coffee, no-doz, etc., I feel groggy all day.  I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

Try setting an alarm to limit your nap to 20-30 minutes.  Most people will be somewhat refreshed by that without having the body go into the "very groggy" state you describe. When you go to sleep, there are a lot of things that slow down – not just heartrate, many other body systems do this.  By going to sleep for 1-2 hours you give your body time to completely shut down – and you’ve seen how hard it is to get it started again.  By taking a short nap you don’t give your body time to completely shut down, so starting up again is a lot easier. In college I pulled a few long nights now and again.  I found that if I finished early enough to get 3 or more hours of sleep it was worth going to bed.  If I was going to get 1-2 hours (just as you describe) it did the same thing for me it is doing to you – made me really groggy the next day.  So if there was only time for 1-2 hours I just stayed awake (hadn’t been told about short naps then).

Response:

DGA wrote:

I’ve been on an antidepressant (Effexor) for about six months now. It has been remarkably effective for the depression, but is affecting the quality of my sleep.

Greetings!  You’ve definitely come the right spot to talk about sleep problems.  Just remember that most of us here are not medical professionals. We can offer our own experience, and that of others, but it’s just that … our own thoughts and opinions, not a medical training!

One thing I notice in particular is that I often wake up after about five hours of sleep and feel tired, but mentally alert.  …

You might want to check out the patient information for this drug.  You can search for it at http://www.rxlist.com/ where I found indications that this drug for a small percentage of people slightly (very slightly) increased the incidence of insomnia and somnolence. You might want to discuss this with your doctor.  Additionally as Kent pointed out, your depression might well be connnected to sleep problems. Also, (and remember this is my own experience only) you might want to change the time you sleep to 1.5 hours instead of 2 hours.  I find that I feel more rested when I get a multiple of 90 minutes of sleep. Regards, =jbf= John B. Fisher

Response:

I was on Effexor for depression but went off of it. I am very groggy when I get up my resting heartbeat is faster than it should be. and I am always in alot of pains. ie. lower back, etc. among other stress and the like.

Response:

DGA wrote:

I’ve been on an antidepressant (Effexor) for about six months now. I guess I don’t understand sleep cycles. How can I be more tired from sleeping two extra hours?  Does this have anything to do with which sleep cycle I’m in when the alarm goes off?  Any ideas on this will be appreciated.

I’ve been on Effexor for 5 years.  It has caused two sleep related problems for me.  The first is called Rem Behavioral Disorder.  This is a condition where you "act out" your dreams, and it makes your sleep non-restful.  The second is called "Periodic Leg Movement Disorder."  I had a related problem (called Restless Leg Syndrome) before I went on Effexor, but SSRIs can make it much worse.  If you have PLMD without RLS, then you probably don’t even know you have it, and Effexor can make it get much worse.  PLMD means you kick your legs every minute or two, all night long.  (except when you are dreaming) The kicks cause you to stay in a less-restful stage of sleep, and keep you from getting enough of the deep sleep you need in order to get real rest. I have noticed over the years on Effexor that if I wake up naturally, then go back to sleep, I will end up sleeping for up to a whole DAY before I can manage to get myself back out of bed.  (Unless something scares me awake, or my wife physically drags my butt out of bed.) I haven’t ever heard about this before, and I always assumed it was because the meds I take for sleep wear off by morning time.  But you are right, it doesn’t seem to make a lot of sense.  I’ll ask my psychiatrist about it, and see if I can find anything about it on the net. One thing you might want to consider is the VERY short halflife of Effexor.  Do you usually take it in the morning?  If you take it when you get up, but you put off getting up, then that _might_ make it so that you start to experience the very mild beginnings of withdrawal.  Effexor withdrawal can be VERY nasty, and it generally involves migraine headaches, _massive_ periods of fragmented sleep where you often can’t clearly distinguish between being awake and being asleep, and vertigo/balance problems.  I’m on Effexor XR, so that I can get by with only one dose per day.  With normal Effexor, I had to take it twice a day, and if I was more than an hour or two late for the dose, I’d start having the headaches, dizziness, etc. About your weird problems when going back to sleep though, with ME, it seems like I stay in a sleep which is kind of like the sleep I have when I’m going through Effexor withdrawal.  I’m 1/2 awake, and 1/2 asleep, and it is impossible to tell if I’m dreaming or not. Any time I experience that "weird sleep," I usually end up not being able to get out of bed for a long time, and I always end up being exhausted for at least 12 hours or so afterwards.  It’s probably some weird sleep problem caused by Effexor, which someone will end up "discovering" in 10 years.  :) Anyway, my best suggestion is to just get up after 5 hours, and try to stick it out til your normal bedtime the next night.  If you need more than 5 hours sleep per night, then eventually the sleep deficit should help you sleep later.  I don’t have ANY idea what to do about the weird grogginess after going back to sleep.  I never even really gave it much thought as being a problem separate from my OTHER sleep problems until I read your post.  Thanks for the info.  :) -Bret Wood -bretw…@cs.uoregon.edu

Response:

Question:

Hi, Sandi…. Glad to know I’m not the only cyber junkie here……:))  I spend way too much time on this computer….In a way, it is an escape for me…. I don’t take zoloft, so I can’t offer any comment about the symptoms your were experiencing… But I *do* hope that you are feeling better… Take care……MikeH – Hide quoted text — Show quoted text – Also, a little LOL I had withdraw from not being able to get on my computer yesterday, My son took the mouse to work with him.  I though it was the end of the world I had to go to the store and buy a mouse so I could get into my support group LOL..(maybe that what cause my aniexty).Hee, Hee Thanks again Sandi

Response:

Hi guys, I need some advice I have in this group for three weeks now and you guys have been all great with your support and I truly thank you. My problem is that I have been feeling good with taking 50mg of zoloft in fact this is the first week that I have been out of the house, driving and have some fun.  The only thing is that yesterday I was having alot of short of breath (it went away later that day).  Last night I started with this weird feeling in the middle of my chest like I ate too much or something, but it felt like I was going to burst.  It was a tightening I guess that how I want to explain it well, anyway it started scaring me I thought I was going to have a heart attack or something.  My husband who I might say is great about all this PA, told me to try to relax, but it was so hard because I was trying to go to sleep and I was really scared.   I gon’t up this morning and I am ok now, does anyone know if they ever had this or is it a side effect from zoloft?  Sorry that this is a long letter.  and Thanks for being there. Also, a little LOL I had withdraw from not being able to get on my computer yesterday, My son took the mouse to work with him.  I though it was the end of the world I had to go to the store and buy a mouse so I could get into my support group LOL..(maybe that what cause my aniexty).Hee, Hee Thanks again Sandi

Response:

Question:

Hello All! Dear Participant I am a student at a university in Colorado Springs Colorado.  I am required to complete a research project. This project is close to my heart since I have been divorced twice, both times it was not my choice.  This research involves no-fault divorce and its effect on the family.

Dennis’ survey is available in online/browser format at: http://www.10mb.com/jbarchuk/opinion/ Under the category ‘Family’. Have a day! — jim barchuk http://www.10mb.com/jbarchuk/

Response:

I <<<think this was a typo…. =15. Divorce eliminates dad relationships reducing stress in the parents =allowing them to better their economical status. = =       ___SA      ___A     ___U      ___D      ___SD Or was it? David

Response:

Dear Participant I am a student at a university in Colorado Springs Colorado.  I am required to complete a research project. This project is close to my heart since I have been divorced twice, both times it was not my choice.  This research involves no-fault divorce and its effect on the family. All data for the project is held in strict confidence.  Your name and other identification are not requested.  The results will not be sold, formally published or used for comercial profit.  However the completed project will be bound and placed in the University’s library. By completing the questionnaire youare giving consent for this information to be used in my research. Dennis N. Rosas I am going to post results in this new group, however if you would like one sent to you check here______ and I will e-mail you a copy.   Male_____               Age_____ Female_____             Have you ever been divorced_____ Please answer the following questions by indicating the response that most closely resembles your thought on the statement that is given.  Please return questionnaire by returning them to Dennis N. Rosas.  Thank you for your participation in this project.  I will post result in this new group on or about 19 May 1997. Use the following guide to respond to the statements: SA – Strongly Agree A- Agree U – Uncertain D – Disagree SD – Strongly Disagree 1.  No-fault divorce has increased problems with today’s youths.         ___SA      ___A     ___U      ___D      ___SD 2.  No-fault divorce negatively effects the emotional well being of teenagers.         ___SA      ___A     ___U      ___D      ___SD 3.  Young adults who come from a divorced home have trouble in future relationships.         ___SA      ___A     ___U      ___D      ___SD 4.  Because society accepts divorce and the breakdown in the family, divorce is more acceptable            now.         ___SA      ___A     ___U      ___D      ___SD 5.  No-fault divorce has placed more children at risk of behavioral disorders.         ___SA      ___A     ___U      ___D      ___SD 6.  Societies mores have nothing to do with the divorce rate.         ___SA      ___A     ___U      ___D      ___SD 7.  Adolescents who come from a broken home understand what it takes to have a good        relationship.         ___SA      ___A     ___U      ___D      ___SD 8.  No-fault divorce eliminates bad relationships preventing undue stress on adolescents.         ___SA      ___A     ___U      ___D      ___SD 9.  Breakdown of society has led to increased pressure on the family unit increasing divorce rates.         ___SA      ___A     ___U      ___D      ___SD 10.  No-fault divorce allows bad marriages to end quickly eliminating stress in the family unit that         could cause negative affects.         ___SA      ___A     ___U      ___D      ___SD 11.  The effect of divorce on teenagers causes increases in failed relationships as adults.         ___SA      ___A     ___U      ___D      ___SD 12.  Quick and easy divorces have little effect on future relationships of young adults.         ___SA      ___A     ___U      ___D      ___SD 13.  Divorce causes undue economical stress on all parties involved.         ___SA      ___A     ___U      ___D      ___SD 14.  Societies view on divorce has nothing to do with the divorce rate.         ___SA      ___A     ___U      ___D      ___SD 15. Divorce eliminates dad relationships reducing stress in the parents allowing them to better             their economical status.         ___SA      ___A     ___U      ___D      ___SD 16.  No-fault divorce has had no effect on raising children.         ___SA      ___A     ___U      ___D      ___SD

Response:

Question:

Hi Rhenda,    The office help at your mom’s doctor’s office is deplorable.  As someone else mentioned, perhaps this dr. doesn’t have enough patients who need Botox to keep a sufficient supply around.  What to do?  Try all the suggestions offered, also consider this one.    The neurologists at the large university hospital where I get Botox, set aside only a couple of days to do nothing but give injections – the hospital obtains a supply of  the poison.  However, a couple of the doctors have suggested to some dystonics in my support group, that if they prefer, their pharmacist possible could order Botox for them.  The patient would then bring the vial(s) with them to their doctor for the injections.  This seems to be advisable or suggested to those people whose insurance likes it that way.  But, why would this not work for your mother – for whatever reason!?  If she can obtain Botox herself, maybe the neuro would be willing to inject her…that is if she can by-pass the rude office help.      Maybe worth a try.  I know of at least two people who obtain their serum directly  from their pharmacist.  One problem of course, would be that she would have to get an Rx for the stuff.     Keep trying!     Best Regards,       Nancy

Response:

– Hide quoted text — Show quoted text -Hi Rhenda,   The office help at your mom’s doctor’s office is deplorable.  As someone else mentioned, perhaps this dr. doesn’t have enough patients who need Botox to keep a sufficient supply around.  What to do?  Try all the suggestions offered, also consider this one.   The neurologists at the large university hospital where I get Botox, set aside only a couple of days to do nothing but give injections – the hospital obtains a supply of  the poison.  However, a couple of the doctors have suggested to some dystonics in my support group, that if they prefer, their pharmacist possible could order Botox for them.  The patient would then bring the vial(s) with them to their doctor for the injections. This seems to be advisable or suggested to those people whose insurance likes it that way.  But, why would this not work for your mother – for whatever reason!?  If she can obtain Botox herself, maybe the neuro would be willing to inject her…that is if she can by-pass the rude office help.     Maybe worth a try.  I know of at least two people who obtain their serum directly  from their pharmacist.  One problem of course, would be that she would have to get an Rx for the stuff.    Keep trying!    Best Regards,      Nancy

Nancy, your idea is great and might provide an avenue around this mess. One problem, though, many trained neuro. at Univ. will NOT inject unless the vials come from their freezer. The problem is legal in nature. I tried to get the vials oversees (price is much less in UK & France). They would have been packaged and remain in a frozen state but the FDA does not allow out-of-country medicine to be used in U.S. Maybe the antibodies I have to BOTOX A & F are a blessing in disguise! —         ——-Dystonia Foundation’s co-Webmaster——         ** (312) 755-0198 [v], (312) 803-0138 [fx],  **         ** http://www.zipnet.net/users/dystonia/     **         ** One East Wacker Drive – Chicago, IL 60601 **

Response:

– Hide quoted text — Show quoted text -Hello all, I found this newsgroup in a search for information for my mother.  I have read the messages available on my server today, but have not searched for an archive or FAQ, or lurked for a decent time before my first post because I’m in a hurry. Everybody is these days, but this is MY MOM. My mother, the most assertive, confident, intelligent person I know, suffers from debilitating spasmodic torticollis.  I could go on for a page or two about her history and symptoms, but for now I will try to be brief.  Mom has been receiving Botox injections since 1992.  They provide her enough relief that she is able to travel with my dad around the country and visit the kids & grandkids.  She was at my house in late May and traveled home in considerable pain expecting to get her next injection soon.  Her treatment has been postponed indefinately by the doctor’s office and they will only tell her that they cannot get the medicine at present and don’t know when more will come in. She has been sitting at home for six weeks now waiting on word that she can get her treatment.  Calls to the clinic have been met with rude treatment from the woman-in-charge.  She will not tell mom why they can’t get the Botox, or when they expect to. Nothing.  She even yelled at MY MOTHER. Well, I’m ready to drive down there and confront the bunch, but mom won’t hear of it.  She has "forbidden" me to even call and talk to the doctor’s staff to try and get more info.  She wouldn’t even give me his name.  She is scared to death they will refuse her treatment when they do get the medicine if I piss them off.  This is incredible behavior from her (see the first sentence of paragraph two above). I am trying to help in the least obtrusive way I can.  Mom said, "I forbid you to call them!"  So, I got on the internet.  I knew the name of the university medical center where she goes, so now I know the Doc’s name, his nurse’s name, his email address, the entire history of Botox development and production, all about the Orphan Drug Act, and Allergan.  What I don’t know is why my mother’s clinic doesn’t have the medicine for her.   My dad suspects this is a ruse, that the doc is stalling because he went out of town or something.  My mom suspects it may be bureaucratic bungling at the university hospital.  Someone lost or destroyed the last batch, they have to go through the red tape to get more.  But it would help her a lot if I could find out something.  Her last communication with the clinic was a talk with the woman-in-charge who said "I’m going on vacation until August 12.  If we have the Botox when I get back, I’ll call you to schedule an appointment.  There’s no point in bothering anyone until then, there’s nothing we can do."  I really want to yell at that woman.  But, I promised my mother.   So…I said all of that to say this:  Does anyone know why, or even if the Botox supply has been interrupted? Thanks, Rhenda

Hi Rhenda and welcome!! Sounds as though you are going through a tough time…good grief! I don’t know a thing about the situation with Botox.  I’d almost be tempted to telephone Allergan and ask them. The treatment your mom is receiving from the drs office is inexcusable IMHO.  However, it is your mom’s dr so it makes the situation delicate for you to say the least. Hopefully others who are more up on Botox will respond to your post.  In the meantime, it wouldn’t hurt to e-mail the Dystonia Medical Research Foundation and ask whether there have been any recent problems that they one recommended by the Foundation…perhaps a mention of situation would be warranted here, although it sounds like the office staff leaves much to be desired moreso than the dr. I wish you luck and a good ending to your mom’s situation. MB

Response:

- Hide quoted text — Show quoted text – Hello all, I found this newsgroup in a search for information for my mother.  I have read the messages available on my server today, but have not searched for an archive or FAQ, or lurked for a decent time before my first post because I’m in a hurry. Everybody is these days, but this is MY MOM. My mother, the most assertive, confident, intelligent person I know, suffers from debilitating spasmodic torticollis.  I could go on for a page or two about her history and symptoms, but for now I will try to be brief.  Mom has been receiving Botox injections since 1992.  They provide her enough relief that she is able to travel with my dad around the country and visit the kids & grandkids.  She was at my house in late May and traveled home in considerable pain expecting to get her next injection soon.  Her treatment has been postponed indefinately by the doctor’s office and they will only tell her that they cannot get the medicine at present and don’t know when more will come in. She has been sitting at home for six weeks now waiting on word that she can get her treatment.  Calls to the clinic have been met with rude treatment from the woman-in-charge.  She will not tell mom why they can’t get the Botox, or when they expect to. Nothing.  She even yelled at MY MOTHER. Well, I’m ready to drive down there and confront the bunch, but mom won’t hear of it.  She has "forbidden" me to even call and talk to the doctor’s staff to try and get more info.  She wouldn’t even give me his name.  She is scared to death they will refuse her treatment when they do get the medicine if I piss them off.  This is incredible behavior from her (see the first sentence of paragraph two above). I am trying to help in the least obtrusive way I can.  Mom said, "I forbid you to call them!"  So, I got on the internet.  I knew the name of the university medical center where she goes, so now I know the Doc’s name, his nurse’s name, his email address, the entire history of Botox development and production, all about the Orphan Drug Act, and Allergan.  What I don’t know is why my mother’s clinic doesn’t have the medicine for her. My dad suspects this is a ruse, that the doc is stalling because he went out of town or something.  My mom suspects it may be bureaucratic bungling at the university hospital.  Someone lost or destroyed the last batch, they have to go through the red tape to get more.  But it would help her a lot if I could find out something.  Her last communication with the clinic was a talk with the woman-in-charge who said "I’m going on vacation until August 12.  If we have the Botox when I get back, I’ll call you to schedule an appointment.  There’s no point in bothering anyone until then, there’s nothing we can do."  I really want to yell at that woman.  But, I promised my mother. So…I said all of that to say this:  Does anyone know why, or even if the Botox supply has been interrupted? Thanks, Rhenda

I would e-mail the dystonia foundation with cc to the hospital.  I would e-mail or write allergen and cc the hospital.  Let the hospital know te enths you ar going to to get the botox for THEM. I think people with a power trip take the phones at clinics.  Either that or the sheer volume of calls make them misanthropes.

Response:

– Hide quoted text — Show quoted text -Thanks for the suggestion, Mary Beth.  Public thanks also to Sherrie and Becky who were kind enough to send very nice email messages with helpful suggestions.  And each of you added a different piece of information!  My next challenge is to get mom on the Internet.  She has a new electronic typewriter and thinks it’s the "cat’s meow".  I tried to get her interested when she was here, but she said she’s too old (62! that used to be "old" when I was 21, but now I’m 41 so it’s not) to learn this new "widget" and it hurt to hold her head still and look at the screen.  (She has essential tremor which she has had since her late teens.  It is familial.  She has had a few "supermarket" diagnoses of Parkinson’s from absolute strangers.  I still can’t believe the stupidity of someone who would offer up unsolicited outrageously inaccurate advice on a medical problem to a total stranger, but I digress.)  I wish I had found this newsgroup before I was trying to turn Mom on to the wonders of the ‘Net. She’ll be back this fall, I hope.  If we can get the damned Meanwhile, I am calling her up (long distance) and reading your email to her. Rhenda

Hey Rhenda!! Tell your Mom that I am 52 and just began with a computer in late 1993, so it is never too late to learn…as you say, 62 is young Rhenda, you are one spunky gal!!  I just want to keep yelling, "Go Girl"!!!  I am certain with you on Mom’s team, she can’t go wrong!  But the doctors sure can–tee hee! Take care, MB

Response:

Tell your Mom that I am 52 and just began with a computer in late 1993, so it is never too late to learn…as you say, 62 is young

My future mother-in-law is 63 and has been using a computer for about a year now.  We got her "addicted" through games and word processing, and now she’s into email and the internet.  My Grannie, at 76 is quite keen on learning the internet and email as well.  Maybe your Mom just isn’t old enough yet. <g Cathy. —  (—-)                                                     (—-)   "  "         http://www.cuug.ab.ca:8001/~collisoc          "  "

Response:

writes: You know BOTOX is very expensive.  Clinics have to buy in bulk as it is cheaper to purchase it this way.  When clinics buy in bulk like this they usually have a set day which they give the injections.  Perhaps your Mother’s clinic feels that there aren’t enough people coming to the clinic to warrent purchasing the BOTOX. My suggestion to you is why don’t you call the DYSTONIA FOUNDATION Headquarters in Chicago (312) 755-0198 — explain your Mother’s situation and find out what other clinics in your Mother’s area are giving BOTOX   injections.  Life is too short and sweet to go thru unnecessary hassle. Your Mother needs attention now and not whenever… Hope this helps some.  Cheerio, Becky

I was wondering how to post what I wanted to pass along to you then I read the above portion of Becky’s post. There is a company called ATHENA RX HOME PHARMACY. The number is 1-800-528-4362. They have Botox listed in thier Neurolgy Products catalog that I have. They don’t give a price for it,say’s to call for price. Maybe your mother can call and get some information from them and then call doctors office and tell them to give her an injection date and she can have the botox there. See how fast they get some Botox in then. Might be worth checking into. I got the information on Athena from some stuff I got at the symposium. Good luck Roger

Response:

- Hide quoted text — Show quoted text – writes: You know BOTOX is very expensive.  Clinics have to buy in bulk as it is cheaper to purchase it this way.  When clinics buy in bulk like this they usually have a set day which they give the injections.  Perhaps your Mother’s clinic feels that there aren’t enough people coming to the clinic to warrent purchasing the BOTOX. My suggestion to you is why don’t you call the DYSTONIA FOUNDATION Headquarters in Chicago (312) 755-0198 — explain your Mother’s situation and find out what other clinics in your Mother’s area are giving BOTOX injections.  Life is too short and sweet to go thru unnecessary hassle. Your Mother needs attention now and not whenever… Hope this helps some.  Cheerio, Becky I was wondering how to post what I wanted to pass along to you then I read the above portion of Becky’s post. There is a company called ATHENA RX HOME PHARMACY. The number is 1-800-528-4362. They have Botox listed in thier Neurolgy Products catalog that I have. They don’t give a price for it,say’s to call for price. Maybe your mother can call and get some information from them and then call doctors office and tell them to give her an injection date and she can have the botox there. See how fast they get some Botox in then. Might be worth checking into. I got the information on Athena from some stuff I got at the symposium. Good luck Roger

Thanks for sharing this bit of info with us, Roger.  Had I gone to the New York Symposium in May, you better believe I would have grabbed *any* BOTOX info there. I do know that BOTOX is *VERY* expensive because I see the charges on my health insurance bills.  The reason BOTOX is expensive is because only one company makes it – as the one you mentioned in your msg.  I may be wrong, but I don’t think the company would issue the medicine to one dr alone unless s/he is associated with a ‘BOTOX’ clinic.  This is a good idea — to call the company and find out if the particular clinic is still giving BOTOX injections and when the injections are given.  But, by the same token, you could also ask where the other ‘BOTOX’ clinics are in the area — if the company would give out such priviledge info.   BUT, then finding another dr would be a ‘hassle’ in this process. Anyway, hassle or no, it is worth the effort to track things down if you feel the particulars are helpful to you.  There, I’ve said my 2%…. Cheerio, Becky

Response:

Hi All: Just wanted to let you all know that I’m alive alive and well.  Just took a ‘computer break’ to write a paper and other things to prepare fore a job that I might be hire for in the Fall…  But, I’ll make my present known on this n/g ASAP… Anyway, just wanted to share with you my answer to Rhenda that I personally answered with you all. Yes, MB, I practically said the same thing you said, but added my 2% worth…  I do lurk on here now and then no matter how *busy* I am.  I know what’s going on…  <<<VBG – Hide quoted text — Show quoted text – Hello all, I found this newsgroup in a search for information for my mother.  I have read the messages available on my server today, but have not searched for an archive or FAQ, or lurked for a decent time before my first post because I’m in a hurry. Everybody is these days, but this is MY MOM. My mother, the most assertive, confident, intelligent person I know, suffers from debilitating spasmodic torticollis.  I could go on for a page or two about her history and symptoms, but for now I will try to be brief.  Mom has been receiving Botox injections since 1992.  They provide her enough relief that she is able to travel with my dad around the country and visit the kids & grandkids.  She was at my house in late May and traveled home in considerable pain expecting to get her next injection soon.  Her treatment has been postponed indefinately by the doctor’s office and they will only tell her that they cannot get the medicine at present and don’t know when more will come in. She has been sitting at home for six weeks now waiting on word that she can get her treatment.  Calls to the clinic have been met with rude treatment from the woman-in-charge.  She will not tell mom why they can’t get the Botox, or when they expect to. Nothing.  She even yelled at MY MOTHER. Well, I’m ready to drive down there and confront the bunch, but mom won’t hear of it.  She has "forbidden" me to even call and talk to the doctor’s staff to try and get more info.  She wouldn’t even give me his name.  She is scared to death they will refuse her treatment when they do get the medicine if I piss them off.  This is incredible behavior from her (see the first sentence of paragraph two above). I am trying to help in the least obtrusive way I can.  Mom said, "I forbid you to call them!"  So, I got on the internet.  I knew the name of the university medical center where she goes, so now I know the Doc’s name, his nurse’s name, his email address, the entire history of Botox development and production, all about the Orphan Drug Act, and Allergan.  What I don’t know is why my mother’s clinic doesn’t have the medicine for her. My dad suspects this is a ruse, that the doc is stalling because he went out of town or something.  My mom suspects it may be bureaucratic bungling at the university hospital.  Someone lost or destroyed the last batch, they have to go through the red tape to get more.  But it would help her a lot if I could find out something.  Her last communication with the clinic was a talk with the woman-in-charge who said "I’m going on vacation until August 12.  If we have the Botox when I get back, I’ll call you to schedule an appointment.  There’s no point in bothering anyone until then, there’s nothing we can do."  I really want to yell at that woman.  But, I promised my mother. So…I said all of that to say this:  Does anyone know why, or even if the Botox supply has been interrupted? Thanks, Rhenda

[ Rhenda 5K ]

– Hide quoted text — Show quoted text – Hello all, I found this newsgroup in a search for information for my mother.  I have read the messages available on my server today, but have not searched for an archive or FAQ, or lurked for a decent time before my first post because I’m in a hurry. Everybody is these days, but this is MY MOM. My mother, the most assertive, confident, intelligent person I know, suffers from debilitating spasmodic torticollis.  I could go on for a page or two about her history and symptoms, but for now I will try to be brief.  Mom has been receiving Botox injections since 1992.  They provide her enough relief that she is able to travel with my dad around the country and visit the kids & grandkids.  She was at my house in late May and traveled home in considerable pain expecting to get her next injection soon.  Her treatment has been postponed indefinately by the doctor’s office and they will only tell her that they cannot get the medicine at present and don’t know when more will come in. She has been sitting at home for six weeks now waiting on word that she can get her treatment.  Calls to the clinic have been met with rude treatment from the woman-in-charge.  She will not tell mom why they can’t get the Botox, or when they expect to. Nothing.  She even yelled at MY MOTHER. Well, I’m ready to drive down there and confront the bunch, but mom won’t hear of it.  She has "forbidden" me to even call and talk to the doctor’s staff to try and get more info.  She wouldn’t even give me his name.  She is scared to death they will refuse her treatment when they do get the medicine if I piss them off.  This is incredible behavior from her (see the first sentence of paragraph two above). I am trying to help in the least obtrusive way I can.  Mom said, "I forbid you to call them!"  So, I got on the internet.  I knew the name of the university medical center where she goes, so now I know the Doc’s name, his nurse’s name, his email address, the entire history of Botox development and production, all about the Orphan Drug Act, and Allergan.  What I don’t know is why my mother’s clinic doesn’t have the medicine for her.   My dad suspects this is a ruse, that the doc is stalling because he went out of town or something.  My mom suspects it may be bureaucratic bungling at the university hospital.  Someone lost or destroyed the last batch, they have to go through the red tape to get more.  But it would help her a lot if I could find out something.  Her last communication with the clinic was a talk with the woman-in-charge who said "I’m going on vacation until August 12.  If we have the Botox when I get back, I’ll call you to schedule an appointment.  There’s no point in bothering anyone until then, there’s nothing we can do."  I really want to yell at that woman.  But, I promised my mother.   So…I said all of that to say this:  Does anyone know why, or even if the Botox supply has been interrupted? Thanks, Rhenda

Hi Rhenda: I’m sorry your Mother has been having a frustrating time — I know what it’s like to go without my BOTOX injections — and I have injections not only to my neck, but also my vocal chords and face. …And it must be very frustrating for you as well not knowing what to do about your Mother’s situation, especially when she *FORBIDS* you not to intercede.  Since when does a loving daughter always obey her Mother???  I know I can relate to your situation as I live with my 90 yr old Mother. Mother’s can be VERY stubborn at times! Anyway, back to your problem with drs and BOTOX.  I’ve been to many a dr and would like to kick some of them in the butt.  Some drs have very poor ‘bedside’ manners.  And their secretaries are like a drill sargeant — if you can get past them you’re lucky…  BUT, there’s no reason for a clinic to act in such a non-professional way.  The only thing I can say here is maybe the clinic is giving up the ‘BOTOX program’ because of budget problems (yeah!  that ’song’ has a ring to it, doesn’t it?). Still, they should have alerted the patients to this. You know BOTOX is very expensive.  Clinics have to buy in bulk as it is cheaper to purchase it this way.  When clinics buy in bulk like this they usually have a set day which they give the injections.  Perhaps your Mother’s clinic feels that there aren’t enough people coming to the clinic to warrent purchasing the BOTOX. My suggestion to you is why don’t you call the DYSTONIA FOUNDATION Headquarters in Chicago (312) 755-0198 — explain your Mother’s situation and find out what other clinics in your Mother’s area are giving BOTOX   injections.  Life is too short and sweet to go thru unnecessary hassle. Your Mother needs attention now and not whenever… Hope this helps some.  Cheerio, Becky <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< |Rebecca Ladew                  |"Watch me disappear!"  CLICK.           | |70323,722 (Compuserve)         |                                        | <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

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