Tag Archives: antidepressant

Making Progress

Day by Day with a Movement Disorder Posted on by 2

I’m pleased to report that my exercises are actually showing improvement. My neck is still giving me trouble, but I have been able to add a small resistance to some of the neck exercises and still do 10 repetitions. I see this as a sign of progress. But I am particularly pleased with improvement in the leg exercises. When I started I could not do a straight leg lift with my left leg at all. It simply would not budge. Now I can raise it for 10 repetitions, although the muscle starts complaining after the first 5. That is a huge improvement! And I can tell that I’m walking better, too.

I’m now on many of the natural herbal versions of my vitamin and supplement routine, as well as taking the full Mito Cocktail regimen. There’s really no way to be sure if the muscle improvement I’m experiencing can be attributed to the exercising, the supplements, or a combination of both. I assume it’s a combination of consistent exercising and the high powered doses of vitamins and cofactors I’m taking. Insurance won’t pay for any of these supplements, so to say the least – they’re expensive. But less pain and my increased energy make it worth it to us.

I continue to read everything I can get my hands on about vitamins and supplements, and I’ve learned a lot and been reminded of much I had already read about. I am now taking a low dose of Prozac, and my Neurologist prescribed Neurontin for pain, so maybe my improved outlook can be attributed to that – but I’d like to think I’m feeling better because I AM better! Either way, I’ll take it!

I Have Been to THE Appointment

Day by Day with a Movement Disorder Posted on by 8

Well, we went Thursday to see Dr. Watts, the head of Neurology at the University of Alabama in Birmingham, who has a great reputation as a Movement Disorder Specialist.

We were both very impressed with how personable he is. One of the other doctors on his staff did all of the preliminary questioning and testing. He was very easy to be with, too. Most of the tests were ones I have been asked to do many times in the last couple of years. A few were different. They both had me make big smiles with my teeth showing several times, which is not something I remember being asked to do by anyone else, and Dr. Watts had me repeat a few of the tests the assistant had already done.

They also gave me the impression that my family history of neurological problems is an important clue – mother with Senile Parkinson’s or Alzheimer’s – uncle with ALS – aunt with depression, drug addiction, alcoholism – grandfather was senile, possibly Alzheimer’s? Until they asked lots of probing questions I had never connected my Grandfather’s behavior and my Aunt’s behavior as being pertinent. That’s why doctors ask things over and over, isn’t it.

Of course, they asked me a million questions about what my symptoms were like, and when and how they started, many questions asked several times. Some I could answer, and some I really couldn’t. He was very interested in knowing about anti-depression and tranquilizer drugs I have taken in the past. I have been on several for short periods of time because of the stress of caring for our parents and our daughters, but I couldn’t tell him much about which ones I have taken. I should be able to get that information from my Primary and from our Pharmacist, plus I rounded up a bunch of prescription bottles of them that I had kept – just in case.

Dr. Watts sat down right in front of me, looked me in the eye, smiled, and talked with me. I had no sense of him being in a hurry to move on to the next patient. That is so rare in doctors these days, and certainly not what I expected out of such a highly renowned specialist.

OK, so now to what happened. I put on quite a show of jerks, tremors, and facial tics the whole time, partly because I was so nervous about what they would find or not find. There is a big part of my mind that is just sure this has all been a psychological problem, but at least he never said that. At least not yet.

I gave a pint of blood in the lab (OK, so I’m exaggerating – but it was maybe 8 vials full), looking for some clue as to what is going on. He talked to me about the possibility of some kind of antibody/autoimmune problem where my own body is causing the problems. He also seemed to think it might be symptoms caused from one of the medicines I have taken in the past.

He has also ordered an MRI at UAB. He says their MRI equipment is different from others I have been in, in that it is more powerful and may see something that the others did not. Plus, it’s been 2 years since I had a brain MRI, and whatever is going on might show up now that hadn’t progressed enough to show back then. They will call me with that appointment, so I don’t know when that will be.

He talked with his assistant, Dr. D, about lots of things it might be, with all kinds of medical jargon. Dr. D was jotting down notes the whole time and seemed to be making a list of possible diagnoses as they discussed my symptoms. Every once in awhile Dr. Watts would ask me to do something or ask more questions. It was exactly like watching a real live “HOUSE” team in action. When he was through talking back and forth with Dr. D, Dr. Watts gave us a layman’s explanation of some of the possibilities. I am not going to list them, since obviously they can’t all be it, and maybe even none of them are “it”. I did come home and get busy Googling every term I could remember hearing them discussing. You knew I would do that, didn’t you. LOL!

He did put me on a titrating dose schedule of Clonazepam, to see if that would calm down the jerks and tics. He said I would be sleepy with it at first, but that this would wear off as my body adjusted to it. I am to take 1/2 tablet at night for a week, then morning and night, and work up to 1 full and 2 halves a day. I have an appointment to see someone else in the practice in May to go over the findings. He said that Dr. D and Dr. Watts would be in on the conference with us at that time.

At this point about all I do know is that it is looking less and less likely that I have Parkinson’s, but that I do have some type of Movement Disorder as yet to be named.

We’ve not told family or friends about all this yet. They know I had the appointment but not why I had it. We decided there was no point in making anyone else worry about all this. We will wait until we actually know something to tell them. I can write it all here, which helps me process it all, because nobody I know personally reads this blog.

Just When I Start Sleeping Later … THE TIME CHANGES!!

Day by Day with a Movement Disorder Posted on by 4

I can’t win for losing! LOL!! I was finally putting together a string of days when I slept until close to 5:00AM, a real accomplishment for me, when the Daylight Savings Time changed on me this morning. So, I’ve been up since “3:30AM”, even though my brain thinks I slept until 4:30AM. I am very pleased that I slept over 7 hours, but I know that I always have a hard time adjusting to these time changes. My appetite gets off schedule, and it has always taken me quite a while to adjust to the different sleep times. Plus, I have my Sleep Study this week. Not the best timing in the world, but it will have to do.

My neck is much better this morning, with pain and stiffness only when I try to turn almost all the way to the sides. I have been very careful with this spasm episode, trying to be very cautious with any stretches, trying to move just to the point of pain, but no further. I have not tried to advance the TAP screw any, since this spasm hit, but I am sleeping with the dental appliance every night.

I have reached an amount of extension of my lower jaw that makes it harder to get the pieces in my mouth. Now, I have to connect the two pieces before they go in my mouth, and then jut my lower jaw forward to meet the mouthpiece. Before, I could put the two halves in separately, and jut my jaw forward to hook them together. I can’t unhook them in my mouth any more in the mornings, either. I have to break the seal with them still hooked together. That’s not an easy thing to do, as they really fit tight. Of course, it’s because they fit my teeth so perfectly that this contraption doesn’t hurt, so I’m not complaining.

I exercise my jaws with the chewing pieces every morning while I’m on the computer, and don’t even really have to think about it. It’s about like chewing gum, really. Then, I also do a series of facial grimacing and stretching exercises for my Parkinson’s, to delay the time when I will lose facial expression. The chewing strengthens my jaw, and should actually help delay the “Mask of Parkinson’s”.

I am in a better mood generally since I started taking the Bentyl, which is an antidepressant as well as an antispasmodic. I’m taking it to soothe my spastic colon, but I’ll take any mood improvement I can get! I’ve managed to get started on several projects that I was previously just overwhelmed by, so that’s a good thing. I even managed to put something new on eBay several days in a row, and posted some new requests for people searching for lost loveys on our Plush Memories blog. I’m still way behind on that, though. But I’m completely caught up on the BLOG VILLAGE membership screenings. The house is still chaotic, but that’s nothing new. I never was a very good housekeeper, sad to say. I do love it when it’s all uncluttered, but I never have been able to find the gumption to keep it that way. All in all, though, I can tell that I’m getting out of the doldrums I’ve been in for some time, and that’s a very good sign!!

Still Having Problems, But I’m Sleeping Longer!

Day by Day with a Movement Disorder Posted on by 2

I have managed to “stay in bed” for over 7 hours now 4 nights in a row. I wish I could say that means I was asleep the whole time, but that hasn’t happened yet. It is still a considerable improvement, however. The last pill I take at night is the Bentyl, which is supposed to calm my colon and prevent the spasms that have been plaguing me for so long. It is an antidepressant, so I suspect that may be at least part of the reason I’ve been able to delay getting up as well as I have been. I continue to wear the TAP each night, so maybe it’s a combination of both of them. Whatever it is, I’m thankful for it.

I’ve spent the last three days trying to overcome the stiffest neck I’ve ever had in my life. It started Wednesday evening, out of nowhere. I could feel the neck muscles all tensed up, and it was impossible for me to turn either way more than a couple of degrees. I tried the hot pad, plus took some Tylenol, and hoped I would sleep it off. I also did not wear the TAP that night, thinking that might make it worse. It was still extremely tight and painful all day Thursday, but I did go back to wearing the TAP. Nothing seemed to make it go away. It was considerably better by Friday, although I did take some Arthritis Strength Tylenol to get to sleep. Now, I am able to turn my head both ways maybe 45 degrees each way before the pain stops me.

I’m not really sure where this spasm came from. I did work out in the yard Wednesday more than I have been, and I could have over done it there. Or, it could be that I have turned the TAP screw past what my jaw can handle. Just in case it was the TAP, I backed up several turns on it to give my jaw muscles a rest.

I did get my flu shot this week, with no side effects at all. And I made sure the nurse put the information in my records about Celestone causing me to have such a horrible Parkinson’s episode. I have not yet returned to the state I was in before the steroid shot, so I guess I won’t be getting back to that point. It’s been too long now. If I were going to recover completely, I would have by now.

I am still having those weird spaced out episodes after lunch mostly. I’ve tried eating meat, not eating meat, staying away from any protein, eating normally, eating things I’m not supposed to eat, like pizza, and eating very carefully selected IBS foods. Nothing seems to be an obvious trigger, so I’m left to think it is the medicine itself doing it. That would be the noon dose of Levadopa/Carbidopa (Sinemet). I’m not sure why I have more trouble with the noon dose, as I take this med with all three meals. It remains a puzzle.

I’ve been working hard on several computer projects lately, so I’m behind on listing items on eBay. I have got to get that done today, though, as we are being squished by all the bags of plush toys packed into our two spare bedrooms. LOL We buy them faster than I can sell them!!

So, I guess it’s time to quit blogging, and start taking some photos!!

Some Things Better, Progress with Others

Day by Day with a Movement Disorder Posted on by 2

I’ve been busy the last few days trying to get used to the TAP and regulating my meds and diet to try to deal with the colon problems I’ve had for well over a year now. The TAP dental appliance is doing as well as I would expect. I slept about 7 hours last night, which is a huge improvement for me. I am still waking up a couple of times in the night to go to the bathroom, though, so it’s not yet a completely restful sleep. It’s time for me to make an appointment for a new Sleep Study, to see if the device is handling my Apnea appropriately. That will be the determining factor on whether I can get my insurance to pay for the TAP or not, and whether it’s worth using.

I am pleased to see that there is a way to use the TAP device as the anchoring mechanism for a CPAP mask, if it becomes necessary to go back on that. A nasal pillow delivery system can be attached directly to the dental appliance, so there would be no straps or mask all over my face. That’s encouraging, as it means I can look forward to either getting by with just the TAP, or the TAP plus CPAP – but NO MASK!!! So, I’m very optimistic about the coming Sleep Study.

As for the elimination situation, I am somewhat improved, although certainly not where I would like to be. I’m still belching and having gas problems, but not having as much trouble actually going to the bathroom as I was. So, the Acidophilus, the Bentyl prescription, and an extra Metamucil capsule a day seem to be the right plan of attack for that problem.

DH and I have been searching for some practical ways for me to keep track of all my pills, the dosing times, and a way to effectively keep me on schedule. I seem to have some kind of Freudian aversion to remembering to take my pills. I hate having to take so much medicine, and I think it’s causing some kind of passive aggressive reaction that I’m going to have to overcome. We’ve taken some positive steps to get over this hump. We bought two Plano tool/fishing tackle boxes, each with 4 storage boxes in it. That gives me enough boxes for 8 days, so I can make up meds once a week and have a spare. Right now I am taking medicine at 12 different times a day, so I put a numbered sticker in the bottom of each little compartment, with the dosing time on it. I can take the small box for one day with me wherever I go fairly easily. I even found that I could use my Bible cover to “hide” my pills on Sunday. I just carried my Bible loose and put the pill box in where the Bible would have been. I have to take a dose between Sunday School and Church, so this worked nicely.

Getting me on a dependable schedule was the next problem to handle. I searched for days all over the Internet, looking for pill reminder systems that I thought would work for me. Most would not give enough alarms to suit my needs, or any PWP’s needs, for that matter. PWP tend to take our meds closer and closer to each other as the disease progresses, so it’s not unusual for a Parkie to be taking something every hour during the day, and even getting up in the night to take something. Also, some of the more promising systems only allowed you to set pill reminders from say 8:00AM to midnight, and my first pill is at 5:00 AM.

So, I ended up buying a Timex Ironman Data Link watch, which can be connected to the computer via USB. It’s like having a PDA on your wrist. It came yesterday, but I have been studying everything I could find about it while I waited for it to come, and I had my pill schedule all ready to send to the watch. It worked like a charm. It beeps and the face lights up and flashes for several seconds, and the names of the pills I need to take scroll across the watch face. If I don’t push a button on the watch, I get another reminder in 5 minutes. Since I’ll be wearing it, I’m much more likely to heed the reminder. I also have the reminders set up on Outlook, since the computer is on all day long, anyway.

The watch needs to be quite large, as you might expect, so it’s the size of a man’s sports watch. I don’t mind that, if it keeps me from forgetting a pill, as I have been prone to do. For now, it’s in my pocket, because I’m going to have some links taken out of the band. There’s a lot to learn about this watch, but the main thing for me was the Alarm mode, as it allows up to 200 alarms a day! And that was super easy to get up and running.

My tremors still remain, not as bad as they were when I went to the ER, but still enough to make me feel like I’m trying to walk on Jello, and it gets worse as I get tired later on in the day. I use the walls and the furniture here in the house to steady myself, and I have managed to do without my cane at church, by the hardest. But anywhere else we go, like our Date Day, or to go out to eat, I’m using the cane. The hand tremors are also more prominent, and don’t seem to ever go away completely, but I can handle a fork and spoon OK, and type, so I can live with that.

My biggest problem has been the odd about to pass out feeling I’ve been getting after lunch and supper, but not breakfast. We’ve checked my blood pressure during a couple of these attacks, and it’s always low, like 98/58 low. I can’t do much but sit very still and wait for the feeling to pass. I have found that eating something sweet makes me feel better, but that may just be because it’s a comfort food for me. Or, it may means that this feeling is from a low blood sugar situation, rather than a low blood pressure one.

We may have narrowed it down to being an interaction between the Sinemet and the protein in my meals. Yesterday, just as a test, I had a vegetable lunch without any meat, and I did not have the weird feeling later on. So, I’ll try that again for a few days, and see what happens.

Dear sweet hubby took over the compost making task for me for the last couple of weeks, but I did it all by myself this morning. I’m very tired, but feeling good that I was able to accomplish it. I’m also sweeping off parts of the driveway almost daily now, and the deck and patio underneath every once in awhile. That gives my arms and shoulders a good workout, and it’s good for my balance, too. I’m also using the trekking poles the whole time at the track now, where I usually do 3 laps, and then the leg exercises and my Tai Chi. My balance is still way off, so the Tai Chi looks pretty ragged, but I’m doing it anyway. After all, nobody but me knows just how pitiful my form is, right? 😉

So, I see progress with several areas of concern, but disappointment that I am in nowhere near as good a shape as I was before I had the Celestone shot that sent me to the ER.

I continue to try my best to live each day with a positive outlook, and I think the Bentyl has helped with the depression I was dealing with.

Catching Up

Day by Day with a Movement Disorder Posted on by 6

My Gastroenterologist finally found an antispasmodic that I can take with all my Parkinson’s meds! I’ve been on it for several days now, and things have improved somewhat. Of course, I’ve also added the Enteric coated Peppermint Gel Caps, Turmeric, and Acidophilus.

Well, I went to see Dr. S Friday, and he said pretty much what I expected him to. Since I was taking 4 prescriptions that had just been added in the last two weeks, in addition to the OTC meds that I have added, he wouldn’t even discuss dosing or changing meds. He wants me to come back in about 2 months, after I have had the Sleep Study with the TAP dental appliance in place.

I had printed out a nice neat list of all my meds, with the times I take them, and I asked him to take a look and see if he thought I had spread the meds appropriately. He didn’t see anything wrong with it, which made me feel good. It took quite a bit of time to figure out how I could keep certain meds away from each other, and take into account such things as having to be on an empty stomach.

I asked for the form to get a handicap parking placard, too. It’s time. On good days I won’t need it, but the way I’ve been lately, I will definitely have to have it available. It is sad to see that check mark in the Permanent Disability box, though. We have dentist appointments tomorrow, so we’ll take care of it then.

I have been using the trekking poles for the last week or so, since I’ve been so wobbly. They make all the difference in the world. I’m wobbly when I try to walk unassisted, but I can stride along at a good clip when I use the poles. I walked a mile this morning, with the poles, even though I’m holding onto furniture and walls to navigate in the house. We bought one adjustable pair some time ago, figuring we could get another pair later, if we thought they were doing any good. We’ll buy another set tomorrow while we’re out, too.

I’ve made 2 quarter turns on the TAP device now, but I couldn’t feel the change when I turned the key. Each quarter turn pulls my lower jaw out about the distance of half the width of a dime. I’m still getting about 5 hours a night, but I am not sleepy when I get up around 2 or 3AM. Of course I go to bed around 9:00PM. I still get miserably sleepy in the afternoon, but I don’t take a nap. I’m afraid if I get in that habit that I won’t ever sleep any longer at knife.

I could feel a huge weight lift from me when I got the call the other day from my Gastro to tell me to order Bentyl, also called Dicyclomine. If I had been there in his office, I would have given him a huge hug!!

So, I continue to stay busy, trying this and trying that, hoping to get the best results possible toward the goal of living as “normal” a life as possible.

Update on Dental Appliance for Sleep Apnea

Day by Day with a Movement Disorder Posted on by 4

I’ve been wearing the TAP device for the last three nights, and thought I’d better let you know what I think of it. All in all I’m very pleased. It’s certainly easier for me than trying to get used to the CPAP mask was. I would be lying if I said it is comfortable, but it’s not painful and I am pretty sure I will eventually wear it without particularly noticing it. I guess it’s about like wearing glasses for the first time.

There are a few things that have to be part of my routine now, because of the dental appliance. It is absolutely a must that I brush my teeth every night, something I’ve never really had a consistent habit about, hanging my head in shame, as I usually fall asleep in the recliner while watching TV. If I don’t, I’m just asking for a bunch of cavities. Also, I have to brush the mouth pieces every morning when I brush my teeth, and leave them out to dry thoroughly.

The big change is that there are two small pieces of pliable plastic that I have to stick in between my teeth at the corners of my mouth every morning to chew on for awhile. The idea is that the TAP pulls the lower jaw forward for sleeping, so in the morning, I have to move my lower jaw back into it’s normal position, so my bite will be correct. It’s kind of like chewing gum, I guess, but there’s no taste. It’s not hard to do, but it’s absolutely necessary. It’s supposed to strengthen my jaw muscles, too, which will be a good Parkinson’s exercise. PWP lose the ability to control their facial muscles eventually, so this should help me forestall the expressionless Parkinson’s Mask, as it’s called.

I haven’t made any turns on the device yet, so I’m still wearing it at the first setting, which has my upper and lower teeth meeting in the front. Now, for some of you, they already do that to begin with, but I have a noticeable overbite. That overbite is one of the main reasons my Sleep Disorder doctor thinks this dental appliance will stop my Sleep Apnea. I figure I’m going to be wearing this thing the rest of my life, so what’s the rush. I want to get used to it first, before I start cranking my jaw out any further, particularly since it’s already set to move my lower jaw out a good bit just to make my front teeth meet.

As far as my sleeping goes, I haven’t been doing much of that. I don’t really think it’s because of the dental appliance, though. I’ve taken Lunesta two nights now, and still didn’t sleep more than three or four hours. I made it to five hours last night, without a sleeping pill, which is the best this week. I’ve never found a sleeping pill that really worked well enough on me to justify taking it, so I can’t say I’m surprised the Lunesta didn’t help.

I’ve been pretty upset with other things that have been going on with my Parkinson’s right now, and I think that’s cutting into my sleep. Also, I’m on several more PD meds since my ER visit, and they may be making the insomnia worse. And, even with the extra meds, I’m still wobbly, although nowhere near as bad as I was before I went to the ER.

I am having some spells of being extremely spacey and unsteady, which pass after about an hour or so, usually right after meals. I’m guessing it’s the combination of all the PD meds I’m on right now, but my Neurologist will straighten that out for sure. I have them all spread out as best I could, so I’m taking something about every hour or two all day long.

I see my Neurologist tomorrow, and I’m very hopeful that he can sort out what needs to be done to help the insomnia and also give my Gastroenterologist some suggestions about medicines I can take to calm the colon spasms. He may have to change some of my PD meds, so that I can take an antidepressant, as that is the class of drugs that the colon relaxing medicines fall in. Oh, I forget to mention that I stopped taking the St. John’s Wort after the first day, as the more I read I realized it was in the category of an antidepressant, and I can’t take those right now.

So I’ll spend today looking forward to tomorrow and some answers, I hope!

Cymbalta + Zelepar = BIG NO NO!!

Day by Day with a Movement Disorder Posted on by 13

I sent my DH to the drug store yesterday evening to pick up the prescriptions I had ordered earlier. When he brought the bag back, our local pharmacist had written a large note on it. It seems my Cymbalta and Zelepar can have a dangerous drug interaction. So, he didn’t fill the Cymbalta, but told me to call my doctor.

Before calling the Neurologist, I thought I’d look up a little about this combination for myself on the Internet. Well …. I don’t need to call the doctor!! Cymbalta is OUT!! Not only do the two cancel each other out, but the combination can cause something called Serotonin Syndrome/Poisoning, which can be fatal in its extreme manifestation. I have definitely had one of the milder symptoms, which I was blaming on the Zelepar, as it started after I started taking it. Out of nowhere, I would start sweating profusely and be so hot I just about couldn’t stand it. I’ve mentioned this before, as it feels just like menopause hot flashes at their worst.

The Cymbalta prescription came from my General Practitioner, who prescribed it almost a year ago. The Neurologist had a complete list of my medications, so at least he should have known I was on it when he put me on Zelepar, which is the dissolving form of Selegiline.

So, as is so often true, it’s the Pharmacist who is the expert when it comes to such interactions of medicines. This is the best argument I know of to use only one pharmacy for all prescriptions.