422) Stopping Paroxetine and current notes

July 28, 2011
Thursday
 
Bernadette called last night to adjust my meds down!  Too much myfortic in my system, so we are dropping to two in morning and two at night.  Good news.  She said, "too much myfortic increases chances for infection..."

This morning on Morning Edition, a story on live transplant procedure that decreases rejection:  check it out at Treatment Boosts Survival Rates For Some Kidney Transplant Patients.

Also, I've been writing on a post reporting on my leaving behind my long-term anti-anxiety meds, paroxetine.  Never finished it cause of busyness in other venues... so, here it is from the draft.  Now it has been two weeks or so without any paroxetine!


If I had continued my July 13 report I would have said that the only real difference I have noticed since quitting is having very vivid dreams that seem so real that I am not sure I am dreaming.  In one instance I woke up when Liz nudged me to let the dog out at 4:30 or so... got up and took her (the dog) downstairs, let her out, stepped out onto the back porch and felt the hot muggy Austin air.  I felt the breeze, gazed around at the completely familiar scene before coming back into the house and wandering towards the fridge for a cold glass of water.  Then back to the squeaky door to let Chelsea in and follow her back upstairs.  I got back in bed an fell back asleep.


A few minutes later Liz was shaking me again: my whole last paragraph was a dream!  Most of these vivid dreams are run-of-the-mill daily living dreams rather than my more usual weird dreams.  They are marked by brilliant color, clearly feeling proprioceptive sensations, and sensing that the dreams are lucid dreams. 

In general, my behavior has been okay, according to Lizzie.  If anything, in my attempts to watch my behavior and not "fly off", get irritable, or act crazy, I have been less demonstrative.  I think she called it "in my self", but maybe she should put in a comment on this post to clarify her reactions to my reactions to quitting paroxetine.  


More to come!
 

July 13, 2011

Wednesday

In the News:  I think I have been mentioning over the past six months or so that I have been in the process of lowering my paroxetine dosage with the hopes of quitting completely.  Partly this plan was instituted to decrease my overall meds use and save money, but also:  I have been wanting to stop being on this anti-anxiety medication that Dr. Moritz prescribed for me sometime around 2002 or 03 (based on review of my meds lists), as I was adjusting to freaking out about having PKD and the prognosis of eventual dialysis and transplant.

# What are the withdrawal reactions occurring with paroxetine?

These symptoms may occur upon stopping treatment with paroxetine. Typically they can include dizziness, altered sensation (eg. numbness, “pins and needles”, “electric shock sensations”), sleep problems including intense dreams, , anxiety and headache.

Less common symptoms include agitation, nausea, tremor (shaking of parts of the body, eg. hands), confusion, sweating, diarrhea, palpitations, emotional instability, irritability or problems with vision (eyesight).

In some patients withdrawal symptoms may be severe in nature or prolonged. Usually, however they are mild to moderate and self-limiting and should resolve within 2 weeks of stopping paroxetine. Patients treated with high doses, those treated for longer duration and patients whose treatment is abruptly stopped may be at an increased risk of withdrawal symptoms.

European Agency for the Evaluation of Medicinal Products (2004) Questions and answers on paroxetine.  Retrieved online July 13 from http://www.antidepressantsfacts.com/2004-04-23-EMEA-paxil-seroxat-warning-EU.htm  

421) Bernadette Report

July 12, 2011
Tuesday
 
Bernadette called this morning to report on yesterday's labs... and said, "Your creatinine is down to 1.5 and dropping your cyclosporine dose in the evenings was evidently a good move.  It is at 145 now."  In explanation, she added that high cyclosporine decreases blood flow thru the kidney and can be a cause of raised creatinine.  This is a good report: next labs set for July 20th.

420) Transplant Clinic Scare

July 6, 2011
Wednesday

After the clinic called last week and change my appointment, I arrived at NAMC this morning at 6:50 am. for re-registration (a task required every three months) and then labs, and then my usual clinic visit at 9:10 am. After lab work, I stopped in at the cafeteria for two breakfast tacos and coffee with my 8 am meds; and settled in to reading my new text for the Fall Semester SFBT class.

At the clinic things started being bothersome as Maxine hurriedly cuffed my arm and pumped me up for my BP while asking me questions and rushing through her tasks. My BP: 157 over 70 something... to which I mumbled something like, "probably cause I just sat down and am talking..." Then, after 10 minutes or so (reading time again), Bernadette enters and informs me that my creatinine is up to 1.7, my hemoglobin is down, and my salt is high. Great news!

"One point seven? That's not good. Whats up with that?" She shrugs... and we briefly discuss whether it is really a bad thing or not.

Dr. Lewis comes in and asks me how I'm doing... "okay" I say... "cept for my back pain... and, I know what thats from... hauling rocks the other day..." He has on the table, listens to my chest and back, asks about swelling, has me lay back on the table while he checks my groin and pokes at my new kidney and abdomen in general. Pulls me up to sitting and goes over to look in my record (All this is his usual protocol).

Looking in there at the most recent labs, he seems worried (to me) about it and shares, "After two years it is really too late to be rejection..." and I wonder if he is talking to me or himself. Rejection? Yikes? "So what do you think it's about?" I ask. He runs through a range of things (which I don't exactly rmemeber cause I'm freakin' out), such as "a fluke", "medication issue", or some other unknown problem. He excuses himself to go find the rest of my record and check this out further, commenting... "...they've thinned out your record... excuse me for a few minutes while I go find what I need..." and out he goes.

I sit there in my brain feeling guilty. I must have brought this on myself. I've been too late on my meds too many times... "I'm lazy and no good! (I hear in a parental voice in my head). "Boy, now I've done it... I've ruined my new kidney..." I fret. Then I try to clear my head, take some deep breathes, wiggle my sore shoulders... stand up to get my text book. "I can't focus on THAT right now!" So I sit back down and begin thinking along two channels: don't worry until there is something to worry about & boy, this is a GREAT time to end my anxiety meds!

Dr. Lewis returns and says he thinks he wants me to get two scans so he can look them over, and get scheduled for more labs in a couple weeks and then we'll see whats going on. He asks about my BP and I say it has been running in the mid 120 over 70's usually and he nods at this data. I ask about quitting the Paroxatine and we agree that this is as good a time as ever.

He honestly says he wants more data before making up his mind about the 1.7.

Maxine comes in and asks if I can hang around today and get the ultrasound and the DMSA renal study. "Sure." So, she goes to set them up while Bernadette works up my next appointments and med chart. Maxine returns: the DMSA is scheduled for 1 pm and the ultrasound they'll "squeeze in" before that. First I have to go back to the lab for another blood draw to check my iron.

After the quick lab I trek over to the imaging waiting room and munch on Lorna Doones, drink more coffee, and read another chapter of my text before they are able to "squeeze me in" for my ultrasound. The ultrasound goes easily... Robert the technician is training a young tech on the newer machine than she is used to and she tells me, "I've been doing these for years; he is just showing me how to use this new machine" as if to assure me she knows what she is doing. I'm fine... whatever. They talk about how to do this and that the same and differently while I lay there. She did use warmed lubricant, which I am in favor of. I had to fill my bladder with four large cups of cold water so I was shivering when I got in there. The warm goo and heated blankets helped me settle right in to a comfortable experience.

Then it was back to waiting for my 1 o'clock scan. I walked around in outside in the 99 degree sun for more warmth. The DMSA scan was conducted by Mark (See Post # 337 & 338, March 2009) and we spent some time catching each other up as he set me up for the scan. This scan takes 30 minutes of stillness and I fall into a slumberous meditation / sleep... and before I know it it is over and I am up and ready to head out. Mark asks me what I am driving these days (still the T-100 of course) and he wonders how I would compare F-150's with the Tundra before I leave.

Later: Bernadette calls me at home in the evening to say that Dr. Lewis looked at the scans and they look okay... is concerned that my cyclosporin (Neoral) is higher than it should be so he wants me to take off the little one (25 mg) at night and she'll set up labs for next Monday, five days from now. I ask about my scare and she seems to think things are A-Okay for now. Whew!