Tuesday, September 29, 2009

Quitting SSRIs safely and patiently

After taking citalopram (Celexa) for just over six years I have finally succeeded in quitting. I'd tried before, even managing to get down from 40mg to 20mg before I accidentally missed a single dose and spent a week going out of my mind. After bumping it up to 30mg I seemed to regain my sanity but a visit with the doctor left me saddened - she told me I would probably never be able to get off the meds.

This past winter I read the book, "Biology of Belief" by Bruce Lipton. It was interesting and inspiring, even if the science is dubious at best. It talked of mind over matter, our ability to heal ourselves, and it made me think of trying to quit the drugs again. Remembering my past experiences I did some research, and found out that one resource among others seemed to help a lot of people - a book by Joseph Glenmullen, "The Antidepressant Solution".

The message of the book boiled down to one thing: the doctors don't know the safe way of going off SSRIs (selective serotonin reuptake inhibitors). I had been following my doctors advice of taking a full dose one day, then a half dose the next, then a full dose again. After a week I was supposed to switch to doing just the half dose. Repeat. What I did this time (for reason well illustrated in the book), was to lower my dose by the smallest fraction possible, which in my case was 5mg, and try to stay on that dose for at least a month. This gives your brain time to adjust and kick in it's own serotonin production. After a month I would lower the dose again by 5mg and so forth. I was also supplementing with an excellent B vitamin complex, which provides choline and lecithin, needed for acetocholine production (that is advice not from the book but this site.)

It took me 5 months, six if you count the number of withdrawal periods. It wasn't pleasant, but it was far less painful than my previous attempts. Among physical symptoms I had dizziness, which would usually come on three days after I lowered the dose, and last a few days. Psychologically, I had some pretty bizarre obsessive thoughts. I didn't recognize them as symptoms until I saw a pattern emerge. I still had the occasional panic or anxiety attack, but no more so then when I was on the drugs.

So now I have been drug free for two months. I am still on the look out for signs that I am slipping back into the anxiety state I was in pre-meds, but so far so good. I should mention that I do not regret the decision to start the medicine in the first place. It was at a time in my life when they were the help I needed to become a person again (perhaps more on that another day?) Still, it feels great to know that I am not a dependent, that if I accidentally miss taking that one little pill I will not have to spend the next few days suffering crazy withdrawal symptoms.

I shall now allow myself a "Yiiiiiiiiiiiiiiiiippeeeeeeeeeeeee!" :)

Friday, September 4, 2009

First Time Acupuncture

Husband has seasonal allergies and doesn't like taking meds, so I thought he should try acupuncture. I got him an appointment and then he decided not to go. So I figured, what the heck, I'll go in his place.

This was my first time getting acupuncture. I wasn't sure what my "major complaint" was, but since I have been freaking out emotionally lately I decided to go with the panic and anxiety and my phobia. First the woman did a variation of the emotional freedom technique (their site), which I have already done in the past. It involves tapping on various points while thinking about what's bothering you. She added to that a kinesiology step to check which points were effective. I felt that the whole thing was rushed, I didn't have time to really focus on what was bothering me, so I am not sure how effective it could be. An interesting thing that came out of it though, was that she felt that I responded well to a 'kidney' point just below the clavicle. Apparently in Chinese medicine, fear is associated with the kidneys. So I told her that I'd had unusual kidney quirks since I was a kid, and that besides, I have three kidneys instead of two. Could there be a connection?

Next she had me lie down and she pushed on various parts of my large intestine, small intestine, bladder and each kidney. Some places hurt, other didn't. The ones that hurt, she would push again while simultaneously pressing on some points on my feet and elbows, and the weird thing is, the pain would go away immediately. That was probably the coolest.

Finally it was time for actual needles. She put some in my feet for the kidneys, one in my forehead for the spirit, and two in my right ear. She also put one in my hand but it hurt, and though I didn't mind the pain, she didn't want me to keep it in. The one in my forehead burned quite a bit, but that was about it. There was no pain when they went in, not even mosquito bite type of pain. I was then left to lie on the table for about 15 minutes, and that was it. Afterward I was seriously spaced out for about an hour. I wondered around downtown because I didn't feel it was safe to drive, and talked to my mother on the phone in strenuously strung together sentences.

In the evening I had a bad headache, and this morning I did not start my day with a panic attack, the first in a week. So that is good.

In the end, my acupuncturist said that for my problems I should really try neurofeedback (explanation here). It is expensive though, probably about $1500 total. I got a book about it, called "The Symphony in the Brain", which I'll check out. I'll keep you posted.

Thursday, September 3, 2009

Laser Bread

This guy makes something new every day. Not all are nice, but here are some creative ones I liked.

Wednesday, September 2, 2009

Internal Dialog

Returning to actual blog posts now (apologies for all the articles lately). I am thinking, once again, of going back to school and getting a PhD. My family insists that it is important to have a PhD, and if I am going to do it, now would be the time since I have no children and my brain is still young enough to retain some new information. Problem is, I have no idea what to study. Here is my line of thinking (or circle more like it, cause it never actually goes anywhere):

Should I go back to grad school? It's now or never really. Should I study art or science? Art is nice but I am not that talented, am emotionally unstable, and would miss science too much. Ok science it is. Should I study what I like to do and am good at, such as molecular biology or perhaps evolutionary bio? It will involve bench work, which I like, and I already have a degree and 5 years working experience to help me along. But it's not what I care about right now! What do you care about? I care about issues of sustainable agriculture, food quality (not quantity, mind you!) and maintaining health in the age of overcrowding, pollution and climate change! But you know nothing about any of this... It doesn't sound like it involves any bench work, and you will probably have to do a lot of 'communicating' and 'leadership' and you know how you tend to freak out about extroverted things! And besides, who is to say that you'll keep caring about this. There was a time when you cared about genetics. But bench work will get old soon too. Can I even handle grad school? It sounds stressful and I am prone to panic attacks. But you can't let fear stop you from doing what you want to do! But I don't know what I want to do! Do you want to go to grad school? It's probably now or never...

The problem is, if I don't do something it will all soon turn from "what could be" to "what could have been" and I'll be sitting in my little home whispering "my precioussss...."

Tuesday, September 1, 2009

Another decent article about health care reform myths

The Five Biggest Lies in the Health Care Debate

By Sharon Begley | NEWSWEEK

Published Aug 29, 2009

From the magazine issue dated Sep 7, 2009

To the credit of opponents of health-care reform, the lies and exaggerations they're spreading are not made up out of whole cloth—which makes the misinformation that much more credible. Instead, because opponents demand that everyone within earshot (or e-mail range) look, say, "at page 425 of the House bill!," the lies take on a patina of credibility. Take the claim in one chain e-mail that the government will have electronic access to everyone's bank account, implying that the Feds will rob you blind. The 1,017-page bill passed by the House Ways and Means Committee does call for electronic fund transfers—but from insurers to doctors and other providers. There is zero provision to include patients in any such system. Five other myths that won't die:

You'll have no choice in what health benefits you receive.
The myth that a "health choices commissioner" will decide what benefits you get seems to have originated in a July 19 post at blog.flecksoflife.com, whose homepage features an image of Obama looking like Heath Ledger's Joker. In fact, the House bill sets up a health-care exchange—essentially a list of private insurers and one government plan—where people who do not have health insurance through their employer or some other source (including small businesses) can shop for a plan, much as seniors shop for a drug plan under Medicare part D. The government will indeed require that participating plans not refuse people with preexisting conditions and offer at least minimum coverage, just as it does now with employer-provided insurance plans and part D. The requirements will be floors, not ceilings, however, in that the feds will have no say in how generous private insurance can be.

No chemo for older Medicare patients.
The threat that Medicare will give cancer patients over 70 only end-of-life counseling and not chemotherapy—as a nurse at a hospital told a roomful of chemo patients, including the uncle of a NEWSWEEK reporter—has zero basis in fact. It's just a vicious form of the rationing scare. The House bill does not use the word "ration." Nor does it call for cost-effectiveness research, much less implementation—the idea that "it isn't cost-effective to give a 90-year-old a hip replacement."

The general claim that care will be rationed under health-care reform is less a lie and more of a non-disprovable projection (as is Howard Dean's assertion that health-care reform will not lead to rationing, ever). What we can say is that there is de facto rationing under the current system, by both Medicare and private insurance. No plan covers everything, but coverage decisions "are now made in opaque ways by insurance companies," says Dr. Donald Berwick of the Institute for Healthcare Improvement.

A related myth is that health-care reform will be financed through $500 billion in Medicare cuts. This refers to proposed decreases in Medicare increases. That is, spending is on track to reach $803 billion in 2019 from today's $422 billion, and that would be dialed back. Even the $560 billion in reductions (which would be spread over 10 years and come from reducing payments to private Medicare advantage plans, reducing annual increases in payments to hospitals and other providers, and improving care so seniors are not readmitted to a hospital) is misleading: the House bill also gives Medicare $340 billion more over a decade. The money would pay docs more for office visits, eliminate copays and deductibles for preventive care, and help close the "doughnut hole" in the Medicare drug benefit, explains Medicare expert Tricia Neuman of the Kaiser Family Foundation.

Illegal immigrants will get free health insurance.
The House bill doesn't give anyone free health care (though under a 1986 law illegals who can't pay do get free emergency care now, courtesy of all us premium paying customers or of hospitals that have to eat the cost). Will they be eligible for subsidies to buy health insurance? The House bill says that "individuals who are not lawfully present in the United States" will not be allowed to receive subsidies.

The claim that taxpayers will wind up subsidizing health insurance for illegal immigrants has its origins in the defeat of an amendment, offered in July by Republican Rep. Dean Heller of Nevada, to require those enrolling in a public plan or seeking subsidies to purchase private insurance to have their citizenship verified. Flecksoflife.com claimed on July 19 that "HC [health care] will be provided 2 all non US citizens, illegal or otherwise." Rep. Steve King of Iowa spread the claim in a USA Today op-ed on Aug. 20, calling the explicit prohibition on such coverage "functionally meaningless" absent mandatory citizenship checks, and it's now gone viral. Can we say that none of the estimated 11.9 million illegal immigrants will ever wangle insurance subsidies through identity fraud, pretending to be a citizen? You can't prove a negative, but experts say that Medicare—the closest thing to the proposals in the House bill—has no such problem.

Death panels will decide who lives.
On July 16 Betsy McCaughey, a former lieutenant governor of New York and darling of the right, said on Fred Thompson's radio show that "on page 425," "Congress would make it mandatory…that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition." Sarah Palin coined "death panels" in an Aug. 7 Facebook post.

This lie springs from a provision in the House bill to have Medicare cover optional counseling on end-of-life care for any senior who requests it. This means that any patient, terminally ill or not, can request a special consultation with his or her physician about ventilators, feeding tubes, and other measures. Thus the House bill expands Medicare coverage, but without forcing anyone into end-of-life counseling.

The death-panels claim nevertheless got a new lease on life when Jim Towey, director of the White House Office of Faith-Based Initiatives under George W. Bush, claimed in an Aug. 18 Wall Street Journal op-ed that a 1997 workbook from the Department of Veterans Affairs pushes vets to "hurry up and die." In fact, the thrust of the 51-page book, which the VA pulled from circulation in 2007, is letting "loved ones" and "health care providers" "know your wishes." Readers are asked to decide what they believe, including that "life is sacred and has meaning, no matter what its quality," and that "my life should be prolonged as long as it can...using any means possible." But the workbook also asks if readers "believe there are some situations in which I would not want treatments to keep me alive." Opponents of health-care reform have selectively cited this passage as evidence the government wants to kill the old and the sick.

The government will set doctors' wages.
This, too, seems to have originated on the Flecksoflife blog on July 19. But while page 127 of the House bill says that physicians who choose to accept patients in the public insurance plan would receive 5 percent more than Medicare pays for a given service, doctors can refuse to accept such patients, and, even if they participate in a public plan, they are not salaried employees of it any more than your doctor today is an employee of, say, Aetna. "Nobody is saying we want the doctors working for the government; that's completely false," says Amitabh Chandra, professor of public policy at Harvard's Kennedy School of Government.

To be sure, there are also honest and principled objections to health-care reform. Some oppose a requirement that everyone have health insurance as an erosion of individual liberty. That's a debatable position, but an honest one. And many are simply scared out of their wits about what health-care reform will mean for them. But when fear and loathing hijack the brain, anything becomes believable—even that health-care reform is unconstitutional. To disprove that, check the commerce clause: Article I, Section 8.

With Katie Connolly, Claudia Kalb, and Ian Yarett

Find this article at http://www.newsweek.com/id/214254