bubbles

[bubbles]

I'm starting to feel a bit better, cold-wise. Still a bit iffy otherwise, so I'll hold.

[bubbles]

My mood is a bit better, but I'm still really tired - from the cold, I guess. I actually fell asleep yesterday when I had a rest after lunch! (I sometimes treat myself to a nap after lunch on a weekend, but never during the week.) I've decided that this means I'm run down and need a bit more time before dropping again.

[bubbles]

Still sniffing and still tired. It was just a cold (not the really bad flu that's going around just now) but it was a bad one. Mood slightly iffy, but generally okay. It's been a few ups and downs this week but it'll all come out in the wash.

 

I've used up all of my 2mg capsules - over the last two weeks I used one 2mg and two 1mg capsules daily, and for the last 2-3 days I'm using four 1mg capsules. It is possible that this change in the last two weeks has contributed to the iffy mood, though this pharmacy is excellent, so the capsules are probably exactly what they say they are.

 

I'm going to hold for another week, and decide next weekend if it is time to drop again.

[ChessieCat]

I doubt that the change in capsules dosages is causing the issue.  It's most probably your body recovering from the cold.

[bubbles]

On 7/14/2019 at 10:54 AM, ChessieCat said:

I doubt that the change in capsules dosages is causing the issue.  It's most probably your body recovering from the cold.

 

Probably.

 

I'm not feeling good, I'm ruminating again. Thinking about going up a bit in dose. Edit. Just made an appointment with the psych for next week. Not sure if that's a great idea or not, but I need to do something at this stage to break this cycle before it gets too entrenched.

 

Def no med drops. Maybe an up imminent. I'll see how I feel after the appointment.

[ChessieCat]

When was the last time you had your thyroid dose checked?

[bubbles]

@ChessieCat Another blood test is due, overdue really. I've been delaying because I keep forgetting my midday (smaller) armour dose and have ended up taking it at bedtime with my sertraline. Not ideal, but that's when I've realised I've missed it and take it then on grounds that it is better to take it imperfectly than not at all... I'm trying to be better about it now that life has settled down a bit. I should probably just get the test now and do another one in a month or so. I expect it to show a suppressed TSH, FT4 just scraping into range, and mid to maybe upper bit of range FT3, based on history.

 

Lately there have been external things that have set me off - I've been much too busy and had some quite stressful things happening.

 

I feel awful today - fluey, though I'm not sick enough for it to be actual flu - and I was awake for hours last night because of it.

[ChessieCat]

21 hours ago, bubbles said:

Def no med drops. Maybe an up imminent.

 

40 minutes ago, bubbles said:

I expect it to show a suppressed TSH, FT4 just scraping into range, and mid to maybe upper bit of range FT3, based on history.

 

Lately there have been external things that have set me off - I've been much too busy and had some quite stressful things happening.

 

Because what you are experiencing is most probably due to the other things I think it would be better not updosing the sertraline.  Just hold at the current dose and try and get the rest of the stuff sorted out.

[bubbles]

Thanks @ChessieCat. 

 

 

[bubbles]

Still not feeling good. Psych appointment Monday.

[Rabe]

How are you doing Bubbles?  Are you feeling any better?  How di the appointment go?  Thinking about you!💜

[bubbles]

Hi @Rabe

 

 

I'm up and down but it isn't dreadful. I'm not going to taper again any time soon, but neither am I currently thinking I should go up.

 

The appointment is tomorrow. Not sure how I feel about it. I am fine at times and then I think that it's a waste of my time and money, then at other times I feel differently and want to go and talk things through. I'll go tomorrow - too late to cancel without a fee - and decide if it is worthwhile for another visit. I suspect not but perhaps I can get myself on the right track with some self care.

 

However, I'm still sick from my cold and as I had one and then another, it's been a bit over 3 weeks now so that's probably not helping matters at all.

 

Thanks for thinking of me.

 

 

 

 

[bubbles]

Update, my cold is finally receding and I'm feeling a bit better - coughing a lot though which is affecting my sleep. I had my appointment the other day but by then I was feeling better already. I think it was worthwhile - touching base and setting the boundaries (no meds) and just a quick talk through of what I'm doing to keep myself on target and a reminder about techniques to. I haven't made another appointment, and probably won't at this stage.

 

Long story short - I'm feeling better, but no med changes at present.

[bubbles]

Having a bit of a wobble again. Also having headaches for no obvious reason, except I guess not sleeping all that well. Need to contact doctor for a prescription refresh.

[Rabe]

Glad to hear you are feeling better Bubbles!  Hope you get even better real soon!  Take care!💜

[JackieDecides]

I hope your sleep gets better soon, Bubbles. 🤗

[bubbles]

Thank you @Rabe and @JackieDecides. My sleep is much better now - my cold has gone. I'm feeling overall better. I'm still going to take steps not to get overly stressed for a bit, and I'm going to hold off on my dose change for a bit longer.

[bubbles]

Yet more weeks have passed with no downward movement in my dose. I picked up some new capsules and have switched to them. No crossover, it kind of took me by surprise that I needed to reorder, oops. Interestingly I think I feel better after a few days of the new capsules and I'm wondering if the older batch had become less potent. They were in date, but at the outer end of it.

 

I replaced the capsules that were running out (higher dose), and didn't yet replace the capsules (lower dose ones) still in date as I still had enough as I haven't been using them during this hold. I'm now wondering if it might be prudent to replace those ones too before I do another drop.

[Rhiannon]

Hi Bubbles! I dropped back in to the forum because of some withdrawal symptoms I'm having. It's been great to "see" old friends. So glad to see you!

[bubbles]

4 hours ago, Rhiannon said:

Hi Bubbles! I dropped back in to the forum because of some withdrawal symptoms I'm having. It's been great to "see" old friends. So glad to see you!

 

Hi Rhi!!! Sorry to hear you're having some symptoms. Hope they subside soon. I see you've gone a long way with your taper.

[bubbles]

I'm still considering an updose in the sertraline. I'm still on 4mg and have been for about five months now. I'm tired and ruminating and there's some anxiety just a bit too close to the surface. I'm due a thyroid test in a few weeks but I suspect the thyroid hormones are probably pretty optimal so I'm not expecting there to be much need to change anything there.

 

Tomorrow's job is to arrange a refill of the smaller doses.

[Rhiannon]

I'm sorry you're having a bit of an uptick in that ruminating and anxiety nonsense...so frustrating. 

 

[bubble]

But you had better days and have been holding for 5 months so it's not really clear how an updose would help... Maybe a time to practice non-drug coping skills?

[ChessieCat]

4 hours ago, bubble said:

But you had better days and have been holding for 5 months so it's not really clear how an updose would help

 

I agree. 

 

6 hours ago, bubbles said:

I'm due a thyroid test in a few weeks

 

Get this done first.

 

Some members have found that they plateau with their symptoms and find that it is time to make a reduction instead of an updose.  After your thyroid test and the change in thyroid drug dose, if needed, you could try a tiny test reduction to see how that affects you.

 

And it has been noticed that there are some doses which members can have difficulty getting past.  Unfortunately it can be different for different people and different drugs so there is no specific dose to go by.  I think it would be better to try a reduction, not an updose.

[bubbles]

Hello @ChessieCat and @bubble

 

Quote

5 hours ago, bubble said:

But you had better days and have been holding for 5 months so it's not really clear how an updose would help

 

I agree. 

 

Maybe not. Better days yes, but the pattern hasn't really changed. It's a little upsetting to think I've left it too long for an updose to help.

 

7 hours ago, bubbles said:

I'm due a thyroid test in a few weeks

 

Quote

Get this done first.

 

I'm really not feeling great. I had a period of taking the armour imperfectly; now that I'm taking it more consistently again I need to leave 6 weeks ish to bring everything to the proper blood levels to make the test worthwhile (though I might be able to spring for a private test in the meantime - I guess if it shows high that might be useful information).

 

Long story, but these symptoms predate that imperfect taking. It's more that I'm (over)due a blood test and as I dislike blood tests I want to make it worthwhile.

 

Quote

And it has been noticed that there are some doses which members can have difficulty getting past.  Unfortunately it can be different for different people and different drugs so there is no specific dose to go by.  I think it would be better to try a reduction, not an updose.

 

I've certainly had the feeling at times on this taper that I was taking too much sertraline - this is a different feeling.

 

Quote

Maybe a time to practice non-drug coping skills?

 

They're not being notably successful at present. I'm better off if I am busy, if I'm rested. I'm downloading an audio book just now, as I find listening to something is helpful when I'm doing things like chores, driving. I feel like it's harder to let the ruminating take hold if someone is talking into my ears.

[bubbles]

Still holding. I've decided that it isn't the right time to drop again. Maybe I'm starting to get on top of it. I'm okay at the moment - it's a beautiful day and I've been out in the fresh air doing some gardening.

 

I didn't get around to getting my meds refilled so I'm stuck on a dose that is an increment of 1mg until I do that. Or until I figure out some way to do a water titration etc. Hmm, will take one of the expired capsules and see how well it dissolves.

 

I'm happy to realise that I've only been holding for four months, not five.

[bubbles]

Very quick update. I'm feeling a bit better. The windows are longer and the waves are shorter and probably less frequent. Continuing to hold was clearly the right move. I'm not sure how much longer I'll hold before attempting a small drop, but I won't be dropping this week.

[JackieDecides]

very glad to hear the good report, Bubbles. 

[Rhiannon]

Yay, glad to hear you're doing better. 

 

I'm a big proponent of holds as you probably know. Still, it can take so long for things to settle down, it's hard to hang in there and trust.

[bubbles]

And another wave.

 

Yes, long holds are the go. My taper has been more hold than taper.

[bubbles]

Was reminded of how LCHF was good for my mood, so I'm going to do that this week and focus on getting lots of fat in (like 80% of calories), since that has helped my mood in the past.

 

I'm doing the other non drug things. I'm trying to get enough sleep (but failing, having disturbed sleep). I'm probably on screens too much, but then again it does distract me from the ruminating, which certainly is bad for me. I had a gentle walk yesterday and will be walking today while running errands. I'm getting some company. It's nice weather so I'll try to do some gardening this week.

 

Anyone got any good podcasts to listen to?

[Rhiannon]

What kind of podcasts do you like?

 

Also, did you have any luck dissolving the expired capsule? 

[bubbles]

Hi @Rhiannon

 

Podcasts - I'm a bit eclectic. I'm listening to The Obesity Code, a couple of local political podcasts, also some thyroid ones. I think I'd like some more diet related ones, now that I've decided on LCHF as a goal for the moment, science-based ones. I had some history ones that were interesting, but they seem to have fallen off the bottom of my list. Will have to dig around for them.

 

Re the capsule, it didn't dissolve quickly. Actually it probably didn't dissolve, rather made a slightly lumpy suspension, but leaving it a bit longer would probably help. I might try a better experiment tomorrow - set a timer and see. The powder came fairly easily out of the capsule (with a bit of a knock).

 

How are you doing now? Has it settled a bit?

 

[bubbles]

Today I will go down to 3.9mg. All going well I will not notice it, but I'm not going to risk a 10% drop. A 10% drop would be to 0.4mg to 3.6mg so I guess (dropping 0.1mg) makes this a 2.5% drop?

 

This is going to be my drop for the month, even if I don't notice it, I will hold this for four weeks.

[bubbles]

End of a busy week and I'm tired. Will stick on 3.9mg as planned

[bubbles]

Looking back at the occupancy paper (https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.5.826) and it looks like the smallest sertraline dose used was 5mg. The graph is a bit "coarse" but it looks like 5mg is about 30%, which is a little alarming. 4mg is about 25%, 3 looks like about 20%, 2 looks about 14/15%, 1 looks like about nothing. If they used 5mg as the lowest dose, anything below that is, at best, a guess, and the chart has been drawn with a lovely smooth line. It seems to indicate that below 1mg might well be difficult.

 

I did a 0.1mg drop a week ago (from 4mg to 3.9mg, which I think is a 2.5% drop) and had planned to stay on it for a month, but maybe I should pick up the pace a bit. I've already measured out next week's capsules, so the 3.9mg can stand for next week but maybe if I still feel okay I should do another 0.1mg drop. As of today I think I'm fine, no indications that the dose changed. I'm at the point where the sertraline half lives will have worked their way out, but not yet the active metabolite - that's another week ish away.

 

I've found the really small drops less problematic, I think, so maybe I will do 0.1mg drops every two weeks for a few drops and see how that goes. It works out to be about 5% a month, so it's not rapid.