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Dr. M: Bad head day for last 3 days--today very jittery, anxious??
yanksgirl posted:
Hi again!
Well, after the encouraging words from the Nurse Practitioner on Monday, I had two days of not feeling so anxious, just bad head pressure--when up and about. Still- we-joined Gold's Gym and walked the track--then got out awhile yesterday. My head was 'bad' but I made myself go in spite of the pressure and feeling light headed!

Today woke feeling like every nerve in my body was 'trembling'--took Prozac, and 2 hrs. later the Xanax (as directed to do if this happened).

Felt like I could scream! This is what happened to me when trying the latest anti-depressants--but the doctor and Nurse Practitioner said Prozac will take longer but I will get better. The Xanax helped for awhile, until it began to wear off.

Do I just 'toughen up' and accept this as a 'bad day'? I almost called his office but thought again and took another Xanax- (after a 4 hour wait (it's the low dose) and then-we walked in the park, grocery shopped (my head was awful in the store), and then came home and I wanted to cry--did some--but as usual, when I start an anti-depressant, after a few doses, I feel like I need to cry, but can't at all or very little---is that unusual?

Again, not your field, but you have a vast knowledge, so am hoping this isn't unusual.

I keep remembering the N.P.'s words," this will take time," but 'you will get better'. It was awfully hard to think on those most of the day.

I'm some better this afternoon. Even posted on the depression board but you don't get an answer there for quite awhile it seems.

Anyway, wondered if you agree that this is just my journey with Prozac and I have to let it get into my system longer?
Toughen up in other words?
I hope so. I'll feel better if you say that too. It's been a difficult day for sure. Hope tomorrow things improve.

I've had 13 days on it now--so it's still awhile until the month goal! Thanks for listening.
Rod Moser, PA, PhD responded:
Sometimes, we expect too much from our medical regimes. We get so excited and encouraged by our "good days', that our bad days seem somehow worse. I can't imagine that your will (eventually) get your anxiety, panic reactions, and depression controlled, but there is really no way to know at this point if Prozac is the right drug for you, or if waiting it out a bit longer, it will start to improve. Most primary care clinicians, myself included, have a limited formulary of anti-depressants that we feel comfortable using, but a pschiatrist knows and uses them all. My only concern about a pscyhiatrist is my fear that they will start you "too high" in an effort to get some more dramatic results, and end up causing you side effects. You have had sooooo many side effects in the past, that I also fear that you will be anxious about taking ANY new drug, and will be just waiting for those inevitable side effects to happen. If you do end up on this pathway, make sure to have a firm, heart-to-heart talk with the psychiatrist about going s l o w & e a s y with you.

Perhaps, you need to approach each day like it was some sort of bizarre "Suprise Party"?? If it is a good day, have fun. If it is a bad day, stay home and just wait for another good day to come down the pike.
yanksgirl replied to Rod Moser, PA, PhD's response:
I'll take your answer as 'give it some more time'. That's what the N.P. said--and I have a daughter who has taken it for years for anxiety issues--and she said the same thing--however, I'm 'alot' older than she is of course. It's scary feeling this way for sure.

This morning the feeling of nerves 'crawling' under my skin, and my hands shaking, occurred soon after I was up and I had decided to take the Xanax before I got up--about an hour actually. Then by the time I ate, another 1/2 hour had passed, and in about 1/2 hour I took the Prozac. The nervousness began within a 1/2 hour or so. Of course, I also took the medication for the A-fib as I take it with food.

Nausea is so bad when I first get up and off and on thru the day too. this is day 14 on the Prozac so I will try to 'tough' it out for the month and see if it's going to help. I agree with you--I'm so concerned about a Psychiatrist giving me meds that I can't tolerate. On and On it goes. My head pressure isn't helping all this. Seems when I'm upright for any length of time I just have to get back in my chair--to get it to calm down--very lightheaded. Hope the Ent doctor has an answer for that when I see him in about 10 days. Thanks for your input as always.
Rod Moser, PA, PhD replied to yanksgirl's response:
You will have to take a chance if the psychiatrist wants to change your medication regime, and I suspect this will happen. As you know, you may not have any side effects whatsoever, but you do need to take them first in order to find out.

I know you are struggling with all of these symptoms and issues that are triggering your panic responses, and my heart goes out to you. Follow your NP and doctor's instructions...they would like to see you get better as well.

Take that Xanax when you need it....but do not exceed the maximum prescribed dose (I know it is low) unless you get the okay from your NP or MD.
yanksgirl replied to Rod Moser, PA, PhD's response:
Don't worry, I won't! My primary said when the Prozac 'kicks in' for me to start cutting back on the Xanax. Well, so far that hasn't happened. Only 3 weeks ago I was taking 1/2 to one Xanax a day, and now--the full dosage of 3 a day--but about 5 hours apart, since I also have to take the Valium (for the inner ear) close to bedtime. Both the primary and Ent ok'd that too.
I'm really very careful about taking meds as prescribed and the ones marked 'as needed', I have tried to take that way too--up to the maximum dose and usually less than that.
Yes, you're probably right--the Psychiatrist--if I see him and that's 'if',because if Prozac starts working, I may not--we'll see. But if I do, he'll no doubt either change my meds or add to them. I really dread that--but will have to give it a try. I'm ready to do whatever it takes. I see all 3 of my own doctors in the next 2 1/2 weeks--then depending on the one with my primary, will see (or not) the Psychiatrist. Have a good weekend--hope your shoulder is responding this time to the surgery in the right way.
Rod Moser, PA, PhD replied to yanksgirl's response:
Your journey is really like a bumpy road....there are smooth sections and bumpy sections and even a few deep holes that one must avoid. Finding that balance may be difficult for a while since you have more than one medical issue, all that is capable of creating "cross-over" symptoms.

If you had to list some of the most bothersome of your symptoms, I would assume that it would look like this....

Anxiety / Panic
Vertigo / Dizziness
Vomiting and Nausea

If you had to rank them in order of concern, how would you do it?
yanksgirl replied to Rod Moser, PA, PhD's response:
I would say depression--causing the anxiety (which can make me feel panic sweep over me), then no vertigo anymore so far.
Lightheadedness--that causes occasional dizzy feeling and then Nausea--no vomiting (but boy has the nausea been bad)
The A-fib is under control so at this point it's not a big concern. I'll find out Monday if all is ok there- as I see my Cardio doctor.

Today was really bad Dr. M: 1/2 hour or so after the Prozac I began shaking--more like tremors--and my head was even shaking. My husband said--'get off all those meds'! I almost agree with him. I know jitters and headache and nausea are common and I can deal with that but the last 3 days it's been like I just described, but worse today. He had me go to bed, I took a Xanax and that began to work--the only thing that does and after awhile my body began calming down and my head stopped that involuntary shaking. So scary! I then got up and dressed--we walked in the park--and my head got such pressure( part of the Meniere's) and I was so nauseated I couldn't wait to get home and sit back. Even the Zofran only holds the nausea down for about an hour! It used to take it away for hours. I'm calmer now--so came in to see If I'd heard from you. I plan to call my primary on Monday about all this of course. Almost called yesterday but kept telling myself--you were told this takes a month. I can tell you it makes a 'nervous wreck' out of a person when it happens. I've always felt strong but think my nervous system has been so 'hit' that I'm not that strong anymore--and of course--the age thing too.
Anyway, eliminate the vomiting--that only happened with vertigo and unless I get bad news tomorrow--take off the A-fib. You were 'right on' with the symptoms, just that I feel the depression from all this has caused the anxiety . thanks
Rod Moser, PA, PhD replied to yanksgirl's response:
Then, the depression needs to be your main focus. If the Prozac does not help soon, you really need to see that psychiatrist and be put on a different antidepressant; one that is compatible with the Xanax and Valium. You are having too many of those "bad days"....
yanksgirl replied to Rod Moser, PA, PhD's response:
I agree--today is the 16th day on Prozac, the shaking began shortly after taking it, but I gave it 2 hours then took the Xanax--as directed by Primary, and I'm doing better now.
Did better yesterday by afternoon and having taken 2 Xanax by then. So, maybe with the Xanax helping me along until a month on the Prozac I'll get better w/out seeing the Psy. as I really 'dred' trying more meds.
However, I'm resigned to doing that if necessary.
I'm' ready for church--yes, I'm going now for about 5 weeks again, and so glad to be--but do have problems with my Meniere's there, the noise, turning my head (try not to so much) and use cotton in my good ear to 'soften music and louder noises. It's a beautiful day--I'm trying to stay 'positive'. Thanks for your reply--I'll let you know something when I do. yanksgirl
Rod Moser, PA, PhD replied to yanksgirl's response:
You are a positive person, but even positive people get frustrated. I do feel that you will find a medication regime that will work....

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