Tag Archives: pharmacist

4 Days of Full Lamotrigine Dose

Day by Day with a Movement Disorder Posted on by 4

I’ve been on the Lamotrigine morning and afternoon 25mg dose for 4 days now, and only the first morning caused me any problems. I went back to sleep after breakfast on that first morning I took a morning dose, and I slept almost 3 hours. That is an extremely unusual thing for me to do. But I haven’t been sleepy since then. It may be helping a little bit, but nothing spectacular. I’m still jerking pretty badly if I’m under even the least amount of stress, which seems to be a lot of late.

One of my triggers seems to be getting in any kind of a crowd, so Church is always very stressful for me. I’m very self conscious about the jerking, and I feel bad for the people who sit behind me, as it must be very distracting.

But I’m not zonked on it, as I was when the Neurontin dose was increased. That’s a good thing. And I know I’m on the smallest dose size the Lamotrigine comes in, so there may be some room for adjustment to lessen the jerks a little bit more. I’m hoping that’s the way it will work out, without putting me in a daze the way the Neurontin did.

I don’t think I’ve ever really explained what the Primidone and Lamotrigine prescriptions are for. They are actually used as anti-seizure meds, and the Lamotrigine can be used with Bipolar Disorders and Depression disorders. The Clonazepam the MDS tried me on first, as well as the Neurontin, were also meds used for seizures and depressive disorders. (Which I thought made it odd that they depressed me!) So it’s kind of like taking a pig in the poke for medicine.

Their use for Essential Myoclonus is considered an off-label use, and from everything I’ve been able to read, the medical profession really doesn’t understand how these meds work in the brain. Evidently when they work properly they calm down whatever erratic electrical signal there is that’s coming from my brain that sets off these muscle spasms.

This is where having a Neurologist I trust is so very important, and a pharmacist who watches over every medicine I take, prescription as well as over the counter. I wouldn’t think of buying some of my prescriptions at one pharmacy and others somewhere else. It’s just too dangerous for me.

So I’m trying hard to be hopeful that my Neuro will find a good balance on my medicines and get me back to where I’m not jerking so much. And I’m fighting the blues, although I certainly haven’t won that battle yet.

Turned Down for Long Term Care Insurance

Day by Day with a Movement Disorder Posted on by 2

When my diagnosis was changed from Parkinson’s, which is progressive, to Essential Myoclonus, which is not, we decided to see if we could improve our term life insurance policy rates, and also see if we qualified for Long Term Care insurance. The preliminary review from both looked promising, so we asked our financial adviser to proceed.

Well, the life insurance folks said wait 6 months from the new diagnosis, which seems reasonable.

The lady who handles the LTC accounts seemed optimistic, despite hubby’s cancer history and my neurological history. But she called yesterday to say that they would not insure me. She said it was not the diagnosis, but what the doctors had written that precluded insuring me. Grrrrr!!! Yuck!!! Dradit!!!

I’ve asked her to fax the report from the doctors to me that caused the rejection. Not a happy camper at all about that, and wondering what in the world they said that alarmed the insurance folks. Plus, that doesn’t sound hopeful for reducing my rates on life insurance, either.

We had a wonderful time visiting with our younger daughter on her birthday. She got off work, and we just hung around and enjoyed each other’s company. We took her out to lunch and even went to a few thrift stores – she’s just as addicted as we are! LOL!!

I had done the dumb stunt again this month and forgotten that my Primidone prescription doesn’t run out at the same time I order all the others. So I had to really scrimp and stretch between doses to get back home before I was entirely out. So I asked hubby to see if our pharmacist would sell us 10 extra pills, so it would coincide with the rest of my order. He gave him the pills! Said we were such good customers that it was the least he could do. Granted, these are not expensive pills, but I was still floored!!! I plan to go thank him in person the next time we’re out.

And we sold one of our finds from Monday to a family who had been searching for it for a long time. I recognized it the moment I saw it and couldn’t wait to let them know it had been found.

So as always, I choose to enjoy the happy moments that come, but can still get freaked out by all the changes this disorder has caused in our lives.

Changing from Bentyl to Triavil for Digestive System

Day by Day with a Movement Disorder Posted on by  

You may remember when my pharmacist caught what would have been a potentially fatal drug interaction some months ago, when I was still on Parkinson’s meds. At that time my Gastro was searching for some way to help my digestive system to work properly. He had prescribed Triavil, but ended up putting me on Bentyl instead. I have been taking it four times a day ever since. It worked well until I started on the Primidone, but I have had increasing and persistent digestive problems ever since.

He put me back on the strict Bowel Retraining program, limited my food choices even more, put me on the high powered PrevPak to heal the ulcerated stomach that the Endoscocpy found, and expected me to improve. I didn’t. Then he tried a week of some new med called Alinia, but still not any real improvement.

So today, since I am no longer on the PD meds that contraindicated it, I start on Triavil.

It might help if I explained how all this tummy trouble is related to the Movement Disorder. When I am not on medicine for it, it’s real easy to see the uncontrolled movements of various skeletal muscle groups. The twitches, jerks, shakes, tremors, and awkward gait could not possibly be ignored.

But what cannot be seen is what is happening inside me. If I try to stick out my tongue, even now that I am on medicine, you see that it is in constant motion. The same thing is true of throat muscles. Sometimes I can hear the click of the soft palate spasms, and I really didn’t realize that this was anything unusual. I have always had times when I could hear that click. Then come the muscles in the esophagus, that should rhythmically move food down to the stomach, where coordinated muscle action churns the food, passing it on to the small intestines. After the coordinated movements of peristalsis push the undigested food into the colon, the body removes the liquid and eventually we eliminate the solid waste, again using coordinated muscle movements.

Gee, did you notice my intentional use of the word coordinated??? Well, mine AIN’T!!!! It’s no wonder I have GERD, stomach cramps, bloating, gas, constipation, and even problems using rectal muscles properly.

So the Neurologist helps with the skeletal muscle problems, but it’s my Gastroenterologist who helps me with all these internal muscle problems. He has found the right combination to keep me comfortable before, and I am confident that he will this time, too.

Weaning Off Clonazepam = Thinking More Positively

Day by Day with a Movement Disorder Posted on by  

I’m down to a half tablet at night now, starting today. I will stay on that for three days, and then I will be through with it. I sense the depression passing somewhat, but certainly not all of it. I was depressed before they put me on it, just not as much.

I’ve been trying to work off as much of my tension and fears in the yard the last few days. I’ve spread the rich composted “dirt” and planted Centipede seed there. I don’t know if any of it will grow, but the weeds are sure enjoying the rich dirt. I can’t very well pull the weeds, as the grass is still germinating. The idea is to let the growing grass choke out the weeds on its own. Since that section of the yard is pretty much finished, I’ve moved to a small section of grass at the front of the house. I’m wetting it down at night and then working on digging all the grass weeds out of it the next day. The hoeing is very therapeutic. It’s kind of like a punching bag for me.

My biggest problem right now is that I can’t get out in the yard without setting off a poison ivy outbreak, no matter how hard I try to stay away from it and bathe as soon as I come in. I’ve been super itchy now for some time, because I don’t want to take any antihistamines on top of the Clonazepam.

I’ve been trying to read about Tardive Dyskinesia, which certainly seems to fit what I look like these days. I can’t even spell it right half the time, but Google very nicely suggests how to spell it for me. If that’s it, then I can add TD to my list of acronyms.

My mouth is definitely jerking and twisting more as the Clonazepam dosage is reduced in my system, but they have told me that there are other prescriptions they will try to reduce the tics and jerks, once I’m off this med. And I’ve started chewing sugarless gum a lot, too, as that keeps my mouth busy. I chewed so long last night I made my jaw hurt, but at least I didn’t have my mouth pulling to the side and twisting all around. I will definitely be using this trick in public, as I am extremely self conscious about the way my face looks now.

Our wonderful pharmacist has printed out all the prescriptions I have been on since he opened his store some years ago. I haven’t yet tried to track down where my records would be stored from the previous drugstore, but he suggested I try the CVS in a nearby town. We went without a drugstore at all for quite awhile there, as the previous pharmacist gave up his store to work for CVS. I haven’t called yet, because it is likely a waste of time. But I will call. I’ll just have to be in the mood to do it.

I’ve tried researching every medicine that I can remember ever being on, and a few are possible causes. But there’s nothing to be done, other than try to deal with the symptoms. Tardive means it’s a delayed reaction, so there is no med to “stop taking” to make the movements go away. Our family has always joked that an aspirin will put me to sleep, so I suppose it’s not surprising that I would be one who had a delayed side effect to some medicine I’ve taken in the past.

I haven’t been going to the Parkinson’s forum. I just don’t know what to say there any more. I guess I would still qualify for membership, since I’m dealing with a Movement Disorder of some kind, but I just don’t feel like I fit right now.

Hubby has been a big help, and isn’t mad at me any more about my reaction to the doctor’s news. He’s such a sweetie, and I know all this has been really hard on his emotions, too. I don’t know what I would do without him.

I ran across a copy of Michael J. Fox’s book, Lucky Man, at a yard sale not long ago, and I finished reading it last night. There were several things in it that made me feel better about myself. He talked about all the things he did to make his early tremors stop – how he tricked his brain – so he could hide it from the television and movie audience. That process of being able to temporarily stop a tremor with little mind and body tricks is one reason I thought I was suffering from a psychosomatic illness. I did not realize that at least some people with PD can consciously stop tremors momentarily. I have feared from the very beginning that being able to stop them for a brief while meant mine were not “real.”

So, as it stands now, I don’t have Peripheral Neuropathy, and there’s no way of knowing if I ever did or not. I’m inclined to think I did, but all the super nutritious foods we have been eating for the last two years, plus the Turmeric and all the vitamins and minerals I take, just healed the nerve pathways.

Parkinson’s is likely not the problem, although I have not ruled it out completely, as the doctor’s always hedge what they say about that. I do have a Movement Disorder of some kind, and I am getting past the point of blaming it on myself. That’s a good thing!!

Reading Fox’s book helped me, so I hope that reading this blog can help someone, too.

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.

Tummy’s Back to Normal – PT Continues

Day by Day with a Movement Disorder Posted on by 6

It took a couple of days of very careful, limited eating, to get my tummy back to a normal situation, but I’m much better now. I’ve gone back to using the glycerin suppositories, and that’s helping the most, other than to avoid some questionable foods.

I talked to my PT Monday, and told her my neck was much better, and that I was surprised they had not had me doing any exercises. She said they wanted to get my muscles calmed down first. So, she is going to add some tomorrow. I told her I wanted to be stingy with my visits, in case I needed to come for something else later on in the year, so she has me on Monday and Thursday now, instead of 3 days a week. Of course, that frees up our Date Day, and that suits me just fine.

I’ve been extremely busy trying to help all the families who have been asking for help find lost lovies, ever since the msnbc.com article came out about our Plush Memories Lost Toy Search Service. We had well over a thousand hits that first day, and our traffic is still about double what it was before the article.

I’m fighting the poison ivy again, and I’m not sure which one of us is winning right now. I have found that I can take one Benadryl at night, and that stops the itching until in the afternoon. Then I take a non drowsy type that the pharmacist said I could use. It doesn’t work all that well, and by early evening I’m in misery. It gets in my blood stream or something, because I end up with rash and blisters in places that it should not be. Very delicate skin itches ten times more than arm or leg skin, I guarantee it!!!

I see the Dermatologist in another couple of weeks, so I will certainly ask him about anything I can do to dry it up quickly.

I think I know where the poison ivy is coming from. We’ve been bringing our outside cats in at night when the weather is below freezing. I am pretty sure I’m catching it from them. We had the brother and sister kitties neutered last week, and the little girl is somewhat frail, so we did not want to take any chances with the cold. The only other possibility is that the wood chips I’m using for the compost have the vines ground up in with it. Our back yard is just full of poison ivy, so that’s certainly possible.

I’m continuing to limit my reading of anything Parkinson’s related, but nothing has changed as far as my foot tremors and facial tics go. Oh, and I still haven’t started back using the TAP. I decided to get my neck calmed down, plus see if the mouth tic was related to maybe my tongue moving around on the inside of the mouthpiece in my sleep, and it getting to be a habit. Well, the neck is calming down nicely, but the mouth tic is still there. So I think I can stop blaming the TAP for that.

Since I’ve been taking the Benadryl at night, I’m sleeping quite well, even without the TAP. Funny, the Benadryl is working much better than all the fancy sleep meds ever did, and I’ve tried almost every prescription they make at one time or another.

My Pharmacist wears an S under his lab coat!!

Day by Day with a Movement Disorder Posted on by 4

Yep, as far as I’m concerned, he’s Superman, ready at any moment to rescue this damsel from danger. I went to my Orthopedist today to get some relief from the painful neck spasms I’ve had for the last two weeks. He prescribed the muscle relaxer, Flexeril, which I have taken before, long before I was diagnosed with PD.

We dropped the prescription off on our way home, and DH went back to get it about an hour later. He came home with Methocarbamol, not Flexeril. Sure enough, I would have had a serious drug interaction with Flexeril and my PD meds. My pharmacist called the doctor and they found a muscle relaxant I could take, all before hubby ever got there to pick it up.

I think that makes three times in the last few months that my fantastic pharmacist has caught medicine errors that my doctors have made.

We live in a very small rural town, and we went without a pharmacist for quite a few years. When this one opened up shop, I told him the first time I went in there that he could depend on us to patronize his shop, even though we realized that we could buy cheaper at Wal-Mart or the chain store pharmacies. He’s not open at night, or on Saturdays and Sundays, but I wouldn’t trade him for anything. He more than pays for his higher prices with his service and the fact that we are close enough to walk to his store if we had to. The franchise pharmacies would require an almost hour round trip, which is no fun if you are miserable. Sure, there have been times when we had no choice but to patronize the big boys on the weekend or at night, but we try our best to give our local fellow as much business as we can.

I’ve said it before, and I’ll probably say it again. Everyone should keep all their prescriptions medicines on file with one pharmacist, and make sure that pharmacist cares about you, and not just about making money!!

Drug Interaction Still Causing Problems

Day by Day with a Movement Disorder Posted on by 10

I went to the Gastroenterologist Wednesday afternoon, and he did X-rays of my abdomen to determine if I was as constipated as he thought I would be, based on my symptoms. He was surprised to find that nothing in my colon was hard or compacted. After examining me, he has come to the conclusion that my problem is caused by spasms of the digestive tract, rather than weak muscles, as he had been telling me it was. So, now he thinks my trouble is exactly the opposite of what he had thought previously!! He prescribed Triavil, which relaxes the colon muscles, and he said I should feel much better by Monday.

I’ve learned my lesson though, so I specifically asked him if he was sure I could take this med with my Parkinson’s meds. He said he did not think this would be a problem, but to ask my pharmacist. Full of hope that he had found a way to stop my very uncomfortable situation, I called our drugstore on the way home to be sure he had it in stock. But, when hubby came back from the drugstore, he didn’t bring in the prescription bag. He said the pharmacist said his computer all but crashed when he put in the medicine, it produced such a strong warning that this was a dangerous combination with my other PD meds!!

At first I handled the news stoically, but later on that evening I went through a rough time of being very depressed, with lots of crying. I called my doctor’s nurse first thing Thursday morning to let her know I couldn’t take it, and to remind her that he would see Selegiline listed in the interaction information, rather than Zelepar, which is just a dissolving form of Selegiline. I think that must be why he didn’t realize I couldn’t take it.

Anyhow, I haven’t heard back from him yet, so DH and I decided it was time to take matters in our own hands. We went enzyme, herb, and spice shopping, as I have been doing some research on my own about Irritable Bowel Syndrome (IBS), and I found some things that should help, without causing problems.

Yesterday, I started taking Turmeric, St. John’s Wort, and Acidophilus capsules. DH’s Oncologist has had him on Turmeric ever since he had colon cancer, and his doctor had already suggested I use it. We had our usual Date Day today, and I continued to belch a lot all day, but did not have any nausea at all, or my usual sensation as if my food was sitting at the top of my throat all day. I’m encouraged that I will find a way to calm my system down and get things back to closer to normal, whether my Gastro can find a medicine I can take or not.

I’m still very wobbly, though, so I used the cane just about everywhere we went today, and I’m using it in the house tonight, too. It may be that it’s just going to take awhile to recover from the really bad state I was in Sunday, plus I may still have some of the Cortisol in my system. I’ll have to see if I can find something about how long it stays in the system after getting an injection. Or, it may be that the St. John’s Wort, added to my other PD meds, is giving me an overdose of Levadopa.

That’s what makes figuring this all out so difficult, as too much PD meds makes for jerky movements, called Dyskinesia. If you’ve seen Michael J. Fox jerking around, you’ve seen it. When PWP have been on meds for a long time their systems process the Levadopa in a very unpredictable way, and you see these wild jerking movements. But early on, if the meds aren’t strong enough, you see tremors. It’s hard for me to tell if my wobbliness is tremor or jerking, so I can’t tell, based on that, if I’m getting too little or too much Levadopa. My hands are only shaking ever so slightly, which makes me think I’m not getting too much. My Neuro will know when he sees me.

By then I should have heard from my Gastro doctor, and I’ll know if the herbs are going to do any good or cause any problems. I will be doing more research, too, to be sure there are no contraindications of these OTC with my prescriptions.

Can’t Take Meds I Used to Take

Day by Day with a Movement Disorder Posted on by 6

I’ve been working out in the yard a good bit lately, as part of my exercise. I’ve made some headway with our yard, but I’ve also come in contact with poison ivy somewhere along the way. I am extremely allergic to it, so I’m broken out over a large part of my upper torso, front and back, on my neck and face, and even in my hair. I have no idea how that happened. We have new cats outside, too, and I may have picked it up cuddling them.

So, I pulled out my trusty Benadryl, in addition to the topical anti-itch meds I always have on hand. Benadryl makes me sleepy, so during the day I’ve always used something like non-drowsy formula Sudafed. When DH went to the store he couldn’t find the exact same Sudafed I was about out of, so he took what appeared to be a similar medicine to the Pharmacist to make sure it was OK for me to take it. He made sure he told her I had Parkinson’s, and she said it would be fine.

I hadn’t even thought about checking for PD drug interactions, so I’m glad hubby did. Particularly since I did take one dose of the 12 hour Sudafed with Pseudophedrine Hydrochloride in it this morning, and I’ve felt yucky all day long today. When I looked on the new box to see how many to take, despite the fact that DH had asked the pharmacist if it was OK, there in fine print, among the list of conditions that made using it unsafe, was – you guessed it — Parkinson’s. The same warning was on my old box of meds, too, and I hadn’t even thought to look. That’s BAD.

So, I called our local Pharmacist to double check, and sure enough, I can’t take it. DH has gone there now to get Chlorotrimiton, which has nothing but an antihistamine. It doesn’t have any decongestant in it. My Zelepar is in the MAO class of drugs, so I have to pay attention to things like that.

As careful as I am to check on drug interactions with prescriptions, it never occurred to me to check out these over the counter meds, as I’ve taken this combination for poison ivy for years. BAD GIRL, BAD GIRL!!

I’ve hopefully learned my lesson, though, and will not let old habits take over again. Cause the old gray mare ain’t what she used to be!!

Zelnorm Is Taken Off the Market

Day by Day with a Movement Disorder Posted on by 4

When I refilled my prescriptions last week, my pharmacist sent me a note that our insurance was no longer covering Zelnorm. I found out today why. It has been recalled. Luckily, the Miralax is doing a good job of keeping my digestive system moving along smoothly, and I didn’t have any problems stopping the Zelnorm. Thank goodness I didn’t have any of the heart problems that some people were having with it!!

That’s twice my pharmacist has come to my rescue. I can’t reinforce enough my suggestion that you buy all your prescriptions from one drug store!