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ProfessorTomoe

Changing Medications (Level of Trust Required)

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My new shrink wants me to fine tune my Imipramine dose over the next few weeks.  To do this I'm to take a 50mg pill plus 1 to 3 10mg pills and work out what dose gives the best result.  She gave me 90 10mg pills for the test.  We are hoping that 70 or 80 mg works best, so that I can change to 3 25mg pills every night vs 1 50 mg pill one night, 2 the next etc.  This should help with my weird sleep cycles.

 

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4:46 a.m. CDT 20171017. T-minus 8 days until surgery. Yes, we're starting the countdown thing again, mainly because my anxiety level has already risen a bit in advance of the HF10 implant surgery. Anyone every see the movie based on Michael Crichton's The Terminal Man? I always get those heebie-jeebies ahead of any kind of nerve stimulation procedure, and this is the doozy of them all. It's the first one to get close to my cerebrospinal area. I don't want to wind up like the main character did.

Overanxiety, I know. I should be superhappy that I'm going to be losing the pain and the hydrocodone. Still ...

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51 minutes ago, ProfessorTomoe said:

Overanxiety, I know. I should be superhappy that I'm going to be losing the pain and the hydrocodone. Still ...

There is nothing strange about that, old friend. You have been through medical hell and it is hard to believe that it may finally be nearing its end. I can relate to it -- all too well, in fact.

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31 minutes ago, The Old Hack said:

There is nothing strange about that, old friend. You have been through medical hell and it is hard to believe that it may finally be nearing its end. I can relate to it -- all too well, in fact.

Don't jinx me! Every time I thing something medical is finally coming to an end, it goes sideways.

I would be interested to hear how you can relate to it, though, if you don't mind sharing.

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33 minutes ago, ProfessorTomoe said:

Don't jinx me! Every time I thing something medical is finally coming to an end, it goes sideways.

I would be interested to hear how you can relate to it, though, if you don't mind sharing.

Mph. A misdiagnosis when I was much younger. I spent seven years of my life on a medication that did not do a thing for my actual problems and drained me of much of my energy and joie de vivre. When I finally rebelled against the stuff I spent four more years refusing to use any medication at all. I was absolutely terrified of returning to my drugged hell. It took years of effort and much patience on behalf of my wife-to-be to convince me to try a medication that might actually help me. I do not recall ever in my life being as afraid as I was that day where I finally tried again.

It ended up working, and now years later I am much better off. I can live with the side effects. But I can't forget those years of hell, or the years that followed where I was terrified of using any medication at all.

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3 hours ago, The Old Hack said:

Mph. A misdiagnosis when I was much younger. I spent seven years of my life on a medication that did not do a thing for my actual problems and drained me of much of my energy and joie de vivre. When I finally rebelled against the stuff I spent four more years refusing to use any medication at all. I was absolutely terrified of returning to my drugged hell. It took years of effort and much patience on behalf of my wife-to-be to convince me to try a medication that might actually help me. I do not recall ever in my life being as afraid as I was that day where I finally tried again.

It ended up working, and now years later I am much better off. I can live with the side effects. But I can't forget those years of hell, or the years that followed where I was terrified of using any medication at all.

Good lord. Seven years?!?!? You have my deepest sympathies, my friend. I don't know what else to say, other than I'm glad you're feeling better.

I can somewhat sympathize, though. After my gall bladder was removed, my bile duct kept wanting to slam shut. Strictures, the doctor said. He had to go back in twice through my mouth to cut it open, again to implant a stent, and again to remove the stent. After that, he put me on a medicine called Actigall, meant to keep gall fluids flowing, in the hope that it would keep me from having strictures. As it turned out, the stent had fixed the problem, but I went on the Actigall unnecessarily for two years after that. It made me sweat uncontrollably at the slightest exertion. You should have seen me at E3—I hope no one recognized me—I had to go back to my room and take a second shower one day of the show because of the sweating. It also gave me massive bile duct spasms that kept me on a pain medication (Talwin NX) for years.

Eventually a gastroenterologist took me off of it and all my problems went away. Miracle cure.

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5:59 a.m. CDT 20171018. T-minus seven days until surgery day. Getting anxious still. Did a blog post about the surgery yesterday. Being stuck in this damned house doesn't help any, and neither does the Astros losing again.

Right now, I'm sitting in my usual place with a heating pad slung over my shoulder to keep from shivering. My Nest thermostat says we're right at 77°F, but my body is feeling the 50s outside.

I've already taken all of my pills and am just waiting for them to kick in and knock me out. Debating about whether or not to get up and toast an English muffin for breakfast.

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3 minutes ago, CritterKeeper said:

Do it while you have the energy to do so.  Being in a negative energy balance and having surgery are not the ideal combination.

English muffin toasted. :D Topped with Tiptree Little Scarlett Conserve, which (according to the novels) was James Bond's favorite jam. That should give me a positive energy rush for a little while. ;)

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5:00 a.m. CDT 20171020. Got an appointment time for my surgery next Wednesday. They'll be implanting the Nevro HF10TM unit sometime after I check in at 8:30 a.m. CDT. It should be an outpatient procedure as long as there are no complications, and no copays since I've his my catastrophic limit. :D

Had a psychiatrist appointment yesterday. Talked (kinda) to him about losing words when I speak. He said "no wonder," basically, considering all of the drugs that I'm on. I'm the equivalent of stoned or drunk, and that's why I can't talk without forgetting words.

I also got laughed at by both my wife and my psychiatrist simultaneously. I found nothing funny about the situation. Gross material follows.

I talked about my opioid-induced constipation, and how at times I've had individual bowel movements so large that I've had to get the plumber's snake out to unclog the toilet afterward.

.

My doctor burst into laughter, after which my wife started laughing (even though she's been here for the aftermath). I felt like shouting, "That's not funny!", or at least saying, "I find nothing funny about the situation." Instead, I kept my mouth shut about the laughing and mentioned that I'd scraped the porcelain of my wife's fancy Toto toilet working the snake while totally grogged out and at her command. That stopped her laughing, at least.

I also discussed hitting what I think is a physical tolerance to the hydrocodone. I'd make an appointment to see the doctor about it, which is SOP for the pain management center, but my surgery is so close that any appointment might come after the operation.

I told him that I'm asleep most of the time, again diagnosed as all of the pills I take.

Finally, I told him (and my wife) that not seeing her so much is a definite depressor. She's doing great work with the TNR program and the pet adoption center, but she spends so much time there that I don't see her much anymore (working from home doesn't count, since she really works from home).

I said if you take all of the above and wrap it all up into a great big ball, you've got something that's got "DEPRESSION" stamped on it.

One thing I didn't add was a Zofran emergency I had halfway through breakfast this morning. I'd hardly eaten anything, and I still got the barf signal. I had to spit out what I was chewing on and take an emergency Zofran pill. Good lord, that's depressing enough on its own.

Wrap it up with an involuntary episode of Project Runway last night. (She is so losing the TV to the Astros game tonight.) All in all, with the exception of getting my surgery time, yesterday sucked.

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FYI, Project Runway is pretty much the only thing I watch on TV.

(My wife, on the other hand, has the TV on pretty much from the time she gets up until the time she goes to bed. And I can't escape the noise. Or having her talk to me about whatever's on, which I'm rarely even listening to so she has to explain everything to me... and half the shows she likes, I'd favor executing most of the people on them for being such horrible excuses for human beings.)

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4:21 p.m. CDT 20171021. This post could go in the "What are you ingesting" thread if it weren't for the accompanying pain.

Had any of you heard about Arby's nationwide one-day rollout of Venison Sandwiches today? They did a three-store test last year, and apparently it was so successful that they decided to go national with it. I mentioned it to Mrs. Prof a few days back and asked if she'd drive me to it. "NO!" she said. She is anti-Bambi-as-a-dish and absolutely refused to drive me. I tried asking my son: he couldn't do it. As a last resort, I asked my best friend. I offered to pay for sandwiches for him as well. He switched around his schedule and said yes.

I was getting very excited as V-day approached.

Then my pain started getting worse. And worse. And much worse. I've ended up pulling sevens on the 1 to 10 scale in between doses of pain medicine. I wouldn't be able to go. I got onto Facebook and sent a message to him yesterday, telling him we'd have to cancel.

"I'll do it for you," he said. I couldn't believe my eyes. There's my best friend for you.

Sure enough, he showed up this morning with three Venison Sandwiches in hand, two for me and one for him. He beat the two-sandwich limit by going to two stores. ;) I paid him for all three. We each enjoyed one—very, very tender (they were cooked sous vide) and with a delicious juniper berry sauce that went well with it. It was bigger than I thought it'd be.

His opinion was that it was good, but he wouldn't order it every day if it were on the menu. My opinion? Good enough to order as a special treat.

Arby's is testing an Elk sandwich in three stores this year. If they roll it out, I hope I'll be able to drive myself to get one next year.

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4:13 a.m. CDT 20171022. I almost didn't make it through watching the Astros game. My pain medicine is lasting shorter and shorter periods of time and letting the pain through. Allow me to elaborate.

I'm on a 4/10/4/10 schedule. That's every six hours, a.m. and p.m., 15mg of hydrocodone per dose for a total of 60mg per day. I've been on this for months, and for months it's worked to alleviate my pain. Well, starting a couple of weeks ago, that was no longer the case. I've felt the pain—sometimes as a low-level, constant, nagging pain, and more recently like the hydrocodone is only lasting a few hours before it begins fading out. Yesterday, I got a bad case of the fade-outs, all day long. It got worse through the day and peaked with the 4 p.m. dose. I didn't think I would be able to make it through to my 10 p.m. dose. My pain grew worse and worse until I was pulling sevens on the one-to-ten scale and threatening to pull an eight.

I made it to 9:30 p.m. and said screw it. I took my dose. Within 30 minutes it felt like a Mack truck had been lifted off of my leg. I was able to enjoy the final few outs of the Astros' victory.

Right now, I'm waiting for pain medication I took before I started this post (approx. 15 minutes ago) to kick in. I woke up around 4 a.m., partly due to recurrent pain, partly due to noise from a passing line of thunderstorms. I'm only pulling a six, thankfully, but I wonder if I'm going to make it through to Wednesday.

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2:51 p.m. CDT 20171022. T-minus three days and counting until the operation, and it can't come too soon. I'm sitting here, watching the Formula 1 United States Grand Prix, and I'm feeling the hydrocodone's effects slipping away like a tide rushing away from the shore. I've still got more than an hour before I can take another dose. There isn't a damned thing I can do that will alleviate the pain until then: walking hurts, sitting hurts, lying down hurts. Level 7 and rising.

God, make it stop, please?

EDIT: I took my pain medicine about 50 minutes ago. It's working, but I've got a bruised-like afterfeeling where my pain was. It's hard to describe. "Incomplete relief" is probably the best term.

I still wish it'd stop. It's 4:43 p.m. right now, and my next dose isn't until 10pm. I doubt my pseudo-relief is going to last that entire time.

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2:35 p.m. CDT 20171023. T-minus 2 days and counting before the operation. I just got a phone call from a representative of Nevro. She wanted to get details on my pain and give me instructions on what to do after the surgery. Their goal is a 50% reduction in pain.

I was hoping for a bit more.

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12:22 p.m. CDT 20171024. T-minus 1 day before the operation. I've just spent almost an hour on the phone with a nurse reading off my spreadsheets of medications, allergies, and operations, along with giving her my medical history. This is really starting to unnerve me. It's going to happen. Dear lord, it's actually going to happen.

I've been told to wait for another call tonight from the anesthesiologist. They'd damn well better not call me in the middle of the Astros game.

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10:19 p.m. CDT 20171024. No phone call from the anesthesiologist tonight. He must have been watching the Astros lose. :icon_cry:

I've taken my next-to-last pain medicine dose. I'll have to set my alarm for 4 a.m. to take my last dose with my last sip of water. After that, I shower for the last time in a week (sponge baths only) and get in the truck with Mrs. Prof to head to the hospital for the implantation.

I'm scared that I'm going to fark it up somehow. I'm even more worried that it's not going to work.

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3 hours ago, ProfessorTomoe said:

10:19 p.m. CDT 20171024. No phone call from the anesthesiologist tonight. He must have been watching the Astros lose. :icon_cry:

I've taken my next-to-last pain medicine dose. I'll have to set my alarm for 4 a.m. to take my last dose with my last sip of water. After that, I shower for the last time in a week (sponge baths only) and get in the truck with Mrs. Prof to head to the hospital for the implantation.

I'm scared that I'm going to fark it up somehow. I'm even more worried that it's not going to work.

Godspeed, Prof. May it go better than you fear.

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7:20 p.m. CDT 20171026. T-plus-1 and counting. I think all of the anesthetic is finally out of my system. They sedated me like a bull yesterday! I'm just now to the point where I'm not going crosseyed.

The wires are doing me some good, I think. As I sit here, they're keeping me from having pain in my right leg. My back is still hurting, especially on the left, so that's going to need to be tweaked. I'll be getting daily phone calls during the seven day trial from the manufacturer's rep to help me fine-tune the external battery connected to the wires inside me. The first call was just a test to see if things were working. We'll likely change things tomorrow.

The most annoying part of the trial is that I can't bend over fully. That makes going to the bathroom a bit of a hassle. That, plus the rats' nest of paper tape they're using to hold the wires in place instead of Tegaderm—it gives me blisters after a couple of days—it gets stuck to my shirt and tries to come off. Urrgh.

I'll fill you in on how the trial is going tomorrow night.

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