Question:

Hi:   I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.   Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

Gargle with a teaspoon of salt in 8 oz of very warm water after taking your meds.  Also, increase your fluid intake. Chris Owens

Response:

Hi:  I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.  Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

I use a Volumatic for my Becotide to keep my voice from getting hoarse. I found that I had to use it for the Serevent too, because that was begining to have the same effect. I also find eating (bio) youghurt sooths my throat when it does get hoarse, perhaps it keeps any sub-clinical oral thrush at bay. Pete

Response:

This may sound like a stupid answer, but….are you rinsing your mouth out after every puff of Flovent?  You should still gargle with water etc., even if you are using a spacer. My apologies if you are already aware. Kelly – Hide quoted text — Show quoted text – Hi:  I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.  Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

Response:

Hi:   I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.   Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

Response:

Do you rinse your mouth out after using the flovent? – Hide quoted text — Show quoted text – Hi:   I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.   Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

Response:

I had this problem when I first started on Flovent. It went away after a couple of weeks. I also use an aerochamber and always rinse my mouth with mouthwash and drink some water after use. I also recently stopped Flovent by using Accolate which works great for excercise induced asthma.

Response:

Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit doug, try using a spacer unit, it will help, and also wash your mouth out with water, and gargle with water or a mouth wash if needed.  this will definitely help with the hoarse voice.  The spacer unit is expensive, but it works.  good luck. Allen Hi:   I use 2 puffs of flovent and 2 puffs of servent daily to control my exercise induced asthma.  However, I am experiencing a major drawback:  my voice is continuously hoarce.  The doctor told me just to lower my medication to the amounts shown above.  I do use one of those extended tubes when taking in the flovent.   Anyone else had this side effect — and were you able to find some way to be able to take the meds and be able to talk.

Content-Type: text/html; charset=us-ascii Content-Transfer-Encoding: 7bit <HTML <FONT COLOR="#CC33CC"<FONT SIZE=+1doug,</FONT</FONT <BR<FONT COLOR="#CC33CC"<FONT SIZE=+1try using a spacer unit, it will help, and also wash your mouth out with water, and gargle with water or a mouth wash if needed.&nbsp; this will definitely help with the hoarse voice.&nbsp; The spacer unit is expensive, but it works.&nbsp; good luck.</FONT</FONT <BR<FONT COLOR="#CC33CC"<FONT SIZE=+1Allen</FONT</FONT

<BLOCKQUOTE TYPE=CITEHi: <P&nbsp; I use 2 puffs of flovent and 2 puffs of servent daily to control <BRmy exercise induced asthma.&nbsp; However, I am experiencing a major <BRdrawback:&nbsp; my voice is continuously hoarce.&nbsp; The doctor told me <BRjust to lower my medication to the amounts shown above.&nbsp; I do <BRuse one of those extended tubes when taking in the flovent. <P&nbsp; Anyone else had this side effect — and were you able to find <BRsome way to be able to take the meds and be able to talk. Search, Read, Post to Usenet</BLOCKQUOTE &nbsp;</HTML

Response:

Question:

I am using Serevent and Flovent 220 mcg, 2 puffs of each in the morning and then again in the evening.  I use the InspirEase spacer to take my medication.  Both medications state they contain enough medication for 120 puffs, which for me is a months worth of medication.  However, I have noticed that after a month instead of the cannisters being almost empty they are still half full.  I put them in water to measure them.  I am wondering why this is.  Could it be that the InspirEase doesn’t extract enough of the medicatiion from the cannister with each puff? Juls

Response:

I am using Serevent and Flovent 220 mcg, 2 puffs of each in the morning and then again in the evening.  I use the InspirEase spacer to take my medication.  Both medications state they contain enough medication for 120 puffs, which for me is a months worth of medication.  However, I have noticed that after a month instead of the cannisters being almost empty they are still half full.  I put them in water to measure them.  I am wondering why this is.  Could it be that the InspirEase doesn’t extract enough of the medicatiion from the cannister with each puff? Juls

How exactly does InspirEase work? All the spacers I’ve ever used simply had an opening on one end for the inhaler (where the mouth would usually be if not using a spacer) and an opening for me to breathe from. If that’s the case with InspirEase, then it wouldn’t make any difference in the amount of medicine that comes out when you press the canister down. I had actually read on some inhalers (might have been serevent, but I don’t remember) that that water measuring trick wasn’t very accurate and the best thing to do was keep track of how much you’re using. Also, is it possible that you have forgot to take every dose in a given month?

Response:

How exactly does InspirEase work? All the spacers I’ve ever used simply had an opening on one end for the inhaler (where the mouth would usually be if not using a spacer) and an opening for me to breathe from. If that’s the case with InspirEase, then it wouldn’t make any difference in the amount of medicine that comes out when you press the canister down.

Exactly..the only difference is that it has accordian -like folds and collapses as you take the meds…;

Response:

I am using Serevent and Flovent 220 mcg, 2 puffs of each in the morning and then again in the evening.  I use the InspirEase spacer to take my medication.  Both medications state they contain enough medication for 120 puffs, which for me is a months worth of medication.  However, I have noticed that after a month instead of the cannisters being almost empty they are still half full.  I put them in water to measure them.  I am wondering why this is.  Could it be that the InspirEase doesn’t extract enough of the medicatiion from the cannister with each puff?

The canisters are otherwise with propellant in order to ensure that the first actuation with have the same pressure as the 120th actuation.  The problem is that after 120 doses all you will be getting is propellant with no medication. No electrons were harmed in the posting of this message.

Response:

Question:

You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also.   90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< – Hide quoted text — Show quoted text – First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper.  The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain.  Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

Thank you Harley for the inforation you provided….printed alot of it off and have it ready for my Dr appointment  on Thursday. It should give him some idea on what I’m talking about. Thanks again…I appreciate all the help everyone has given me…….Joan

Response:

Hi Joan. I am 28yrs. and I would like to share my medication history with you.  I have been on narcotics for the treatment of Avascular Necrosis for the past 3yrs  I am currently taking 30mg of methadone every 6hrs; 120mg/day.  75mg of morphine ER/day ;30-45mg twice a day . Also, oxycodone 10mg every 4hrs.; 60mg/day.  However, I am still in a great deal of pain every second of the day.  Before switching to Methadone, I was on oxycontin 80mg/day along with the same dose of oxycodone and things where pretty much the same.  So, if cost is the only issue, I would give methadone a try.But i was recently told that methadone can damage the bones.  Therefor, I am now lookng for a drug to replace methadone since I already have a bone disease. I pray that you will soon find the right medication for you.

Response:

I agree…so I guess I need to only treat patients with good insurance????? No, you made some good points. — Bill Work

– Hide quoted text — Show quoted text – You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also. 90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper. The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain. Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

May I ask why you are on so many different narcotics?????  You should be on only ONE narcotic and maximize that to its fullest potential. Reminds me of hospice referrals we would get from the Internal Medicine teams.  They would discharge someone on Duragesic patches, OxyContin, Percocets and MS IR (no joke!).  BTW, the patient would still be in 7/10 pain. So, your dose of methadone is too small.  If this is the drug of choice for you (I hadn’t heard about the bone stuff), then it should be maximized. What is the limit?  There is NO limit.  You take an increasing dose until you either have the pain to a manageable level or you get tired of taking so many pills. As a pain physician, I would be VERY uncomfortable giving you that diverse of a medication regimen.  It sounds too complex and more likely to have problems getting the proper doses. Just my two cents…and I didn’t even bill you for it… — Bill Work

– Hide quoted text — Show quoted text – Hi Joan. I am 28yrs. and I would like to share my medication history with you.  I have been on narcotics for the treatment of Avascular Necrosis for the past 3yrs  I am currently taking 30mg of methadone every 6hrs; 120mg/day.  75mg of morphine ER/day ;30-45mg twice a day . Also, oxycodone 10mg every 4hrs.; 60mg/day.  However, I am still in a great deal of pain every second of the day.  Before switching to Methadone, I was on oxycontin 80mg/day along with the same dose of oxycodone and things where pretty much the same.  So, if cost is the only issue, I would give methadone a try.But i was recently told that methadone can damage the bones.  Therefor, I am now lookng for a drug to replace methadone since I already have a bone disease. I pray that you will soon find the right medication for you.

Response:

Ironman is quite right. Trying to last 12 hours on one pill did not come close to helping me anyway. I have found the change to QID, yes every 6 hours for oxycontin has a made major improvement in my quality of life – at least for me. TID is a near norm with many I’ve read over the last year. Some thoughts I wanted to pass along. My previous pain doc used methadone as his fist narcotic of choice for some chronic patients because of it being affordable. This enabled him to treat all folks with pain both rich and the poor uninsured – me. Fortunately I now receive help due to past employment before I could not work. I’m still paying on the previous bills for medication over several years.  I hope and pray each month my medications go through one more time. I could never afford the meds and would be back to my past situation borrowing money. Oxy works best for me, unfortunately. Thought you might find this interesting. Have a good day, Matt

– Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics.  Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? Dr. Work, While OxyContin is a very good pain reliever, it doesn’t last 12 hours. IMHO it stops being effective after 6-8 hours. YMMV, but she could need to take 40 mg. 4x per day. This is just my spin on the situation. ironman Got questions?  Get answers over the phone at Keen.com. Up to 100 minutes free! http://www.keen.com

Response:

Dear Doc.  Thank you for the info.  I am certainly going to request that my medications be re_ evaluated.  My pain alway ranges 7to 10.  I was starting to feel that there was no hope of having my pain managed.  My doc said that 120mg of methadone was as high as it could be.  That is why morphine er was added.  The oxycodone is for breakthrough pain and my pain is so grea that I take it every 4hrs. around the clock. THANKS FOR ANY HELP YOU CAN GIVE

Response:

William: I know you were joking, but no…..the key is to use drugs that have generic formularies with under- or noninsured patients. Methadone comes to mind for a "long-term" delivery drug. Another option is to use a suspension form of hydrocodone in syrup form.  This tends to stay in the body for an extended period of time. Bunch of these on the market for people with severe coughing. Still nothing wrong with Percocet/dan.  Keep in mind that the drug companies have now come out with 2.5/5/10 mg formulations.  Drs need to specify which strength they are writing for. Vicoden ES or its generics are cheaper (by comparison).  Norco is not all that expensive either. OR…..if you have a compounding pharmacy near your practice and you want to avoid APAP toxicity……have the pharmacist compound pure hydrocodone.  IT CAN BE DONE. With poorer folks, you just need to be a little bit more creative. They will thank you for it 1000% over tho  (:o) – Jon  (:o)}< – Hide quoted text — Show quoted text – I agree…so I guess I need to only treat patients with good insurance????? No, you made some good points. — Bill Work You have learned a very important thing about there being no upward bound.  The key is to make sure the patient is titrated upward properly.  Many doctors mistakenly believe that at a certain dosage, resp failure will ensue.  That is BS just as long as the patient has been *gradually* taken up to their dosages. As for cost, Oxy and MS-Con are VERY expensive.  Oramorph is about the same price also. 90 Oxycontin of 40 mg strength can run anywhere from $400 to $500. (I’ve heard that the methadone equivalent of these is about $15-$25. You can see why some patients might need to use methadone). That is ALOT of dough for either Oxy or MS-Contin.  It is important for pain physicians to discuss what insurance their patients have and to work with them to make sure they can afford the meds.  Before the doc even pulls out the prescription pad, a discussion should take place about what insurance the patient has (if any).  Most people can simply not afford paying over $1000 per month out of pocket (assuming prescriptions for Oxycontin and a breakthru med like Oxyfast). – Jon  (:o)}< First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper. The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain. Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

What this demonstrates is that everyone is different and everything about the person must be taken into account…..snippage I am never concerned about a chronic pain patient over-medicating.  They would have to prove to me that they are incompetant with their meds before I begin to get worried.  I know a pain doc here in town who on the first visit, gives the patient a large amount of MS IR to use and asks them to write down each day how much and how often they use it.  He then re-evaluates them in one month and starts them on a chronic dose.  I personally don’t do that but instead make an educated guess as to how much to start and give breakthrough MS IR/Oxy IR then make the adjustment.

When I began methadone I was prescribed 100 5 mg tablets. I was instructed to start at 5 mg every 6 hours for three days and then titrate the doseage by 5 mg increments every three days till I felt comfortable. I then settled at 10mg every 6 hours, a relatively small dose. I am now at 20 mg every 6 hours but I have only needed two small adjustments in 18 months. It took me two years of agony to get into that doctor’s care, I certainly don’t recommend that you take that long to find the right MD! I never take stuff for granted after having gone through so much. I know how fortunate I am because I don’t live in this NG anymore! I actually have days now, where I forget about this stuff entirely. Jim S Jim S

Response:

Many many patients find that Oxycontin does not last 12 hours.  It is more like 8 hours.  Many Oxy prescriptions are now for dosing one TID. I’ve read reports of patients on 4x daily dosing.  Since the drug comes in so many different strengths, it is very useful for the clinician since they can easily titrate the dose. Since different patients metabolize oxycodone at different rates, I can imagine patients who might need QID dosing.  We’ve had patients on this newsgroup that were/are taking "heroic" amounts of Oxycontin on a daily basis and their pain was barely in check. Pain management requires an "exploratory" mindset.  Just because the manufacturer promises a certain delivery, does not mean a given patient will achieve that. If I had lost my insurance, I would give methadone major consideration.  It is dirt cheap and works very well. – Jon  (:o)}< – Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics.  Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? — Bill Work I have been lurking for several months and have gotten alot of help from this group. I am looking for information on methodone…how well does it work for pain control and where could I find web sites to learn more about it? I am on oxycontine 40 mg 4 x a day right now for neck and arm pain (cervical injury)…..however my insurance company, workers comp, has stopped paying for my meds and I am having a very difficult time paying for all the meds my dr. prescribes. I have heard that methodone is cheaper, but want to know if it is some thing I should , or would want to start on in place of oxycontine. I have a very compassionate dr who is willing to help me in any way he can, however admits he does not know enough about the methadone, being used for chronic pain, to tell me if it would be the right drug for me, or how well it really works. I would appreciate any help that you could give me on this. Thank you…..Joan

Response:

First, this is my own personal preferences.  Doctors are allowed to be fickle too (most are MORE so).  I guess if I start using it more and get more comfortable with it, then I’ll start to use it more.  The hospice I direct has contracts for MS Contin/Oxy Contin so they get it cheaper.  The residency program I came from had a pharmacy that had both Oxy/MS and methadone.  I just preferred the first two. Now allow me to clear up one misconception you stated: there are no upper limits for ANY opiate that is not mixed with something else.  So there is no upper limit for morphine, oxycodone or methadone.  You keep taking more until you get the dose that benefits you.  That is one simple rule that many docs don’t like.  Some incorrectly believe that there is some "magic" number that if they pass that dose, the patient (still in horrible pain) will stop breathing.  That is simply NOT true.  No one will be dying from respiratory failure from too much narcotic while they still have significant pain.  Pain is the PERFECT antagonist for opiates…better than naloxone. Cost can be a significant factor, but I have not encountered that yet.  I know I will, just not yet. It does sound like you have a great pain doc.  Stick with her and tell your friends about her too. — Bill Work

– Hide quoted text — Show quoted text – Personally, it is my last choice for long-acting, oral narcotics. Notice I said "personally".  It has a half-life of 24 hours but you must take it three times a day for pain relief. Is the 3x/day dosing the reason you don’t like the methadone, or is there another reason for not liking it? It surely is a life saver cost wise for those who cannot afford the high prices of OxyContin and other meds which have no generics. My pain-management physician also says that there is no upper limit on methadone. She prescribes whatever it takes to reach the goal that one is seeking for pain relief and gives breakthrough medication also. Now a few questions…who in the world put you on OxyContin four times a day?  What if you took 80 mg every 12 hours (not twice a day but every 12 hours)?  Does it make you too sleepy?  Do you get too much breakthrough pain? I was on OxyContin a while back and found it to be practically useless for me. My first pain-management physician started me out on 3x/day because he said that it didn’t last longer than 8 hours for most people. I can’t see any difference between taking OxyContin 3x/day and methadone 3x/day except for the fact that methadone works much better for me than OxyContin, and I have saved a bundle of money. Annie B.

Response:

I was wondering if you or anyone else would know where I can find information on methodone for pain management that I can print out for my Dr to read.

Joan–.–    I’ll find you something and either post it or send it to you directly, your choice.  Methadone is `wonderful` stuff!  It, at the very LEAST, doubled the quality and intensity of my life! –

Question:

I must say that I did not find Simple Green very good as a degreaser.  I sprayed it full strength on the chain rings and several areas of the frame with no luck at cutting the grease even after vigorous rubbing.  I even let it sit for a while.  I went back to the citrus degreaser which works great. Mark

I find Simple Green ($7 for a whole gallon at Sam’s Club — and you can dilute it and use it as a general household cleanser) works great in my Vetta Chain Cleaner, but really is not that effective on heavy degreasing jobs, such as cleaning headset bearings in races.  Still, it’s a relative bargain compared to many bicycle-specific products. Ron

Response:

: Does anyone have some experience which cheap degreasers, which do not : include the mtb premium price, i.e. are not primarily made for cycling use. : Try WD40, works great for me. Try Turpentine (Synthetic sort) Costs about

Question:

- Hide quoted text — Show quoted text – My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter. Yes. A thought goes through my mind and it circulates and intensifies and it becomes very hard to get rid of. At times the thoughts are very positive obsessions (now that the Zoloft is lifting the depression); other times they are negative obsessions. It could be part of anxiety or depression IMO. The Zoloft has merely transferred them more often to the "positive zone." Of course, you constantly have to work to break those negative cycles. Don’t simmer on anything but positive obsessions.

Hello Marie, Thanks for your reply.  Obsessing about things is a big problem with me.  It seems everyday I am obsessing about some new thought or worry. I have been really bad for this for about six years now.  Sometimes I’ll get so worked up I’ll be just beside myself and don’t know what to do.  When I get like this Seroquel PRN seems to be really helpful. Anyways, thanks again for your reply.  Take care. Chris Hecker

Response:

Hello group, I have been struggling with anxiety pretty much my entire adult life. In addition to anxiety I also suffer from depression, possibly bi-polar.  The meds that I am curently on are Effexor XR- 150 mg Seroquel – 50 mg HS Inderal (to counteract shaking caused by my meds) 40 mg Lithium carbonate – 600 mg HS My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter. Chris H. Internet Security 101 – http://www.internetsecurity101.net

Response:

My anxiety/panic attacks are actually a lot better than they use to be.  My depression isn’t as intense as it was say a couple of months ago either.  Right now, my biggest problem seems to be obsessive thoughts that I cannot get out of my mind.  For example, I called a lady friend of mine night before last and she still hasn’t called me back.  She normally calls be back shortly after I call her.  This evening I have gotten myself all worked up about her not calling, thinking that she doesn’t like me anymore or is mad at me about something.  Does anyone else experience this obsessive type of thinking?  Is it part of anxiety or is it possibly a deeper problem?  Take care and happy Easter.

Yes. A thought goes through my mind and it circulates and intensifies and it becomes very hard to get rid of. At times the thoughts are very positive obsessions (now that the Zoloft is lifting the depression); other times they are negative obsessions. It could be part of anxiety or depression IMO. The Zoloft has merely transferred them more often to the "positive zone." Of course, you constantly have to work to break those negative cycles. Don’t simmer on anything but positive obsessions.

Response:

Question:

Might depend upon the manufacturer. c – Hide quoted text — Show quoted text – Nobody asked me a single question about my income; the doctor just took my word for it, which is good because I was telling the truth.  I’m sure it’s not this way in all situations, though.    KSF It is a great program for those who qualify.  I think the income restrictions could be lowered.  How about in proportion to the rise in drug prices? c My situation w/ getting my Effexor from the drug company in 3 month supplies didn’t require me to give any information beyond that my insurance company had dropped it from its formulary list, and that I couldn’t pay for it. Nothing further was asked.  I had just told my family doctor that much, she brought out the form, filled out her part, I filled out mine–meaning I signed my name and date–she sent it in, and about a month later there were my 3 little bottles.  It’s been continuing that way for several years now. I’m pretty sure the patent on Effexor is coming to an end soon, OR already has, and there’s been no change in my forms, etc.  I’m grateful beyond imagining for this program!    Kathy F.  (KSF) You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

Nobody asked me a single question about my income; the doctor just took my word for it, which is good because I was telling the truth.  I’m sure it’s not this way in all situations, though.    KSF

– Hide quoted text — Show quoted text – It is a great program for those who qualify.  I think the income restrictions could be lowered.  How about in proportion to the rise in drug prices? c My situation w/ getting my Effexor from the drug company in 3 month supplies didn’t require me to give any information beyond that my insurance company had dropped it from its formulary list, and that I couldn’t pay for it. Nothing further was asked.  I had just told my family doctor that much, she brought out the form, filled out her part, I filled out mine–meaning I signed my name and date–she sent it in, and about a month later there were my 3 little bottles.  It’s been continuing that way for several years now. I’m pretty sure the patent on Effexor is coming to an end soon, OR already has, and there’s been no change in my forms, etc.  I’m grateful beyond imagining for this program!    Kathy F.  (KSF) You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

It is a great program for those who qualify.  I think the income restrictions could be lowered.  How about in proportion to the rise in drug prices? c – Hide quoted text — Show quoted text – My situation w/ getting my Effexor from the drug company in 3 month supplies didn’t require me to give any information beyond that my insurance company had dropped it from its formulary list, and that I couldn’t pay for it. Nothing further was asked.  I had just told my family doctor that much, she brought out the form, filled out her part, I filled out mine–meaning I signed my name and date–she sent it in, and about a month later there were my 3 little bottles.  It’s been continuing that way for several years now. I’m pretty sure the patent on Effexor is coming to an end soon, OR already has, and there’s been no change in my forms, etc.  I’m grateful beyond imagining for this program!    Kathy F.  (KSF) You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

My situation w/ getting my Effexor from the drug company in 3 month supplies didn’t require me to give any information beyond that my insurance company had dropped it from its formulary list, and that I couldn’t pay for it. Nothing further was asked.  I had just told my family doctor that much, she brought out the form, filled out her part, I filled out mine–meaning I signed my name and date–she sent it in, and about a month later there were my 3 little bottles.  It’s been continuing that way for several years now. I’m pretty sure the patent on Effexor is coming to an end soon, OR already has, and there’s been no change in my forms, etc.  I’m grateful beyond imagining for this program!    Kathy F.  (KSF)

– Hide quoted text — Show quoted text – You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

Thanks for correction. I need to find me some cheap or free Wellbutrin. Was getting free Effexor but with med change things are about to get expensive (AGAIN). -Gandalf

That’s because it’s .com, not .org. http://www.needymeds.com/ typed: – Hide quoted text — Show quoted text -Hi Colleen Went out looking for your link www.needymeds.org, and it didn’t work. Tried google and it doesn’t know of any needymeds.org? Is this a typo, or is there a problem on my end? TY -Gandalf You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

OOPSH! C

– Hide quoted text — Show quoted text – That’s because it’s .com, not .org. http://www.needymeds.com/ typed: Hi Colleen Went out looking for your link www.needymeds.org, and it didn’t work. Tried google and it doesn’t know of any needymeds.org? Is this a typo, or is there a problem on my end? TY -Gandalf You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

Hi Colleen Went out looking for your link www.needymeds.org, and it didn’t work. Tried google and it doesn’t know of any needymeds.org? Is this a typo, or is there a problem on my end? TY -Gandalf

You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c

yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always

informative,helpful (esp. in the area of "patient assistance" [from drug

cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance

programs,which can save – Hide quoted text — Show quoted text – you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most

expensive meds I take. – Hide quoted text — Show quoted text – Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

Hi ghost, This is totally unacceptable. Vote with your feet and never go back. Besides our relationship with our pdocs and therapist, a good pharmacist is very important to us. They do exist, even in NY. Find somebody you trust, who is careful, and who has time when you need it. You deserve that. -Gandalf

..net… Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M.

Response:

You can get infor at www.needymeds.org .  They give a lot of ingo there. They tell you you need to order a book but don’t.  Your doctors should be able to get you the necessary forms.  These programs are very income contingent and you can’t have any other kind of med coverage.  If you qualify though, they are great.  (Let me know if I don’t have the URL right. I’ll look it up again.) c

– Hide quoted text — Show quoted text – yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry once more with feeling-at one place I’m tempted to count everything in their presence.harry  stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned. Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

Next order/rx is going to be through CanadaDrugs, though. Even though it takes a couple weeks, 100 x 600mg caps of lithium carbonate is $16.54 as compared to Walgreens’ $52.00 (or RiteAid’s $77.00)….I’ll order a couple hundred from the Canadians and it will hold me a few months.

Wal Mart, I got mine for $7.00 and at the local mom and pop pharmacy I use to get my insulin charged me $10 the one time I got my lithium filled there.  I’m not on lithium now, it’s been three years, but I don’t think the prices have gone up that much. Yeah… but I’ve been warned FALSELY in at least one case… a pharmatron (hmm, Walgreens again) wouldn’t fill a script and told me I couldn’t take Seroquel with Parnate because "you can’t take SSRIs with MAOIs". I tried to explain to him that Seroquel is an anti-psychotic, and nowhere near an SSRI… he remained ignorant until I pointed out his error in a PDR.

I’m a regular at the two drug stores I will go to, so they know me and they know that when it comes to most meds (for me, not for anyone else in my family) they are wasting their breath when they "counsel" me on the drug.  I would also just tell the pharmatron "thank you" and then leave, unless he wouldn’t give you your meds, at which point you should demand to speak to his supervisor. Well, I’m going to count pills from now on… and examine them before I leave the pharmacy.

I do that, as well as count the money in the envelope before I leave the bank.

Response:

yes-maybe lucky,i’ve used a pharmacist at a mental health center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry

once more with feeling-at one place I’m tempted to count everything in their presence.harry

 stop- … it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned.

Hi Harry, I NEED to take advantage of those patient assistance programs… particularly for Lamictal and Zyprexa, the two most expensive meds I take. Currently I order Lamictal from Canada and my pdoc gets me coupons for Zyprexa… but this is not an optimum situation. Maybe I should web search and post any results for drug companies’ med assistance pages. Sorry you lost your good pharmacist. I’d settle for a competent one. Jim . Jim M.

Response:

– Hide quoted text — Show quoted text – Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT.

Hi Jim, I too use Walgreens but in Tallahassee, FL.  I have generally had good luck with them.  Once in a while they will not have one of my meds in stock or are short x number of pills and have to order more.  When that happens I always tell them that I am likely to be on that medicine for quite some time and ask them to keep plenty on hand to fill my scripts in the future.  In the past three years I have never had the pharmacy have to order a medication more than once. By the way, what is Dynamic Therapy and CBT? Matt

Response:

- Hide quoted text — Show quoted text – Find another pharmacy.  I’m very happy with the folks I use.  I’m warned about drug interactions and not to take certain OTCs with what i take. I do my homework most of the time, except on the straterra and its mildy entertaining hallucinations. I’ve never been shorted and not told. KG Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when  I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag  before I demanded to know what was going on. The idiot "professional"  investigating this then disappeared for about half an hour before returning and  informing me that they didn’t have the 600mg in stock… wanted to send me to  fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments  I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from  error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as  possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M. yes-maybe lucky,i’ve used a pharmacist at a mental health

center(until he got ill recently)-always informative,helpful (esp. in the area of "patient assistance" [from drug cos.]programs,and over years he’s alqways been kind and patient with clients.I wonder if others take part in those patient assistance programs,which can save you money,but dealing with the companies can be a pain.I’m not on Medicaid,do I need their help).if you don’t have a good relationship-trust,competence,reliability-there can be problems.The private store I go to for other meds I am wary of.harry                               once more with feeling-at one place I’m tempted to count everything in their presence.harry                                                 stop-                                                                               it seems like life is difficult in every aspect.the pharmacists know when filling psychiatric medications approximately what ill you’re being treated for,don’t they?& every one isn’t like the guy i first mentioned.

Response:

I think it is NY pharmacists…they filled my mom’s prescription with a LOT more insulin than she needed. <

Is that a good thing? Doesn’t insulin have a shelf life or something? I think that our lives are parallel right now.  My boyfriend is STILL not talking to me.  I’m spending all day studying.  My old roommate moved out two weeks ago (yay!), but my rent is completely insane.  Also, she never paid the last month’s rent, so my landlord is annoying me.  when I asked for the money back, she gave me a check which bounced.

The first thing you need from a roommate is the rent. Period. I don’t necessarily like having one in the first place… but it’s roommate and doctor’s visits and rx… or no roomate and no doctor and no drugs. And since I’m going to be 60 before me and my current girlfriend get it together… One could get nasty and go after someone for passing bad checks… I HATE roommates.  Especially ones that smell bad and don’t shower and leave dishes in the sink and don’t open windows and clog the drains with their hair. <

Yep…sounds like the one I got (who’s leaving tomorrow). Good luck. Jim M.

Response:

Find another pharmacy.  I’m very happy with the folks I use.  I’m warned about drug interactions and not to take certain OTCs with what i take. I do my homework most of the time, except on the straterra and its mildy entertaining hallucinations. I’ve never been shorted and not told. KG

– Hide quoted text — Show quoted text – Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M.

Response:

Find another pharmacy.  I’m very happy with the folks I use.

Yeah… I know….trying to save a few bucks (Walgreens is the cheapest I’ve found in this area). Next order/rx is going to be through CanadaDrugs, though. Even though it takes a couple weeks, 100 x 600mg caps of lithium carbonate is $16.54 as compared to Walgreens’ $52.00 (or RiteAid’s $77.00)….I’ll order a couple hundred from the Canadians and it will hold me a few months. But, in any case, most of the NYC pharmacies that I’ve been to are toxic, careless and a chore to deal with. I’m warned about drug interactions and not to take certain OTCs with what i

take.< Yeah… but I’ve been warned FALSELY in at least one case… a pharmatron (hmm, Walgreens again) wouldn’t fill a script and told me I couldn’t take Seroquel with Parnate because "you can’t take SSRIs with MAOIs". I tried to explain to him that Seroquel is an anti-psychotic, and nowhere near an SSRI… he remained ignorant until I pointed out his error in a PDR. (snip) I’ve never been shorted and not told.

Well, I’m going to count pills from now on… and examine them before I leave the pharmacy. Thanks for the note. Jim – Hide quoted text — Show quoted text – KG Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M.

Response:

Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M.

Response:

I think it is NY pharmacists…they filled my mom’s prescription with a LOT more insulin than she needed.  I think that our lives are parallel right now.  My boyfriend is STILL not talking to me.  I’m spending all day studying.  My old roommate moved out two weeks ago (yay!), but my rent is completely insane.  Also, she never paid the last month’s rent, so my landlord is annoying me.  when I asked for the money back, she gave me a check which bounced. I HATE roommates.  Especially ones that smell bad and don’t shower and leave dishes in the sink and don’t open windows and clog the drains with their hair.  I love how my apartment is nice now, I like being around my stuff, not her pseudo-socio-politico-commentaries on the oppressive male, or Zena warrior princess shite. Hurray for fabric softener and makeup and nice clothes and fluffy towels and vaccuum cleaners and cute, adorable haircuts!!!! –S

– Hide quoted text — Show quoted text – Well, maybe only New York pharmacists. Caught one at the local Bronx Walgreens filling my rx for 100 x 600mg lithium carbonate caps with 100 x **300mg** caps… I only caught it when I wondered about the price (me being self-pay)… they would have never noticed. It was bottled, bagged and almost in a plastic shopping bag before I demanded to know what was going on. The idiot "professional" investigating this then disappeared for about half an hour before returning and informing me that they didn’t have the 600mg in stock… wanted to send me to fucking Yonkers to get the right rx. Have to go back Monday for the correct count. This is besides being the rudest, most inefficient pharmacy departments I’ve ever been subjected to… second only to Duane Reade in general assholishness. Then these morons in white want to "counsel" you as to your rx. I got your counsel right here, Mr. Pharmacist. Learned more in these groups than any pharmacist would know. Object lesson that might help others: ALWAYS inspect and verify your prescriptions before you leave the pharmacy…it will protect you from error and possible fraud. I don’t need this, I honestly don’t. This has been a BAAAAD week for me. Duking it out with my pdoc, Dr. Josie over side fx and her doing some half-assed "dynamic therapy" on me instead of something that works…like CBT, fucked-up roommate finally moving out while being as toxic as possible in the process, searching for a new roomate, money worries… Well, at least I got my esoteric tobacco shipment in… not exactly bootlegging, as bulk tobacco isn’t counted the same as cigarettes… sampling offbeat tobacco being maybe my only joy in life. Bah. Jim M.

Response:

Question:

Folks,           I’ve been on the Paxil for about five weeks now,  feeling better but really experiencing the sexual side effects of the Paxil. I have heard that Serzone gives you all the benefits of Paxil and No sexual side effects.          Can anyone respond both pro and con for switching to Serzone. I’d like to get my drive/libido back. Also if you have made the switch from Paxil how did you do it, were you weaned off the Paxil slowly or just a cold turkey switch to the serzone. Thanks in advance for any and all responses. — Dan ICQ 108553906

Response:

         I’ve been on the Paxil for about five weeks now,  feeling better but really experiencing the sexual side effects of the Paxil. I have heard that Serzone gives you all the benefits of Paxil and No sexual side effects.         Can anyone respond both pro and con for switching to Serzone. I’d like to get my drive/libido back. Also if you have made the switch from Paxil how did you do it, were you weaned off the Paxil slowly or just a cold turkey switch to the serzone.

My doctor switched me from paxil to serzone just before new year’s. No weaning — quit paxil one day, started serzone the next. I can definitely attest to the fact that serzone doesn’t depress libido the way paxil did. However, I’m not as certain that the serzone is as effective as paxil was in controlling anxiety. I *do* know that I’m prepared to stick with the serzone….. — Tom

Response:

I have had no sexual side effects as a result of taking Serzone. It has also gotten rid of my insomnia. I took Paxil for one day and it freaked me out!

– Hide quoted text — Show quoted text –          I’ve been on the Paxil for about five weeks now,  feeling better but really experiencing the sexual side effects of the Paxil. I have heard that Serzone gives you all the benefits of Paxil and No sexual side effects.         Can anyone respond both pro and con for switching to Serzone. I’d like to get my drive/libido back. Also if you have made the switch from Paxil how did you do it, were you weaned off the Paxil slowly or just a cold turkey switch to the serzone. My doctor switched me from paxil to serzone just before new year’s. No weaning — quit paxil one day, started serzone the next. I can definitely attest to the fact that serzone doesn’t depress libido the way paxil did. However, I’m not as certain that the serzone is as effective as paxil was in controlling anxiety. I *do* know that I’m prepared to stick with the serzone….. — Tom

Response:

Danny, I didn’t go from Paxil to Serzone but did go Zoloft-Wellbutrin-Serzone, which I now have been on for about five months.  With the Wellbutrin I ramped off, and then began the "starter pack" of Serzone.  But even the lowest dosage I found intolerable at first – it upset my stomach and made me feel like I had drank ten cups of coffee.  I had to break the beginning pills in half to make it comfortable and move up from there.  Once you’re on it it’s fine, but it’s bumpy getting there. As far as libido or sexual side effects there were none . . . . at first. However (and this could just be me, obviously) at about the four month mark I did start to have problems, similar to what the Zoloft was doing.  It disperses my concentration to the point where it’s very difficult to "finish" in bed.  I don’t know why it took this long to kick in, but it did. I’m currently at 150mg twice a day, and at one point my doc tried to increase it to 400 total.  That DIDN’T work, made me feel like a zombie and totally screwed with my physical coordination, so I went back to 300.  But I’m seriously thinking of ramping off it entirely, not just because of the sexual problem but other side effects as well.  I’ll call my doc and talk about it. Good luck to you, however, and don’t take my experience as a negative for trying Serzone.  I’ve noticed on the other meds many times I have an unusual reaction which just proves we all react differently to some degree. Wayne

– Hide quoted text — Show quoted text – Folks,           I’ve been on the Paxil for about five weeks now,  feeling better but really experiencing the sexual side effects of the Paxil. I have heard that Serzone gives you all the benefits of Paxil and No sexual side effects.          Can anyone respond both pro and con for switching to Serzone. I’d like to get my drive/libido back. Also if you have made the switch from Paxil how did you do it, were you weaned off the Paxil slowly or just a cold turkey switch to the serzone. Thanks in advance for any and all responses. — Dan ICQ 108553906

Response:

Question:

Sasha — Please do not change your doses on your own… go to your doctor…. If you present your situation (your complaints regarding how you feel), and you ask your doctor to work with you to make you feel your best both physiclly and emotionally, I am sure they will make the effort to work with you.

Yes, thanks, I’ve calmed down a bit now.  I have already reduced my zoloft to 150 mg, but we had already talked about doing that, so I just jumped the gun a little.  I’m going towait to discuss changes in the Ritalin at my appt next week.  The thing is, my pdoc likes to make changes one at a time so he will know exactly which drug is having the effect.  It may take awhile to get off the zoloft and see how I do for awhile, and maybe have to go back on again if it has a bad effect.  Ritalin may be quicker to see the effects. If, as you say, you are BP II, and weight gain and energy are concerns I would make the following recommendation: the Lithium (lithobid) could be replaced with either Topamax, Lamotrigine (Lamictil), or Neurontin (gabapentin). I would, personally, try the Topamax first — only because it is the one I have personal experience with and it has some tendancies for some people to cause weight loss (I have lost about 45 pounds in the year on it).

The thing is, there really was a big improvement with the lithium, and I am afraid to make a change.  Several years ago I was on depakote monotherapy which caused me to bruise easily and frequently, and to gain weight too.  So that didn’t seem to work very well, not to mention I went through several two week jobs while I was on it anyway.  So I’m a little wary of the seizure drugs.  Tose you mentioned are newer though, right?  I tried Neurontin breifly in addition to all the others I’m on, but it only contributed to my sleepiness, so It was stopped.  It’s a shame too, since even at a low dose it really seemed to help with my pain.  If Icould take that, then maybe I wouldn’t need anything additional for pain too.  I try not to take things for pain if I can help it, but anti-inflammitories actually seem to help with my energy, but I can’t take too many because it interferes with the lithium. The B-12 may help your energy, if it is a result of your anemia, however, I would alsoe suggest that you get your thyroid checked again — you may need an adjustment of the Synthroid to level out your energy levels.

I was hoping for awhile maybe These were the only problems and if I get them treated, then maybe I’m not really "crazy" after all.  But I don’t think it’s gonna turn out that way, and they will probably just find something else wrong with me anyway.  Besides that theory doesn’t account for the sudden change in energy from barely being able to move for weeks, and then one day I hardly need to sleep and find that I can move around very easily and rush to cram weeks worth of stuff into just a few days, before the gravity gets me again so I can’t move, etc… As for the Ritalin… that is a really difficult issue as ADD and BP II are nasty together… personally, my attention span is sometimes that of a wet noodle…:-) But, you must remember that Ritalin is an amphetamine — a powerful stimulant, and CAN destabalize the bi-polar mind. Once you get the Mood-Stabalizer checked out, and the thyroid… try and see how low a dose of Ritalin you can tolerate, and maintain your concentration. This may, in the long run, be very beneficial for you.

Actually, it doesn’t really seem to help me with concentration.  I’m beginning to think its something else besides ADD.  I need to talk with my neuroloist about it too to see what he thinks.  He has EEGs from before I was on it, and there is supposed to be something in that that can distinguish ADD.  He seemed surprised that I was taking it. Good luck, and please keep us posted. Peter

Thanks Sasha

Response:

What is does your diet consist of on the average, and what is your activity level? I’m on a couple of drugs, but I seem to have gotten very good results from diets principles of a Santa Barbara endocrinologist along with moderate daily walking.

I go for walks daily too now, although there are the times when I hardly have the strength to go to the mailbox, or am too paranoid to go outside. I’ve been well enough to go on walks for months now though.  The thing is I used to be very active, or at least during active spells.  Even in deep depression, I would get out of bed to go to dance class – the only thing I would do, it was that important to me.  A couple years ago I started having trouble breathing and got dizzy when I ran or biked for more than a couple minutes and had to abandon my workout.  I just figured I was out of shape and getting old.  Now I’m thinking it was probably the hypothyroid and pernicious anemia.  I was on a fairly good diet at the time. It’s hard to say what my average diet is because it changes in phases.  I don’t eat on a regular schedule, or take in a regular amount of calories from day to day, and that combined with the quality of food switch leads to a very inconsistent diet which probably screws with my blood sugar levels. I don’t eat much meat or fat, which leaves too many carbs, and in some phases too much sugar.  I do like fruits and vegetables though, and those are supposed to be good for you, right? I don’t know if a diet would help me much until I learn to become more consistent in my whole life.  There is a lot I need to work on, including paying bills and getting errands done, and soon going to class and getting assignments in on time.  The first thing I’ve been working on lately, is getting to all of my doctors appts and taking all of my medication on time, which takes a good deal of my concentration.   Thanks for the advice though Sasha

Response:

– Hide quoted text — Show quoted text – Hi Sascha, Help!  I’m having urges lately to screw with my medication and reduce doses to eventually eliminate two of them.  Ok, heres what I’m on. Synthroid 25mcg Lithobid 900 mg Zoloft 200 mg Seroquel 25mg Ritalin 45mg Everything was going so well a few months ago with all these medications, but I was getting increasingly tired again, and had gained a little weight, so I complained.  Pdoc wanted to get rid of the seroquel –  didn’t work. What happened?

Paranoia, hypervigilence, dissociation, irritability, ultrawithdrawn, things looked/ seemed weird, etc… – Hide quoted text — Show quoted text – Last time he said start taking it every night again, and also take all my lithobid at night so maybe I wouldn’t be so tired throughout the day, then maybe next month we can try reducing the zoloft.  Ok, then I find out I have this pernicious anemia thing, and so I’m hoping maybe these vitamin B-12 shots will give me energy. They should help. But then I think back to when my thyroid was so low, and the synthroid was supposed to make me all better, which it seemed to for awhile, but then I got so very tired and sleepy again (perhaps I’m still cycling a little too?) so I think what if the same thing happens here? Perhaps it is time to have yout TSH level chcked

Yes I’m getting it checked later this week – Hide quoted text — Show quoted text – I’m getting very impatient.  I start school in like two weeks and I want to have energy and concentration for it!  I can’t wait to see if these shots fix everything and then the next illness comes along to wipe me out! Maybe I’m just taking too much medicine.  So I’ve already lowered my zoloft dose a little, but I want to go ahead and get rid of the ritalin too.  It hasn’t helped my concentration any, and it is no longer keeping me awake, so what good is it? Ask your doctr that question….he is the best source of info since he know your history.

I know, I’m just getting impatient.  I’m tempted to start reducing it already just to see.  I only have one week before I see the pdoc, so I guess maybe I should just wait.  I already made one change earlier than we had planned anyway, reducing my zoloft to 150 mg. – Hide quoted text — Show quoted text –  What if it’s actually making me sleepy now, like caffein does? Pdoc seems to think it should help me though.  I dunno.  And if I’m really BP ll then should I be taking lithium anyway?  I just want my brain to work better and be out of this hazy foggy state.  I know it can’t all be the drugs though, because I was sleeping just as much before I sought treatment. OK, that’s enough for now. Sascha, it sounds like a thorough medication evaluation is needes as well as some blood work. I can empathazie with your frustration as I have been there too . When was the last time tou had a complete physical exam? Perhaps the folloeing tests should be condisered: CBC with differential Electrolyte Panel BUN and Creatinine Serum Iron Lithium level

I’m scheduled to have my lithium and TSH checked.  My neurologist gave me a bunch of tests recently too, with only the vit B-12 screwed up.  Good luck with school.

Thanks, I’ll need it  May I ask what you will be studying? Well, about 5 years ago, I was two classes away from graduating with a BA in anthropology, but I freaked out manicstyle and did not complete my thesis or take my statistics final, and ran off and became a stripper instead. Brilliant huh?  Well, now I’m planning to finish up the degree, or the one in English which I was also very close to finishing, but I have to take these freshmen courses that are required here in CA before they will admit me as a senior.  So I’m going to summer school Sasha – Hide quoted text — Show quoted text – Love, Lynda

Response:

What is does your diet consist of on the average, and what is your activity level? I’m on a couple of drugs, but I seem to have gotten very good results from diets principles of a Santa Barbara endocrinologist along with moderate daily walking. – Hide quoted text — Show quoted text – Help!  I’m having urges lately to screw with my medication and reduce doses to eventually eliminate two of them.  Ok, heres what I’m on. Synthroid 25mcg Lithobid 900 mg Zoloft 200 mg Seroquel 25mg Ritalin 45mg Everything was going so well a few months ago with all these medications, but I was getting increasingly tired again, and had gained a little weight, so I complained.  Pdoc wanted to get rid of the seroquel –  didn’t work. Last time he said start taking it every night again, and also take all my lithobid at night so maybe I wouldn’t be so tired throughout the day, then maybe next month we can try reducing the zoloft.  Ok, then I find out I have this pernicious anemia thing, and so I’m hoping maybe these vitamin B-12 shots will give me energy.  But then I think back to when my thyroid was so low, and the synthroid was supposed to make me all better, which it seemed to for awhile, but then I got so very tired and sleepy again (perhaps I’m still cycling a little too?) so I think what if the same thing happens here? I’m getting very impatient.  I start school in like two weeks and I want to have energy and concentration for it!  I can’t wait to see if these shots fix everything and then the next illness comes along to wipe me out!  Maybe I’m just taking too much medicine.  So I’ve already lowered my zoloft dose a little, but I want to go ahead and get rid of the ritalin too.  It hasn’t helped my concentration any, and it is no longer keeping me awake, so what good is it?  What if it’s actually making me sleepy now, like caffein does? Pdoc seems to think it should help me though.  I dunno.  And if I’m really BP ll then should I be taking lithium anyway?  I just want my brain to work better and be out of this hazy foggy state.  I know it can’t all be the drugs though, because I was sleeping just as much before I sought treatment. OK, that’s enough for now. Sasha

Response:

Sasha — Please do not change your doses on your own… go to your doctor…. If you present your situation (your complaints regarding how you feel), and you ask your doctor to work with you to make you feel your best both physiclly and emotionally, I am sure they will make the effort to work with you. If, as you say, you are BP II, and weight gain and energy are concerns I would make the following recommendation: the Lithium (lithobid) could be replaced with either Topamax, Lamotrigine (Lamictil), or Neurontin (gabapentin). I would, personally, try the Topamax first — only because it is the one I have personal experience with and it has some tendancies for some people to cause weight loss (I have lost about 45 pounds in the year on it). The B-12 may help your energy, if it is a result of your anemia, however, I would alsoe suggest that you get your thyroid checked again — you may need an adjustment of the Synthroid to level out your energy levels. As for the Ritalin… that is a really difficult issue as ADD and BP II are nasty together… personally, my attention span is sometimes that of a wet noodle…:-) But, you must remember that Ritalin is an amphetamine — a powerful stimulant, and CAN destabalize the bi-polar mind. Once you get the Mood-Stabalizer checked out, and the thyroid… try and see how low a dose of Ritalin you can tolerate, and maintain your concentration. This may, in the long run, be very beneficial for you. Good luck, and please keep us posted. Peter – Hide quoted text — Show quoted text – Help!  I’m having urges lately to screw with my medication and reduce doses to eventually eliminate two of them.  Ok, heres what I’m on. Synthroid 25mcg Lithobid 900 mg Zoloft 200 mg Seroquel 25mg Ritalin 45mg Everything was going so well a few months ago with all these medications, but I was getting increasingly tired again, and had gained a little weight, so I complained.  Pdoc wanted to get rid of the seroquel –  didn’t work. Last time he said start taking it every night again, and also take all my lithobid at night so maybe I wouldn’t be so tired throughout the day, then maybe next month we can try reducing the zoloft.  Ok, then I find out I have this pernicious anemia thing, and so I’m hoping maybe these vitamin B-12 shots will give me energy.  But then I think back to when my thyroid was so low, and the synthroid was supposed to make me all better, which it seemed to for awhile, but then I got so very tired and sleepy again (perhaps I’m still cycling a little too?) so I think what if the same thing happens here? I’m getting very impatient.  I start school in like two weeks and I want to have energy and concentration for it!  I can’t wait to see if these shots fix everything and then the next illness comes along to wipe me out!  Maybe I’m just taking too much medicine.  So I’ve already lowered my zoloft dose a little, but I want to go ahead and get rid of the ritalin too.  It hasn’t helped my concentration any, and it is no longer keeping me awake, so what good is it?  What if it’s actually making me sleepy now, like caffein does? Pdoc seems to think it should help me though.  I dunno.  And if I’m really BP ll then should I be taking lithium anyway?  I just want my brain to work better and be out of this hazy foggy state.  I know it can’t all be the drugs though, because I was sleeping just as much before I sought treatment. OK, that’s enough for now. Sasha

Response:

Hi Sascha, Help!  I’m having urges lately to screw with my medication and reduce doses to eventually eliminate two of them.  Ok, heres what I’m on. Synthroid 25mcg Lithobid 900 mg Zoloft 200 mg Seroquel 25mg Ritalin 45mg Everything was going so well a few months ago with all these medications, but I was getting increasingly tired again, and had gained a little weight, so I complained.  Pdoc wanted to get rid of the seroquel –  didn’t work.

What happened? Last time he said start taking it every night again, and also take all my lithobid at night so maybe I wouldn’t be so tired throughout the day, then maybe next month we can try reducing the zoloft.  Ok, then I find out I have this pernicious anemia thing, and so I’m hoping maybe these vitamin B-12 shots will give me energy.

They should help. But then I think back to when my thyroid was so low, and the synthroid was supposed to make me all better, which it seemed to for awhile, but then I got so very tired and sleepy again (perhaps I’m still cycling a little too?) so I think what if the same thing happens here?

Perhaps it is time to have yout TSH level chcked I’m getting very impatient.  I start school in like two weeks and I want to have energy and concentration for it!  I can’t wait to see if these shots fix everything and then the next illness comes along to wipe me out!  Maybe I’m just taking too much medicine.  So I’ve already lowered my zoloft dose a little, but I want to go ahead and get rid of the ritalin too.  It hasn’t helped my concentration any, and it is no longer keeping me awake, so what good is it?

Ask your doctr that question….he is the best source of info since he know your history.  What if it’s actually making me sleepy now, like caffein does? Pdoc seems to think it should help me though.  I dunno.  And if I’m really BP ll then should I be taking lithium anyway?  I just want my brain to work better and be out of this hazy foggy state.  I know it can’t all be the drugs though, because I was sleeping just as much before I sought treatment. OK, that’s enough for now.

Sascha, it sounds like a thorough medication evaluation is needes as well as some blood work. I can empathazie with your frustration as I have been there too . When was the last time tou had a complete physical exam? Perhaps the folloeing tests should be condisered: CBC with differential Electrolyte Panel BUN and Creatinine Serum Iron Lithium level  Good luck with school. May I ask what you will be studying? Love, Lynda

Response:

Help!  I’m having urges lately to screw with my medication and reduce doses to eventually eliminate two of them.  Ok, heres what I’m on. Synthroid 25mcg Lithobid 900 mg Zoloft 200 mg Seroquel 25mg Ritalin 45mg Everything was going so well a few months ago with all these medications, but I was getting increasingly tired again, and had gained a little weight, so I complained.  Pdoc wanted to get rid of the seroquel –  didn’t work. Last time he said start taking it every night again, and also take all my lithobid at night so maybe I wouldn’t be so tired throughout the day, then maybe next month we can try reducing the zoloft.  Ok, then I find out I have this pernicious anemia thing, and so I’m hoping maybe these vitamin B-12 shots will give me energy.  But then I think back to when my thyroid was so low, and the synthroid was supposed to make me all better, which it seemed to for awhile, but then I got so very tired and sleepy again (perhaps I’m still cycling a little too?) so I think what if the same thing happens here? I’m getting very impatient.  I start school in like two weeks and I want to have energy and concentration for it!  I can’t wait to see if these shots fix everything and then the next illness comes along to wipe me out!  Maybe I’m just taking too much medicine.  So I’ve already lowered my zoloft dose a little, but I want to go ahead and get rid of the ritalin too.  It hasn’t helped my concentration any, and it is no longer keeping me awake, so what good is it?  What if it’s actually making me sleepy now, like caffein does? Pdoc seems to think it should help me though.  I dunno.  And if I’m really BP ll then should I be taking lithium anyway?  I just want my brain to work better and be out of this hazy foggy state.  I know it can’t all be the drugs though, because I was sleeping just as much before I sought treatment. OK, that’s enough for now. Sasha

Response:

Question:

Dear Brenda, Please tell me what it is about meds (Xanax in particular) that you are afraid of? Perhaps we could offer some help in that direction. I have been reading all of your posts and I am so distressed for you. I posted you awhile back about the safety of Xanax and offered some relaxation and breathing techniques. Have you tried them? I guess I just cannot understand how a medphobic can take Zoloft with all the anxiety it causes you and refuse to take Xanax which could ease or eliminate your suffering. Why do you fear Xanax so much? And I sincerely believe that it is your fear of it that increased your anxiety when you took it. Just my opinion, of course. I just cannot stand to see someone suffer when they do not have to. Worried about you, Kathryn

Response:

WEll last night I upped my Zoloft from 12.5 to 19mg.(big deal). Woke up at 6am took .25 Xanax went back to bed for about 2 hours. Here is the question. I am med phobic and have not upped my Xanax to .50mg 3x day. Still take .25.My main symptom is constant and I do mean hyperventilation and shortness of breath. Today is day 15 on the Zoloft. Well this afternoon I decided to take .37mg of Xanax (a 25mg pill and a half). Within 10 minutes my anxiety went up. Tried to distract myself then I felt the Xanax kicking in. I get real groggy BUT THE BREATHING STILL IS SHORT.I was afraid to up my dose cux what if it doesnt help the breathing then I will feel hopeless. I am still kinda shook up and depressed and afraid.Please tell me Im doing something wrong or this is just normal for day 15 upping the dosage and being med phobic. Brenda

Response:

Kathryn I think that my biggest fear of taking the Xanax is that it wouldnt work. Now I started off with .25. My problem is my breathing  (shortness of breath ans hyprventilation). I was hoping the Xanax would help be I really doesnt that much. It may take the edge off of the anxiety but the breathing  problem remains. Also did you read my ost where yesterday was the first day that I upped my Zoloft from 12.5 to 19mg. I will post about that later. Now another fear I battle is that I have always hated lose of control. And when I first took the Xanax I would get very groggy,symptoms still there but very groggy. I would have bad thoughts on what if I cant breathe and am too groggy to breathe. That wont happen in Jesus name but the thoughts still come. Now when I wake up at 5 or 6am and take .25mg Xanax I can go back to sleep. I dont know maybe Ill have to upped the Xanax gradually. The pdoc want me to take .50 3 times a day. Brenda

Response:

Kathryn I think that my biggest fear of taking the Xanax is that it wouldnt work.

Brenda, it is possibly, but highly unlikely that xanax won’t work for you – Xanax can calm an elephant!  But, I guarantee that if you don’t take it, it definitely won’t do a thing. Now I started off with .25. My problem is my breathing  (shortness of breath ans hyprventilation). I was hoping the Xanax would help be I really doesnt that much. It may take the edge off of the anxiety but the breathing  problem remains.

Xanax can lessen your anxiety, but it isn’t a cure all. I suspect that your hyperventilating/shortness of breath has become ingrained to the point were its become an almost automatic response. Xanax cannot undo that, no med can. But breathing exercises like those previously mentioned by another poster should.  The bottom  line in this Brenda is that drugs aren’t magic. They can help a great deal, but you have to make an effort too.  Sorry, but if this was easy, we wouldn’t all be here. Also did you read my ost where yesterday was the first day that I upped my Zoloft from 12.5 to 19mg. I will post about that later. Now another fear I battle is that I have always hated lose of control. And when I first took the Xanax I would get very groggy,symptoms still there but very groggy. I would have bad thoughts on what if I cant breathe and am too groggy to breathe.

Okay, firstly the grogginess will diminish as your body gets used to the Xanax. Secondly, Xanax won’t stop you breathing, even if you pass out. In fact you will probably breath better. What is happening at the moment is that the conscious parts of your brain are overriding the auto settings. Left to its own devises the autonomous system would be doing a better job than you are!!   Even when knocked unconscious most people continue to breath.   The benzos are very safe drugs, even when taken in enormous overdose quantities most people just sleep them off. That wont happen in Jesus name but the thoughts still come. Now when I wake up at 5 or 6am and take .25mg Xanax I can go back to sleep. I dont know maybe Ill have to upped the Xanax gradually. The pdoc want me to take .50 3 times a day. Brenda

tackle the increase at a pace you can cope with, but be assured, the meds won’t kill you, drug companies find it cheaper to keep repeat customers rather than continually having to find new ones!!!!. Take care Ian

Response:

One of my fears about taking my ativan is that it wont work.  When i am in the middle of a PA, I always have the comforting thought of "At least I can always take my pill".  My fear is what if i take it and it still doesnt control my attack and my racing thoughts.  My biggest fear is that I will need to go to the hopital because I will not be able to reign myself back in.  Do you ever feel that way?  D

Response:

OMG that is the biggest fear that I have with my Xanax and alot of the time it doesnt help me that much because of the extra anxiety I have. However I suppose to be taking .50 3x a day and I only take .25 sometimes twice. But I couldnt believe somebody else has the same fear though. Brenda

Response:

One of my fears about taking my ativan is that it wont work.  When i am in the middle of a PA, I always have the comforting thought of "At least I can always take my pill".  My fear is what if i take it and it still doesnt control my attack and my racing thoughts.  My biggest fear is that I will need to go to the hopital because I will not be able to reign myself back in.  Do you ever feel that way?  D

Although, reports of antidepressants suddenly failing to work are becoming more common, its rare for his to happen with benzodiazepines. What may happen is that you begin requiring higher doses to achieve the same levels of control. But, most with anx/pan seem to gradually take/need less, not more benzos. Ian

Response:

Ratzenfratzen ISP lost (or did receive) about two days worth of my newsgroup messages. So I had to do a deja search to find out what I missed. <grrrr I think that my biggest fear of taking the Xanax is that it wouldnt work. Now I

It certainly will not work if you do not take it. I know if I tried only .25 I wouldn’t notice a thing. I must take from .5 to 1mg to have any relief at all. There have been days when I have taken up to 2mgs at once. started off with .25. My problem is my breathing  (shortness of breath ans hyprventilation). I was hoping the Xanax would help be I really doesnt that much. It may take the edge off of the anxiety but the breathing  problem

Have you seen a doctor to make certain that your breathing problem is definitely physical? If it is not physical, that is, one of the many symptoms of anxiety and panic then Xanax can definitely help by letting you be calmer. When you are calmer you can breathe easier. I hope you have ruled out any physical cause such as asthma, though. remains. Also did you read my ost where yesterday was the first day that I upped my Zoloft from 12.5 to 19mg. I will post about that later. Now another

I read about it. Pretty gutsy! Good work! fear I battle is that I have always hated lose of control. And when I first took the Xanax I would get very groggy,symptoms still there but very groggy. I

The grogginess passes quickly (MUCH quicker that the side effects of Zoloft!) if you continue taking it. Maybe the symptoms are still there because of your fear of the grogginess or the Xanax not working. I hate the feeling of losing control, too. Which is why I don’t drink anymore. Hardly. But grogginess is not loss of control. When you are in a high anxiety state you are way too alert, sensitive to every little thing and your mind races ahead of you. Xanax can put the brakes on all of that and the drowsiness you feel just may be your body saying to you, “Thank goodness! Now maybe we can get some rest!“ would have bad thoughts on what if I cant breathe and am too groggy to breathe. That wont happen in Jesus name but the thoughts still come. Now when I wake up

Too groggy to breathe? Impossible in anyone’s name! In fact, I can guarantee you that you will breathe BETTER when you allow yourself to sleep. I have said it before and I will say it again that our bodies function quite nicely when we give it over to the brain’s automatic control system. Better, in fact! We muck things up by over thinking. We all just think too much!  You know, the Divine Creator gave us pretty nifty bodies and will take care of them for us just fine when we give them over to sleep. For that matter, the Creator gave us Xanax through providing the plant valerian and us the intellect to use it. at 5 or 6am and take .25mg Xanax I can go back to sleep. I dont know maybe Ill have to upped the Xanax gradually. The pdoc want me to take .50 3 times a day.

Up it as you wish. But do it. I want to hear some success stories from you! BTW, I take Xanax .5 every four hours (that’s about 4 to 5 times a day) PLUS I take 1 mg of Klonopin (another benzo) at bedtime. I have the okay from my pdoc to take extra of either if I need to. Which happens, but rarely. BTW, my husband has mentioned to me that I breathe slower and deeper when I am asleep. I was very happy to hear that because I still have to work on breathing that way (the CORRECT way) when I am awake. Have you asked your hubby how your breathing is when you sleep? If not, ask! I wager he will tell you the same thing. To MissMaine7, Hi. Have you ever taken an Ativan at the onset of a PA? If so, how much? Did it not work at all, work a little, or work well? Love and blessings to all, Kathryn

Response:

Question:

–                             Rational Negativism:                A Divergent Theory of Emotional Disorder Objective: To account for self-worth related emotion (i.e., needs for    love, acceptance, moral integrity, recognition, achievement,    purpose, meaning, etc.) and emotional disorder (e.g., depression,    suicide, etc.) within the context of an evolutionary scenario; i.e., to    synthesize natural science and the humanities; i.e., to answer the    question:  ’Why is there a species of naturally selected organism    expending huge quantities of effort and energy on the survivalistically    bizarre non-physical objective of  maximizing self-worth?’ Observation: The species in which rationality is most developed is    also the one in which individuals have the greatest difficulty in    maintaining an adequate sense of self-worth, often going to    extraordinary lengths in doing so (e.g., Evel Knievel, celibate monks,    self-endangering Greenpeacers, etc.). Hypothesis: Rationality is antagonistic to psychocentric stability (i.e.,    maintaining an adequate sense of self-worth). Synopsis: In much the manner reasoning allows for the subordination    of lower emotional concerns and values (pain, fear, anger, sex, etc.)    to more global concerns (concern for the self as a whole), so too,    these more global concerns and values can themselves become    reevaluated and subordinated to other more global, more objective    considerations. And if this is so, and assuming that emotional    disorder emanates from a deficiency in self-worth resulting from    precisely this sort of experiencially based reevaluation, then it can    reasonably be construed as a natural malfunction resulting from    one’s rational faculties functioning a tad too well. Normalcy and Disorder: Assuming this is correct, then some    explanation for the relative "normalcy" of most individuals would    seem necessary. This is accomplished simply by postulating    different levels or degrees of consciousness.  From this perspective,    emotional disorder would then be construed as a valuative affliction    resulting from an increase in semantic content in the engram indexed    by the linguistic expression, "I am insignificant", which all persons of    common sense "know" to be true, but which the "emotionally    disturbed" have come to "realize", through abstract thought,    devaluing experience, etc. Implications: So-called "free will" and the incessant activity presumed    to emanate from it is simply the insatiable appetite we all have for    self-significating experience which, in turn, is simply nature’s way of    attempting to counter the objectifying influences of our rational    faculties. This also implies that the engine in the first "free-thinking"    artifact is probably going to be a diesel.    "Another simile would be an atomic pile of less than critical size: an    injected idea is to correspond to a neutron entering the pile from    without. Each such neutron will cause a certain disturbance which    eventually dies away. If, however, the size of the pile is sufficiently    increased, the disturbance caused by such an incoming neutron will    very likely go on and on increasing until the whole pile is destroyed.    Is there a corresponding phenomenon for minds?" (A. M. Turing). Additional Implications: Since the explanation I have proposed    amounts to the contention that the most rational species    (presumably) is beginning to exhibit signs of transcending the    formalism of nature’s fixed objective (accomplished in man via    intentional self-concern, i.e., the prudence program) it can reasonably    be construed as providing evidence and argumentation in support of    Lucas/Godel. Not only does this imply that the aforementioned    artifact probably won’t be a computer, but it would also explain why a    question such as "Can Human Irrationality Be Experimentally    Demonstrated?" (Cohen, 1981) has led to controversy, in that it    presupposes the possibility of a discrete (formalizable) answer to a    question which can only be addressed in comparative    (non-formalizable) terms (e.g. X is more rational than Y, the norm, etc.).      Along these same lines, the theory can also be construed as an    endorsement or metajustification for comparative approaches in    epistemology (explanationism, plausiblism, etc.)    "The short answer [to Lucas/Godel and more recently, Penrose]     is that, although it is established that there are limitations to the    powers of any particular machine, it has only been stated, without    any sort of proof, that no such limitations apply to human intellect "    (A. M. Turing).    "So even if mathematicians are superb cognizers of mathematical    truth, and even if there is no algorithm, practical or otherwise,    for cognizing mathematical truth, it does not follow that the power    of mathematicians to cognize mathematical truth is not entirely    explicable in terms of their brain’s executing an algorithm.  Not    an algorhithm for intuiting mathematical truth —  we can suppose that    Penrose [via Godel] has proved that there could be no such thing.      What would the algorithm be for, then?  Most plausibly it would be an    algorithm — one of very many — for trying to stay alive … " (D. C.    Dennett). Oops!  Sorry!  Wrong again, old bean.      "My ruling passion is the love of literary fame" (David Hume).    "I have often felt as though I had inherited all the defiance and all the    passions with which our ancestors defended their Temple and could    gladly sacrifice my life for one great moment in history" (Sigmund    Freud).    "He, too [Ludwig Wittgenstein], suffered from depressions and for long    periods considered killing himself because he considered his life    worthless, but the stubbornness inherited from his father may have    helped him to survive" (Hans Sluga).    "The inquest [Alan Turing's] established that it was suicide.  The    evidence was perfunctory, not for any irregular reason, but because    it was so transparently clear a case" (Andrew Hodges) —                Phil Roberts, Jr. Feelings of Worthlessness and So-Called Cognitive Science         http://www.geocities.com/Athens/5476

Response:

Perhaps we could start with defining self-worth, and considering evolutionary roots leading to it, or how it is seen (or not seen) in lower animals. Below is a suggestion of the meaning of "self worth."  There are needs for certain aspects of belonginness.  Perhaps self-worth would include an assessment of the probability of their being met.  Perhaps this would also include an assessment of one’s "deservingness" of their being met, or in other words, an absence of shame or guilt. We might also consider that there may be brain based templates for such things as shame or guilt, such that if they are stimulated, or their conditions met, an unpleasant feeling is generated, which has the effect of modifying behavior. (more)

 :–  :                            Rational Negativism:  :               A Divergent Theory of Emotional Disorder  :  :Objective: To account for self-worth related emotion (i.e., needs for  :   love, acceptance, moral integrity, recognition, achievement,  :   purpose, meaning, etc.) and emotional disorder (e.g., depression,  :   suicide, etc.) within the context of an evolutionary scenario; i.e.,  :to  :   synthesize natural science and the humanities; i.e., to answer the  :   question:  ’Why is there a species of naturally selected organism  :   expending huge quantities of effort and energy on the  :survivalistically  :   bizarre non-physical objective of  maximizing self-worth?’  : If we view nature films of animals which live in groups, we find the existence of a heirarchy in many of them.  Often that heirarchy is constantly shifting, and is frequently re-ordered.  Sometimes, an individual is on the low end so often, he becomes a permanently low-status member.  He is fearful, and doesn’t even dare to challenge a higher-status member. Since the capacity for this behavior is species-wide, there must be templates for those behaviors involved.  Certainly, one can not impose them on reptiles, or solitary animals like certain cats.  Coincidentally, those seem to be the same animals which are prone to domestication. What are those templates?  How about feelings, such as shame, guilt, fear, a feeling of "less than," of being impressed with another who is "more than." In other words, feelings of a lack of self-worth.  And why do some individuals strive to change the pecking order?  Because those feelings are unpleasant, and they wish for them to be lost.  The way to lose those feelings is to increase one’s status, and with an absence of shame and fear, one has a greater feeling of self-worth. Viewing this in an evolutionary way, why would it happen?  For one thing, a group is more efficient in meeting its needs if it is organized.  For another, lower status enhances cooperation.  And it may be that the higher status individuals breed more often, passing along the genes of the stronger members of the group more frequently than those of the weaker ones. Thus, it is advantageous that the lower ones should strive for higher status, as a test of their potential for ancestry of a future group.  And it may be advantageous if the bolder ones lead the group in defending against intruders. Consequently, we have negative feelings and if not opposite feelings, then at least the absence of the negative ones. There is also an element of confidence.  With confidence, one feels that his behavior is likely to produce a desired result.  And he feels that he has the personal ability to carry out the behaviors.   Consequently, he is more likely to act when he is unable to know the outcome, than would a less confident individual.  Feelings of self-worth seem to be necessary for one to have confidence, and energy to carry out a plan. With the problem of bipolar disorder, this mechanism seems to go astray. The person attains such high confidence, he gambles on high risk propositions.  He has the energy to do a lot of work, and may be aggressive without purpose, as if he were at the top of a pack. Then he swings toward the opposite end, and lacks all confidence, lacks all energy, as if he were at the very bottom.  Is it possible that bipolar disorder means that existing templates for feelings and behavior are being triggered without environmental information which generally does that?  :Observation: The species in which rationality is most developed is  :   also the one in which individuals have the greatest difficulty in  :   maintaining an adequate sense of self-worth, often going to  :   extraordinary lengths in doing so (e.g., Evel Knievel, celibate  :monks,  self-endangering Greenpeacers, etc.).  : We have imposed culture upon our biological nature.  Where other creatures might be satisfied to find a place within a small pack, humans overlay their learning on this impulse, and seek through displays of wealth or education to gain the esteem of others, to bolster their self-esteem.  They may be holier than thou, humbler than thou, stronger or more beautiful, wherever they might find their niche.  Their learning may communicate to them that better means more powerful or more envied, or that better means more right.  :Hypothesis: Rationality is antagonistic to psychocentric stability  :(i.e.,  :   maintaining an adequate sense of self-worth).  :  :Synopsis: In much the manner reasoning allows for the subordination  :   of lower emotional concerns and values (pain, fear, anger, sex, etc.)  :   to more global concerns (concern for the self as a whole), so too,  :   these more global concerns and values can themselves become  :   reevaluated and subordinated to other more global, more objective  :   considerations. And if this is so, and assuming that emotional  :   disorder emanates from a deficiency in self-worth resulting from  :   precisely this sort of experiencially based reevaluation, then it can  :   reasonably be construed as a natural malfunction resulting from  :   one’s rational faculties functioning a tad too well.  : Negative information can cause negative feelings, but negative feelings can also cause all information to seem negative.  There is also a theory that depression has an evolutionary survival function. There was an observation of I think, some perigrene falcons, which mate for life.  The female did not return to the nest, and the male waited for her until he starved to death.  It was concluded that this was not helpful to the species, and therefore, depression was a fluke of nature. However, what would have happened if he had eventually concluded that she was not returning, and he was hungry and needed to find a meal?  Possibly the behavior of mating for life would have been weakened, which is connected to the survival of that species.  So if that happened a lot, and such birds passed along their genes and increased in number, the behavior may have diminished or disappeared, together with its survival function. So a very strong motivation to be loyal to the partner to the very end, possibly contributes to the survival of that species.  Consequently, depression is not without its function there (assuming the bird was depressed, of course.)  :Normalcy and Disorder: Assuming this is correct, then some  :   explanation for the relative "normalcy" of most individuals would  :   seem necessary. This is accomplished simply by postulating  :   different levels or degrees of consciousness.  From this perspective,  :   emotional disorder would then be construed as a valuative affliction  :   resulting from an increase in semantic content in the engram indexed  :   by the linguistic expression, "I am insignificant", which all persons  :of  :   common sense "know" to be true, but which the "emotionally  :   disturbed" have come to "realize", through abstract thought,  :   devaluing experience, etc.  :  :Implications: So-called "free will" and the incessant activity presumed  :   to emanate from it is simply the insatiable appetite we all have for  :   self-significating experience which, in turn, is simply nature’s way  :of  :   attempting to counter the objectifying influences of our rational  :   faculties. This also implies that the engine in the first  :"free-thinking"  :   artifact is probably going to be a diesel.  : Huh?  :  :   "Another simile would be an atomic pile of less than critical size:  :an  :   injected idea is to correspond to a neutron entering the pile from  :   without. Each such neutron will cause a certain disturbance which  :   eventually dies away. If, however, the size of the pile is  :sufficiently  :   increased, the disturbance caused by such an incoming neutron will  :   very likely go on and on increasing until the whole pile is  :destroyed.  :   Is there a corresponding phenomenon for minds?" (A. M. Turing).  :  :  :Additional Implications: Since the explanation I have proposed  :   amounts to the contention that the most rational species  :   (presumably) is beginning to exhibit signs of transcending the  :   formalism of nature’s fixed objective (accomplished in man via  :   intentional self-concern, i.e., the prudence program) it can  :reasonably  :   be construed as providing evidence and argumentation in support of  :   Lucas/Godel. Not only does this imply that the aforementioned  :   artifact probably won’t be a computer, but it would also explain why  :a  :   question such as "Can Human Irrationality Be Experimentally  :   Demonstrated?" (Cohen, 1981) has led to controversy, in that it  :   presupposes the possibility of a discrete (formalizable) answer to a  :   question which can only be addressed in comparative  :   (non-formalizable) terms (e.g. X is more rational than Y, the norm,  :etc.).  : There are some games, including the prisoner’s dilemma, which generally result in irrationality.  There is also a bird which has a behavior of tearing down its neighbor’s nest.  The bird has several choices.  1.) Spend all his time guarding what part of his nest is built, 2.) Look for new … read more »

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