☼ LilBit: polypharmacy nightmare

[LilBit]

Dec 31

 

134.8 lbs (16.4% fat, 56.3% water, 23 BMI, 107.4 lbs muscle)

 

2050 cal

 

8:30am  diarrhea

9:30am  325mg Depakote, Enteragam packet

11:15am  cereal, banana (600 cal)

12:30pm  diarrhea

3:45pm  smoked turkey sandwich with chips (600 cal)

4:00pm  250mg Florastor 

5:20pm  applesauce (100 cal)

5:30pm  emotional, crying, feelings of hopelessness

6:00pm  brain fog

7:45pm  salmon with mashed potatoes and zucchini with squash (750 cal)

10:00pm  22.5mg quetiapine, 2mg diazepam 

12:30am  bedtime, got about 3 hours broken sleep. Final wake time was 5am.

 

[LilBit]

Jan 1

 

134.6 lbs (16.4% fat, 56.3% water, 23 BMI)

 

What is odd to me is that my weight seems to be constant over the past month, but I am continuing to see fat/muscle loss in my back (over the past week my shoulder blades are now visible), arms, hands, neck and knees/legs/ankles.  Still lots of trouble with sleep.  Noticing a bit of an increase in appetite which is definitely welcome at this point.

 

2150 cal

 

9:30am  diarrhea

9:45am  325mg Depakote, 1 packet Enteragam

10:30am  bowl of cheerios and banana (550 cal)

2:00pm  white rice with black eyed peas, pork roast and potatoes (500 cal)

2:30pm  Florastor

5:40pm  chicken fajita pita and egg roll (485 cal)

7:30pm  grilled chicken breast with basmati rice, black beans and peas (620 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam

11:30pm  bedtime

Woke 3 or 4 times, used cpap all night and had to get up around 4am to use the bathroom.  Woke at 6, had hard time getting up because I was still tired.  Got about 4 hours of sleep.

 

 

Jan 2

 

135lbs (18% fat, 55.4% water, 23.1 BMI, 104.3 lbs muscle, 5.5 lbs bone)

 

2140 cal

 

9:15am  325mg Depakote

9:20am  loose bm/diarrhea 

10:30am  cheerios w/lactose free low-fat milk and banana (550 cal)

2:00pm  diarrhea

2:45pm  grilled chicken sandwich with vanilla milkshake (950 cal)

2:45pm  Florastor 

6:00pm  small avocado (240 cal)

7:20pm  beef stew with rice and broccoli (400 cal)

9:30pm  22.5mg Quetiapine, 2mg Diazepam

10:40pm  bedtime

Woke many times due to shoulder hurting, not being comfortable in bed or with CPAP mask.  Got up at 3am and took a while to fall back asleep.  Got up at 7:30am. Maybe got about 3 hours of sleep.

 

 

Jan 3

 

136 lbs (17.4% fat, 55.8% water, 23.2 BMI, 106.5 lbs muscle, 5.7 lbs bone)

 

I am feeling extremely out of it and sleep deprived today like my brain is working in slow motion.  I feel very jittery and weak.

 

2170 cal

 

10:00am  325mg Depakote, 1 pkt Enteragam

10:20am  loose bm

11:00am  cereal and banana (550 cal)

1:30pm  small avocado with apple juice (350 cal)

3:00pm  headache

4:30pm  roast turkey and swiss sandwich (710 cal)

5:30pm  florastor 

8:00pm  grilled chicken with rice and black beans (560 cal)

9:30pm  22.5mg quetiapine, 2mg diazepam, .6mg melatonin

11:00pm bedtime, got about an hour or less of sleep

 

Edited January 4, 2019 by ChessieCat
bolded melatonin

[ChessieCat]

I've highlighted the melatonin in your log so that it is easier to see that took something different that day.

[LilBit]

Thanks ChessieCat 🙂  Going back to my Depakote taper, I really want to make sure I am doing this correctly.  Right now, I am combining a 250mg Depakote ER tablet with 50mg of Depakote Sprinkles, for a total of 300mg in the AM.  However, I have seen several articles that reference how ER and DR (Sprinkles) dosing is not equivalent due to reduced bioavailability in ER, and that the two are not interchangeable.  When converting from DR to ER, the dosage should roughly be 12% higher (anywhere from 8-20%) in ER to make an equivalent dose to ensure same level of serum valproic acid.  Does this mean I should switch to all Sprinkles, adjust my dose, and take in the AM and PM to complete my taper?  They recommend multiple times a day for DR/Sprinkles vs once a day for ER to ensure a consistent level in the blood and I’m afraid this might be causing me symptoms and potentially be affecting my taper but not sure.

 

 

Information on Valproates

 

Bioavailability and metabolization difference in Depakote ER and DR

 

[Altostrata]

5 hours ago, LilBit said:

Thanks ChessieCat 🙂  Going back to my Depakote taper, I really want to make sure I am doing this correctly.  Right now, I am combining a 250mg Depakote ER tablet with 50mg of Depakote Sprinkles, for a total of 300mg in the AM.  However, I have seen several articles that reference how ER and DR (Sprinkles) dosing is not equivalent due to reduced bioavailability in ER, and that the two are not interchangeable.  When converting from DR to ER, the dosage should roughly be 12% higher (anywhere from 8-20%) in ER to make an equivalent dose to ensure same level of serum valproic acid.  Does this mean I should switch to all Sprinkles, adjust my dose, and take in the AM and PM to complete my taper?  They recommend multiple times a day for DR/Sprinkles vs once a day for ER to ensure a consistent level in the blood and I’m afraid this might be causing me symptoms and potentially be affecting my taper but not sure.

 

 

Information on Valproates

 

Bioavailability and metabolization difference in Depakote ER and DR

 

 

We covered this before. Please do not worry about substituting Sprinkles for PART of your dose. The point is to reduce Depakota anyway, not maintain your current dosage.

[LilBit]

Okay.  The main reason I was wondering is because I wasn’t sure how I should proceed once I get to 250mg, if I should switch entirely to Sprinkles at that point and maybe at a lower dose than 250mg, like 225mg.

[Altostrata]

After you get Depakote down to 300mg, I would start tapering Seroquel. So don't worry about how you're going to titrate Depakote now.

[LilBit]

If possible I think I would really really like to come off of the Depakote before tapering the Seroquel.  I know this goes against your recommendation but  I feel like it is doing me the most harm and I have actually noticed my loss of appetite getting better since lowering my dose.  I don’t get nauseous anymore either!  It would also be less stressful for me in terms of working with my psychiatrist because I know her taper plan for the Seroquel is going to be faster than we want so I am preparing myself for that.  I sent my primary doctor a message about the Myers cocktail and chronic pancreatitis so waiting to see what his thoughts are.  I am not sure how concerned about pancreatitis I am since my CT scan and ultrasound came back normal and the main symptom I seem to have is the loose bowel movements.  I wonder if they are a side effect of the Depakote or lack of sleep, but I think the Enteragam and probiotic are helping.  I have a follow up with my GI doc on Wednesday.

 

Today I feel like I am going crazy from how tired and sleep deprived I am.  I can’t think and can barely function.  I get a headache every now and then and my muscles are sore all over.  I never feel rested and this constant feeling of beeing trapped between falling asleep and being unable to fall asleep is extremely uncomfortable. 😔

[LilBit]

Jan 4

 

135 lbs (18% fat, 55.3% water, 23.1 BMI, 104.6 lbs muscle, 5.5 lbs bone)

 

2000 cal

 

11:00am  small bm (no diarrhea)

11:00am  300mg Depakote

11:40am  bowl of cereal and banana (550 cal)

12:00pm  went for a walk

1:14pm  abdominal pain left side

2:30pm  veggie sandwich from Schlotzsky’s (500 cal)

7:30pm  eggs benedict with avocado (950 cal)

10:00pm  22.5mg quetiapine, 2mg diazepam

10:30pm bedtime

Woke several times but I know I slept, got about 3-4 hours of sleep

 

 

Jan 5

 

135.4 lbs (16.2% fat, 56.4% water, 23.1 BMI, 107.8 lbs muscle, 5.7 lbs bone)

 

2200 cal

 

9:30am  Enteragam 1pkt and 300mg Depakote

10:00am  maple fruit oatmeal and egg mcmuffin (600 cal)

2:00pm  fish tacos with white rice and pinto beans (1100 cal)

4:00pm  banana (100 cal)

4:30pm  pain in left shoulder

8:00pm  grilled chicken sandwich (400 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam

10:30pm  bedtime

Got about 4 hours of fragmented sleep.

 

 

Jan 6

 

134.4 lbs (16% fat, 56.5% water, 23 BMI, 107.1 lbs muscle, 5.7 lbs bone)

 

2400 cal

 

9:00am  loose bm

9:40am  300mg Depakote

9:45am  Enteragam packet

11:30am  2 slices of toast, 2 scrambled eggs, banana and apple juice (550 cal)

3:15pm  bowl of cereal (550 cal)

3:15pm  Florastor 

6:30pm  grilled salmon and shrimp with rice, mashed potatoes and broccoli (1300 cal)

10:00pm  22.5mg quetiapine, 2mg diazepam

11:00pm  bedtime, woke 3 times, got about 4 1/2 to 5 hours of broken sleep.

 

 

Jan 7

 

134 lbs (15.9% fat, 56.6% water, 22.9 BMI, 106.9 lbs muscle, 5.7 lbs bone)

 

2220 cal

 

8:00am  loose bm

10:00am  300mg Depakote, 1 pkt Enteragam

11:00am  oatmeal with bananas (520 cal)

1:30pm  avocado with apple juice (350 cal)

1:50pm  brain fog

2:40pm  grilled chicken sandwich (450 cal)

3:00pm  left shoulder pain

3:10pm  florastor

3:15pm  diarrhea 

4:30pm  feeling depressed and hopeless, keeping myself distracted to replace negative thoughts 

5:00pm  anxiety

6:20pm  toast with banana and peanut butter (400 cal)

8:00pm  3 small beef fajitas on corn tortillas with rice and beans (500 cal)

9:45pm  22.5mg Quetiapine, 2mg Diazepam 

11:00pm  bedtime

Woke a few times, got about 4 hours of sleep

 

 

Jan 8

 

134.4 lbs (16.1% fat, 56.5% water, 23 BMI, 107.1 lbs muscle, 5.7 lbs bone)

 

Today I have very heavy brain fog and feeling extremely out of it and tired.  Having a hard time getting thoughts together and focusing.  I pushed myself to hang out with a friend of mine today and we went and played putt putt golf and had lunch.  I also went to the grocery store on the way home from visiting with him.  I hope I get some sleep tonight!

 

2230 cal

 

8:10am  diarrhea/loose bm

9:45am  300mg Depakote, 1 pkt Enteragam

10:00am  cereal and banana (500 cal)

1:30pm  grilled chicken sandwich (500 cal)

2:30pm  brain fog

4:15pm  3 scrambled eggs, turkey bacon, buttered toast and mixed fruit (550 cal)

7:00pm  salmon with potatoes and broccoli (530 cal)

9:15pm  22.5mg Quetiapine, 2mg diazepam

9:30pm  graham crackers (150 cal)

11:30pm  bedtime

Woke a few times, tried with cpap, took mask off around 5am, woke at 6, got up at 6:30, got about 3 1/2 hours of sleep

 

[LilBit]

Today I kept myself busy and tried to stay productive by helping a friend of mine with some computer work in his office, and I also had an appointment with my gastroenterologist this morning.  He wants to do more labs, to check for pancreatitis (Lipase and Amylase levels, among others) and also wants to do an Enteroscopy to eliminate any other possible causes of my constant diarrhea.  I am also following up with my primary care doc tomorrow regarding this and the pain in my shoulder, and the Myers cocktail.  I was doing some browsing online and found the below product which is supposed to help with insomnia.  I usually don't go for these types of things, but given how desperate I am for sleep, I figured it couldn't hurt to look into.  Has anyone heard of the SomniResonance SR1?  It's supposed to be a device a third of the size of a business card that you place strategically near your collarbone, and it sends an electromagnetic signal to your brain (a form of TMS) similar to the slow wave sleep pattern your brain follows when you go to sleep.

 

SomniResonance SR1 for Insomnia

[Altostrata]

On 1/6/2019 at 12:01 PM, LilBit said:

If possible I think I would really really like to come off of the Depakote before tapering the Seroquel.  I know this goes against your recommendation but  I feel like it is doing me the most harm and I have actually noticed my loss of appetite getting better since lowering my dose.  I don’t get nauseous anymore either!  It would also be less stressful for me in terms of working with my psychiatrist because I know her taper plan for the Seroquel is going to be faster than we want so I am preparing myself for that.  I sent my primary doctor a message about the Myers cocktail and chronic pancreatitis so waiting to see what his thoughts are.  I am not sure how concerned about pancreatitis I am since my CT scan and ultrasound came back normal and the main symptom I seem to have is the loose bowel movements.  I wonder if they are a side effect of the Depakote or lack of sleep, but I think the Enteragam and probiotic are helping.  I have a follow up with my GI doc on Wednesday.

 

Today I feel like I am going crazy from how tired and sleep deprived I am.  I can’t think and can barely function.  I get a headache every now and then and my muscles are sore all over.  I never feel rested and this constant feeling of beeing trapped between falling asleep and being unable to fall asleep is extremely uncomfortable. 😔

 

Yes, I agree you are having side effects from Depakote, and they have decreased as you've decreased the drug. You can certainly continue to taper it if you think that's best.

 

I am worried that the Seroquel is also irritating your pancreas (if that's what's going on). Both drugs appear in the literature connected to drug-induced pancreatitis.

Then there is the probable interaction between the two drugs 

https://www.pharmacytimes.com/publications/issue/2010/january2010/druginteractions-0110

Quote

Valproate 
Several studies have addressed a possible interaction between quetiapine and valproate, and it appears that valproate may somewhat increase quetiapine plasma concentrations.6 Other evidence suggests that the combined use of quetiapine and valproate may increase the risk of bone marrow suppression. 7 

 

^ This means that valproate blocks your body's metabolism of quetiapine somewhere and raises the amount in your bloodstream. Because the quetiapine is not being normally metabolized, it hangs out longer in your organs, including your liver and maybe your pancreas, where it can cause mischief.

 

And, may I point out, the Seroquel is not helping you sleep at all. (In fact, it may be causing a paradoxical reaction keeping you from sleeping.) A small decrease from 22.5mg to 20mg would be a trial to see if lowering the Seroquel yields even greater improvements than lowering Depakote.

 

However, I'm only guessing that both drugs are making you sick. Your intuition that it's the Depakote may be correct.

 

Working with your psychiatrist should not be in the least bit stressful, she should be a member of your team. Given your health problems, which most likely are related to the absurd combinations of psychiatric drugs you've been prescribed, I would think your current psychiatrist would bend over backward to assist you in any way she can.

 

All she needs to do is prescribe you 20mg Seroquel and let you do what you think is best. If she does anything to hamper your safely going off quetiapine, I would fire her out of hand and look for a GP who will write your prescriptions.

 

I don't know why you defer to her, she hasn't done a single thing to help you other than not prescribe additional psychiatric drugs. With your health problems, she should have shown a lot more interest at the very start in getting you off the drugs. She's been phoning it in.

 

Strongly advise you tell your psychiatrist you find working with her stressful because she needs to be more understanding of your physical fragility and not subject you to withdrawal risk on top of it.

 

Please note that subclinical pancreatitis may not show up on imaging such as CT scan and ultrasound. Loose bowel movements are far from your only symptoms, you have body wasting and malnutrition even though you're eating. You feel terrible. If your GP has somehow overlooked this, you need a new GP.

 

(You are probably also suffering from low blood sugar and vitamin depletion, all of which can interfere with sleep. Good to hear you might have access to Myers cocktail. I hope it agrees with you. By the way, Pharmaca, a local integrative pharmacy here in San Francisco, was giving walk-in shots of vitamin B12 and Myer's cocktails without prescription a couple of months ago. You may wish to find an integrative clinic or MD for these treatments.)

 

Your situation is serious. None of your doctors should not wait for potential subclinical pancreatitis to progress to acute pancreatitis before they wake up and smell the coffee. You need people who know what they're doing instead of avoiding looking at the problem because they don't know what to do about it. You may need to get used to firing your doctors.

 

Do not allow your gastroenterologist to wave off the possibility of subclinical pancreatitis. What enzymes would you take if you had subclinical pancreatitis? If the risk of serious side effects is low, if I were you, I'd ask the gastroenterologist to prescribe a low dose to start.

 

About enzymes for pancreatitis: http://columbiasurgery.org/news/2013/12/20/what-you-need-know-about-pancreatic-enzymes
 

Quote

 

Who needs to take pancreatic enzymes?

If you have a medical problem affecting your pancreas that does not necessarily mean you need to take pancreatic enzymes. You may want to discuss with your doctor if you notice any of the following: yellow, floating, or greasy stools or diarrhea, excessive gas, painful cramping after eating, or weight loss despite eating your usual amount of food. Most people only experience one or two symptoms. These are all signs of malabsorption, which means you may not be making enough pancreatic enzymes to digest your food and could benefit from taking pancreatic enzymes.

 

 

About that electrical device, see  

You may wish to find a therapist who can teach you self-hypnosis. This can be effective for sleep.

[LilBit]

Alto thank you so much for all of the information!  I agree that it is very possible that both drugs are harming me in a way that I did not realize, and that the interaction of the two drugs is compounding the problem.  I would feel safe tapering off of the Depakote just because the side effects are very scary to me, but I am also curious as to what has caused my sleep to worsen as of late.  The good thing is that at the rate I am going, it shouldn’t be much longer before I am off of the Depakote.  I am intrigued about lowering the Seroquel possibly improving my sleep though, I am just so scared to stay on the Depakote any longer than necessary.  I have also considered that tapering it more rapidly might have made my sleep worse but not sure.  Maybe I will go down to 275mg and if sleep still does not improve soon, try holding there and loweing the Seroquel... what do you think? 

 

I will say this about my current psychiatrist:  yes, in the beginning she was just like all other psychiatrists as far as the suggestions she made.  I explained to her that I want off all drugs and the damage they have done to me.  She agrees that I was misdiagnosed to begin with and irresponsibly prescribed the wrong drugs.  She also agrees that I need to taper slowly and unlike my first pdoc, does not threaten to drop me as a patient if I do not agree with her suggestions.  She put up no argument when I decided which drug to taper, and has been referring me to various specialists for dysautonomia, epilepsy (she herself has a background in neurology), and even suggesested the possibilty of complex PTSD (as did my therapist) causing my sleeping problems.

 

 She seems genuinely concerned and like she is trying to think outside the box.  I have made progress with her so I am giving her a chance.  I just know that in some ways she still thinks like most psychiatrists so I may get some resistance.  I have to be careful because of my disability claim also, because I don’t want to raise any red flags like I have factitious disorder, or I am doc shopping or looking for something in particular.  Right now I am looking at possibly losing my disability benefits, my job, or both and may have to go back to work (which I feel i am in no condition to do yet but may not have a choice).

 

I have had numerous docs (GPs and psychiatrists) try to get me to switch drugs or add new ones and it no longer surprises me like it used to.  I am not super impressed with my new GP so far and may be finding another new one soon, but am giving him a chance.  I also will discuss the subclinical pancreatitis further with the gastroenterologist.  It seems like I have been having to switch doctors so often as of late so yes I am familiar with firing docs and it is getting tiring.  I have not been having very good luck finding competent doctors at all!

 

Yes what is going on with me is definitely serious... I feel if my sleep could improve somehow, even just a little, then other things would start falling into place.  I don’t see the weight and other issues and symptoms improving if I cannot even get a decent night’s sleep so my body can heal.  I actually feel like my brain functioning is progressively getting worse the longer I go being sleep deprived.  This is what has me the most concerned to the point of looking for devices that may help and supplements, etc.  I did some searching online, and a woman who says 2 years of barely sleeping almost killed her due to being poisoned by fluoroquinolones says she took Colvita Collagen and Colway Vitamin C supplements for a month and her sleep started coming back.  I have been very tempted to try this but am aftaid that simce I am still on meds that I may not benefit, or that I may react in an unpredictable way.  As you can see, I am really desperate to do anything to try to get sleep again.

 

I will keep you updated on what happens with my doctors. Thank you so much for being there for me and all of the advice you have given.  It really helps to have guidance during what has been the absolute most difficult time of my life, where I have felt like giving up so many times.

[Songbird]

On 1/10/2019 at 2:27 PM, LilBit said:

Has anyone heard of the SomniResonance SR1?  It's supposed to be a device a third of the size of a business card that you place strategically near your collarbone, and it sends an electromagnetic signal to your brain (a form of TMS) similar to the slow wave sleep pattern your brain follows when you go to sleep.

 

SomniResonance SR1 for Insomnia

 

I haven't seen this before, and it looks interesting, but very expensive.  While not the same technology, I've used Holosync, which is a kind of brainwave entrainment program using binaural beats,  which has helped me get to sleep (although that isn't primary purpose - it's designed as a meditation program).  You can pick up Holosync CDs 2nd hand on ebay fairly cheaply.  There are lots of other brainwave entrainment programs available (on YouTube, etc.), although I'm not sure I'd trust many of those, as potentially anyone can make a binaural beats program without necessarily knowing what they're doing.

 

See: Binaural beats and isochronic tones for depression anxiety and recovery

 

I've also used sleep hypnosis recordings when I've had severe insomnia.  The one that worked for me was called "Achieving Perfect Sleep" by Dr. Hilary Jones (I think this is also available on ebay).  There are many others available, but I haven't tried them so can't recommend any in particular.

 

See: Relaxation exercises, guided meditations, calming videos, sleep hypnosis

[LilBit]

Thank you very much for the information Songbird, will definitely have to check those out.  I have heard of binaural beats being beneficial before and it definitely couldn’t hurt anything.

 

I had a really bad headache when I woke up yesterday morning.  Rested in bed for a bit until it went away.  It was a pretty good day although I was a bit tired but my mood was much better.  We went to an outdoor flea market, had lunch and then met up with a friend of ours to watch a movie.  Overall I would say it was a good day.

 

Today on the other hand a completely different story.  I discovered this morning that my scale has not been accurately measuring doses... When I remove and place the small measuring plate on the scale, the weight would change by a hundredth of a gram.  This is horrifying because I am not sure how long this has been happening.  I am pretty sure that the doses of diazepam and quetiapine have been consistent, but this has definitely affected the Depakote dose by a small amount.  I am now wondering if these inconsistent doses have affected my symptoms, sleep, etc.  I am going to try to recalibrate the scale and see if this makes a difference.

 

 This morning, I also noticed I am apparently acting out my dreams now, I was in a halfway asleep state and I remember swinging my arm down, and upon waking I was also swinging the same arm.  My partner also told me at one point I hit him when I was sleeping.  Not hard but enough for him to notice.  Upon research I found this is called REM sleep behavior disorder, and could be a precursor to dementia or Parkinson’s Disease.  It is a fact that sleep deprivation can cause buildup of amyloid plaque in the brain, which can lead to dementia.   I’m not trying to catastrophize anything but this definitely has me concerned.  I am really trying to hang in there but it is becoming increasingly difficult.  I lately have been feeling so out of it like I am zombified and I hope this is not yet another thing I need to be worried about.

 

I just read Alto’s post on RBD associated with AD use, very interesting information.  I am not sure if everything I am experiencing are WD symptoms or because of severe sleep deprivation, but this is another new development.  I am also starting to feel slight nerve pain throughout my body now.

 

Antidepressants and REM sleep behavior disorder:isolated side effect or neurodegenerative signal?

 

 

[Altostrata]

Your psychiatrist does sound like she wants genuinely to be helpful, that's good. But you should not be afraid to ask her for anything. This may be your own stuff, you need to be more assertive now.

 

Have you found a source for the Myers cocktail? What about those pancreatic enzymes for potential subclinical pancreatitis?

 

Yes, I agree, reducing Depakote is a good idea. But both Depakote and Seroquel carry serious health risks.

 

My guess is that the 22.5mg Seroquel at night combined with diazepam may be causing a paradoxical reaction that interferes with your sleep. Reducing the Seroquel might help. So far, reducing Depakote has not improved your sleep.

 

In my opinion, a reduction to 20mg Seroquel is worth trying to improve sleep, with little risk of withdrawal symptoms. If the reduction helps sleep, so much the better, you can go back to reducing Depakote.

[Songbird]

9 hours ago, LilBit said:

Thank you very much for the information Songbird, will definitely have to check those out.  I have heard of binaural beats being beneficial before and it definitely couldn’t hurt anything.

 

I think it's fairly low risk, but if it does cause any adverse effects, stop using it, or at least take a break from it.

 

9 hours ago, LilBit said:

I discovered this morning that my scale has not been accurately measuring doses... When I remove and place the small measuring plate on the scale, the weight would change by a hundredth of a gram.  This is horrifying because I am not sure how long this has been happening.  I am pretty sure that the doses of diazepam and quetiapine have been consistent, but this has definitely affected the Depakote dose by a small amount.  I am now wondering if these inconsistent doses have affected my symptoms, sleep, etc.  I am going to try to recalibrate the scale and see if this makes a difference.

 

I've had similar issues when using scales, they can be frustrating!  New batteries might help.  Also make sure you use them on a stable surface, away from draughts, etc.

 

9 hours ago, LilBit said:

 I’m not trying to catastrophize anything but this definitely has me concerned.  I am really trying to hang in there but it is becoming increasingly difficult.  I lately have been feeling so out of it like I am zombified and I hope this is not yet another thing I need to be worried about.

 

No, it isn't.  You don't "need to be worried" about anything.  Worrying isn't preventative.  It doesn't help anything, all it does is make you feel bad.  Focus your attention instead on gentle self-care, and positive thoughts and actions.  You are in a difficult situation and need to look after yourself and be kind to yourself.

[Altostrata]

Of course you feel zombified. You're taking two anti-psychotics plus a benzo.

[Carley66]

Hi @LilBit

 

  I am new to this site but have been reading for a few months and I came across your thread and wanted to ask you: Have you had an 8am cortisol blood test? Your symptoms sound like they could be adrenal failure (addison’s Disease.) Just wanted to mention it in case that test hasn’t been done yet

[LilBit]

On 1/13/2019 at 4:33 PM, Altostrata said:

Your psychiatrist does sound like she wants genuinely to be helpful, that's good. But you should not be afraid to ask her for anything. This may be your own stuff, you need to be more assertive now.

 

Have you found a source for the Myers cocktail? What about those pancreatic enzymes for potential subclinical pancreatitis?

 

Yes, I agree, reducing Depakote is a good idea. But both Depakote and Seroquel carry serious health risks.

 

My guess is that the 22.5mg Seroquel at night combined with diazepam may be causing a paradoxical reaction that interferes with your sleep. Reducing the Seroquel might help. So far, reducing Depakote has not improved your sleep.

 

In my opinion, a reduction to 20mg Seroquel is worth trying to improve sleep, with little risk of withdrawal symptoms. If the reduction helps sleep, so much the better, you can go back to reducing Depakote.

 

Thanks for checking in Alto... I haven’t found a good source for the myers cocktail yet or the pancreatic enzymes.  I hope I can soon so I can see if those help. I reduced my dose to 20mg of the Seroquel 2 days ago so I am keeping my fingers crossed!  Last nightI did get a few hours sleep although I woke a couple of times but it did seem better, so I am hopeful.  I also am following up with my doctors.  I have been helping out at the office for a friend of mine the past 2 days and keeping my mind active instead of ruminating definitely seems to help.  You are right Songbird, thank you for that 🙂

 

 

[Altostrata]

That's good news about the Seroquel reduction. Perhaps tapering that is the way to go in the short term.

 

Integrative doctors and pharmacies may provide the Myers cocktail as well as pancreatic enzymes.

 

Darkening of the skin is a hallmark of Addison's, do you have this? If so, you might ask your doctors to check for that, too. See https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293

 

(Adverse drug effects on your organs seem more likely to me.)

[LilBit]

On 1/15/2019 at 1:15 PM, Altostrata said:

That's good news about the Seroquel reduction. Perhaps tapering that is the way to go in the short term.

 

Integrative doctors and pharmacies may provide the Myers cocktail as well as pancreatic enzymes.

 

Darkening of the skin is a hallmark of Addison's, do you have this? If so, you might ask your doctors to check for that, too. See https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293

 

(Adverse drug effects on your organs seem more likely to me.)

 

Last night was not so great, I didn’t get much sleep at all.  I haven’t noticed the darkening of the skin but I did mention Addisons to my endocrinologist just so we can rule it out.  I am with you on it being adverse drug reactions more than anything else.

[LilBit]

On 1/15/2019 at 12:18 PM, Carley66 said:

Hi @LilBit

 

  I am new to this site but have been reading for a few months and I came across your thread and wanted to ask you: Have you had an 8am cortisol blood test? Your symptoms sound like they could be adrenal failure (addison’s Disease.) Just wanted to mention it in case that test hasn’t been done yet

 

I did and that came back normal within range thankfully. 🙂 That’s what makes it so frustrating (and good) at the same

time—all labs come back normal as I continue to fall apart!

[Altostrata]

It will take at least 4 days for your system to fully register that reduction in Seroquel. Hang in there.

 

Seroquel comes in a liquid by prescription. It may be time for you to get it and gradually change from tablet to liquid. It's a lot easier to taper with a liquid.

[LilBit]

On 1/16/2019 at 9:26 PM, Altostrata said:

It will take at least 4 days for your system to fully register that reduction in Seroquel. Hang in there.

 

Seroquel comes in a liquid by prescription. It may be time for you to get it and gradually change from tablet to liquid. It's a lot easier to taper with a liquid.

 

I will have to look into that.  I followed up with my endocrinologist and he said they checked for Addison’s and I do not have that.  Also, my sleep has been absolutely horrible the past 3 nights.  I am giving the cpap a little longer before I ditch it I think, it doesn’t seem to be helping my sleep any.  My mind seems clearer in the sense that there is less brain fog, but I feel more tired and find myself doing small things like misspelling words, dropping things, and looking for things in the wrong places etc.  What I wouldn’t give for just ONE decent night sleep after 6 months!

 

The newest development is a pain in my lower abdomen/groin on one side that gets worse when I bend over or sit that started a few days ago.  I am just hoping it is a strained muscle and not a hernia or something.  

[Altostrata]

37 minutes ago, LilBit said:

The newest development is a pain in my lower abdomen/groin on one side that gets worse when I bend over or sit that started a few days ago.  I am just hoping it is a strained muscle and not a hernia or something.  

 

You need to let your gastoenterologist know first thing Monday.

[LilBit]

Jan 9

 

135.6 lbs (15.6% fat, 56.5% water, 23.1 BMI, 108 lbs muscle, 5.7 lbs bone)

 

2000 cal

 

7:15am  loose bm

8:20am  diarrhea

8:30am cereal and banana (600 cal)

8:30am  300mg Depakote

11:20am  grilled chicken sandwich (400 cal)

1:30pm  diarrhea

4:20pm chicken fajita pita with egg roll (500 cal)

5:20pm  Florastor 

6:00pm  palpitations

8:00pm  grilled chicken with rice and peas (500 cal)

10:00pm  22.5 Quetiapine, 2mg Diazepam 

12:00am  bedtime

Tried cpap again, wore for an hour and a half, tossed and turned, woke early, got a couple hours of sleep maybe.

 

 

Jan 10

 

Sleep seems to be getting worse, feel “high” like I can’t think or focus, extremely tired and yawning.  Got maybe an hour or 2 of sleep last night.  I am going to try to use the cpap consistently and see if I can get used to it for my sleep apnea.  If it is not possible I may have to look into other options.

 

135.2 lbs (15.5% fat, 56.8% water, 23.1 BMI, 108 lbs muscle, 5.7 lbs bone)

 

2600 cal

 

8:30am  diarrhea/loose bm

9:30am  300mg Depakote, Enteragam

10:00am  bowl of cereal and banana (600 cal)

1:30pm  grilled chicken caesar salad (600 cal)

1:45pm  Florastor

3:40pm  vanilla shake (800 cal)

6:30pm  mixed veggies (peas, carrots, spinach, celery, parsley) (200 cal)

7:40pm  chicken sandwich (400 cal)

9:30pm  22.5mg Quetiapine, 2mg Diazepam

11:00pm  bedtime, used cpap, got about 4 hours of sleep

 

 

Jan 11

 

135.5 lbs (15.5% fat, 56.9% water, 23.1 BMI, 108 lbs muscle, 5.7 lbs bone)

 

2000 cal

 

7:00am  small bm

8:00am  diarrhea

8:30am  Enteragam

9:30am  300mg Depakote

11:00am  Quinoa power bowl from Broken Egg Cafe (granola, blueberry with coconut crusted bananas, strawberries, coconut milk)(1200 cal)

12:40pm  palpitations

4:00pm  peanut butter with toast (300 cal)

7:30pm  spaghetti (500 cal)

9:30pm  22.5mg Seroquel, 2mg Diazepam 

11:30pm  bedtime, used cpap, woke twice, got about 4 hours sleep.

 

 

Jan 12

 

134.4 lbs (16.3% fat, 56.3% water, 23 BMI, 107 lbs muscle, 5.7 lbs bone)

 

2250 cal

 

Had a really bad headache when I woke up this morning.  Rested in bed for a bit until it went away.  Today was a pretty good day although I was a bit tired but my mood was much better.  We went to an outdoor flea market, had lunch and then met up with a friend of ours to watch a movie.  Overall it was a good day.

 

8:30am  small loose bm

9:30am  300mg Depakote, Enteragam

10:00am  2 sausage and cheese kolaches with apple juice (770 cal)

3:00pm  Fuddruckers veggie burger with vanilla shake (1060 cal)

8:30pm  spinach veggie wrap with fruit cup (420 cal)

10:00pm 22.5mg Quetiapine, 2mg diazepam 

11:00pm bedtime

Fell asleep around 11:30 before putting cpap mask on, woke up around 2, put it on and went back to bed, woke 3 times and got another 2 hours of sleep for a total of about 4 1/2 hours.  Woke very tired next morning.

 

 

Jan 13

 

135 lbs (16.4% fat, 56.4% water, 23.1 BMI, 107.6 lbs muscle, 5.7 lbs bone)

 

1390 cal

 

I discovered this morning that my scale has not been accurately measuring doses... When I remove and place the small measuring plate on the scale, the weight would change by a hundredth of a gram.  This is horrifying because I am not sure how long this has been happening.  I am pretty sure that the doses of diazepam and quetiapine have been pretty consistent, but this has definitely affected the Depakote dose by a small amount.  I am now wondering if these inconsistent doses have affected my symptoms, sleep, etc.  This morning, I also noticed I am acting out my dreams now, and upon research I found this could be a precursor to dementia or Parkinson’s Disease.  It is a fact that sleep deprivation can cause buildup of amyloid plaque in the brain, which can lead to dementia.   I’m not trying to catastrophize anything but this definitely has me concerned.

 

Brain fog all day today

8:00am  small soft bm

9:30am  300mg Depakote, Enteragam

10:00am  double smoked bacon and egg sandwich (490 cal)

2:30pm  rice with corn, green beans and squash (500 cal)

6:00pm  blueberry muffins (400 cal)

6:30pm  crying, severe brain fog, can’t think or focus, hopelessness 

8:00pm  rice and beans with broccoli (500 cal)

9:45pm  20mg Seroquel, 2mg diazepam

11:00pm bedtime

Wore cpap for 2 hours, woke 4 times, got about 4 hours of sleep

 

Jan 14

 

135.6 lbs (15.4% fat, 56.9% water, 23.1 BMI, 108.2 lbs muscle, 5.7 lbs bone)

 

Today, particularly this evening, I noticed a pain in my lower right abdomen near my groin/bladder area.  Not sure if it is from the manual labor I did on Sunday (we were doing landscape work, picking up branches and tree limbs) or something else.

 

1800 cal

 

7:00am  regular bm

7:45am  Enteragam

8:00am  bowl of cereal (460 cal)

9:20am  300mg Depakote 

9:30am  diarrhea

9:45am  dull pain left and right side of abdomen

10:30am  banana (100 cal)

2:50pm  chicken cordon bleu sandwich (620 cal)

4:00pm  brain fog

8:30pm  general tso chicken with rice and broccoli (620 cal)

10:00pm  20mg Seroquel, 2mg diazepam 

10:45pm  bedtime

I have been using the cpap when I go to bed, this time I took it off around 3:30am but don’t remember doing that.  I got about 5 hours of sleep.

 

 

Jan 15

 

135.4 lbs (15.5% fat, 56.8% water, 23.1 BMI, 108.2 lbs muscle, 5.7 lbs bone)

 

The pain in that same abdominal area continues this morning, seems to be more pronounced when I bend over.  The good news is that I actually slept last night I think! I feel a little more rested this morning, still tired but I know it is going to take some time for that to improve.  I am remaining hopeful that things will eventually turn around for the better.

 

1820 cal

 

7:00am  small bm/pebbles (constipated?)

8:00am  bowl of cereal (600 cal)

8:00am  Enteragam

10:40am  apple juice (110 cal)

11:30am  banana (100 cal)

11:30am  300mg Depakote

2:00pm  grilled chicken with rice, mashed potatoes, wheat roll and cucumber salad (800 cal)

2:20pm  florastor

2:30pm  brain fog / cog fog

4:20pm  banana (100 cal)

7:00pm  apple juice (110 cal)

9:40pm  20mg Seroquel, 2mg diazepam

11:00pm bedtime

Kept cpap on for about an hour and a half, could not sleep, got maybe 1-2 hours of interrupted sleep.

 

 

Jan 16

 

136 lbs (15.2% fat, 57% water, 23.2 BMI, 108.5 lbs muscle, 5.7 lbs bone)

 

2125 cal

 

6:40am  diarrhea

8:00am  bowl of cereal (500 cal)

10:00am  brain fog

11:40am  Enteragam

11:50am  Banana (100 cal)

1:45pm  black bean burger with chips (500 cal)

5:30pm  cookies (225 cal)

6:45pm  tilapia with rice and broccoli (800 cal)

7:00pm  Florastor

7:30pm  brain fog

9:30pm  20mg Seroquel, 2mg diazepam

11:00pm  Bedtime, got 4 hours of broken sleep

 

 

Jan 17

 

135.6 lbs (16.3% fat, 56.3% water, 23.1 BMI, 107.6 lbs muscle, 5.7 lbs bone)

 

2640 cal

 

I had to fast this morning to do labs for my endocrinologist.  I am also doing labs for my infectious disease doctor this morning.  I slept last night, but kept waking and got probably about 4 hours of sleep.  I kept the cpap mask on all night.  I’m pretty tired from not sleeping and my body is a bit sore but otherwise doing ok.  Today I have actually been in a better mood than I have in quite awhile, at least as of the time I am writing this (5pm). 🙂 We went shopping at the mall and did a lot of walking and I felt ok.

 

6:30am  loose bm/diarrhea 

9:50am  300mg Depakote 

10:20am  2 egg and potato taquitos (800 cal)

1:30pm  La Madeleine cream mushroom chicken with rice and broccoli with lentil and kale soup (750 cal)

3:00pm  chocolate chip cookie (80 cal)

4:00pm  apple juice (110 cal)

5:00pm  banana (100 cal)

7:30pm  Southwest Eggrolls (800 cal)

9:40pm  20mg Seroquel, 2mg diazepam

11:40pm bedtime, got 3 hours of sleep

 

 

Jan 18

 

I am so tired today and feel terrible, got maybe 3 hours of broken sleep last night. I was not able to get comfortable and got up in middle of the night to pee.  I am having a difficult time focusing and thinking today, much different than I felt yesterday.

 

135.4 lbs (16.1% fat, 56.5% water, 23.1 BMI, 107.8 lbs muscle, 5.7 lbs bone)

 

2330 cal

 

7:00am  soft bm

9:30am  Enteragam, 300mg Depakote

9:45am  bowl of cheerios (450 cal)

12:00pm  apple juice (110 cal)

1:40pm  chicken lettuce wraps from Pei Wei (670 cal)

4:45pm  sliced pears (160 cal)

8:00pm  grilled bbq chicken salad (940 cal)

8:20pm  Florastor

9:40pm  20mg Seroquel, 2mg Diazepam

11:00pm  bedtime (after listening to binaural beats audio about 30 min before going to bed), got about 3-4 hours of restless sleep

 

 

Jan 19

 

134.4 lbs (16% fat, 56.5% water, 22.9 BMI, 107.1 lbs muscle, 5.7 lbs bone)

 

1850 cal

 

9:00am  300mg Depakote

11:00am  bowl of cereal (500 cal)

2:00pm  grilled chicken sandwich (600 cal)

6:00pm  pain in lower abdomen (worse when sitting)

7:00pm  palpitations

8:00pm  fresh veggie sandwich (500 cal)

8:30pm  nerve pain in various places in body

9:00pm  large avocado (250 cal)

9:45pm  20mg Seroquel, 2mg diazepam

11:30pm bedtime, tried listening to binaural beats audio before going to bed

 

Used the cpap, forgot to set alarm... not sure how well I slept but remember tossing and turning and having a hard time getting comfortable.  Whenever I tried to lay on my side the mask would leak.  Woke up feeling tired around 5:15am.  Tried to go back to sleep but couldn’t so eventually got up around 7.  I probably got 3-4 hours of sleep.

 

[LilBit]

This morning upon getting up I felt very tense, agitated like I have had caffeine, and restless/anxious. Intense brain fog is also back.  I was thinking it was the morning cortisol spike but it is lasting well into mid morning and usually I feel better by now whenever this happens.  My first thought was please not let this be akathisia... but trying to remain calm and accept what is happening.  My mom called me this morning talking about how she is really stressed and had to take an “anxiety pill” because their car is having problems again.  She is on disability and he doesn’t make very much so her and her husband turn to me and my partner every time they have a problem, which really isn’t helping matters.

[Altostrata]

Did you phone your gastroenterologist today about the abdominal pain? This is important.

 

It doesn't seem to me that the Seroquel reduction changed anything. Do you want to go back to tapering Depakote? You might reduce it by 25mg.

[LilBit]

Lost another pound today after gaining 2 back.  Feel tired but maybe a little less tired than yesterday.  I actually had a pretty good day today for a change!  I ran some errands in the morning and then a friend of mine came to visit.  We had lunch at ihop, took my pups to the vet and then did some browsing at Goodwill.  I found a $120 paper shredder for $18... not too bad 🙂  I was feeling a little tired in the afternoon and needed a pick me up, so I got myself a vanilla shake.  Figured at this point it couldn’t hurt anything but I don’t make it a habit.

 

I am trying to stay active and positive even though sometimes it is difficult, but it’s the times when I feel ok that make it worth it.  My primary care doc wants me to have an ultrasound of the abdomen for the pain I am having but I had one of those already.  Not sure if I should schedule an appointment with him or talk to my gastroenterologist first.  I did leave a message with the GI doc so waiting for a call back, will try him again tomorrow.

 

I think tapering the Depakote is a good idea. I have noticed improvements since I have been lowering the dose and I am most afraid of adverse effects from that drug at the moment.

[LilBit]

I hate this.  Yesterday and today I can't think, I am super emotional and want to cry, and my cognitive skills are crap.  I am misspelling words, dropping things, looking in the wrong places for things, unable to communicate properly and feel like I am in a constant fog.   I know there are windows and waves in recovery, but I feel like my symptoms are worsening.  I am genuinely concerned that if my sleep does not start improving at least a little bit soon, that I may be reaching a point of no return.  When I used to look in the mirror, I saw a young man full of hope, pride, energy and intelligence with healthy looking skin and muscle tone...  Now I see an unhealthy, aged, tired, weak, emaciated looking person who is barely getting through day to day.   Thank you psychiatry!  The chronic sleep deprivation is damaging me more than anything I think and is really driving me crazy.

[Altostrata]

You are taking two antipsychotic drugs and a benzo. Any of these drugs alone can cause foggy brain. Why are you waiting to reduce Depakote?

 

You must have that pain examined. You might have had an ultrasound before but something new might have cropped up. Please move forward with getting someone to look at it ASAP.

 

Why can't you have a vanilla milkshake every day, or two, or three?

[LilBit]

5 minutes ago, Altostrata said:

You are taking two antipsychotic drugs and a benzo. Any of these drugs alone can cause foggy brain. Why are you waiting to reduce Depakote?

 

You must have that pain examined. You might have had an ultrasound before but something new might have cropped up. Please move forward with getting someone to look at it ASAP.

 

Why can't you have a vanilla milkshake every day, or two, or three?

 

I actually did take your advice and reduced the Depakote to 275mg a couple of days ago.  My GP wants me to get another ultrasound and my gastroenterologist hasn't responded yet, now cost is an issue with that since I just found out I will have to either sign up for COBRA or change insurance now that I am on LTD.  I have very little money left because almost all of it has been going to health related expenses since June.

 

Oh, and I have been treating myself to milkshakes, you don't have to worry about that!  😋

[Altostrata]

If I were you, I'd sign up for COBRA, if it's a good plan.

 

Are you eligible for your company's disability insurance or state disability?

 

I would push those doctors along, get someone to see you ASAP.

 

Are you taking 275mg Depakote now? The reduction could be the reason you feel a bit foggy, tapering Depakote is starting to cause some mild withdrawal symptoms.

 

We should stick to 25mg cuts for a while, probably not more often than every week or 10 days.

[LilBit]

I may do that, I am just afraid of how expensive COBRA is going to be to keep my current level of benefits, I might have to change and look for something in the marketplace if that's an option.  I was receiving short term disability benefits and was just approved for long term disability thank goodness. 

 

What's weird is for the longest I was feeling foggy and then when we started reducing Depakote that seemed to go away over the past month, and now it is back with a vengeance and even worse than before, with the increase in cognitive decline.  I am catatonic sometimes, just staring off into space.  

 

That sounds like a good taper plan for the Depakote.

[LilBit]

I really hate this.  Cognitive decline getting worse and worse to the point that my brain is mush and people asking me if I am okay because I look catatonic.  I can barely think and have no doubt it is not just the meds I am on because I have been on them since August, but because of severe sleep deprivation.  I feel like it is progressively getting worse.  Been getting anywhere from 1-3 hours of sleep here lately, 4 if lucky and it is never continuous.  Last couple of nights I’ve gotten a couple hours of broken sleep.  We just moved back to the part of town we used to live in which is a good thing (more quiet, bigger place, actually have a washer and dryer, closer to friends) so hoping that helps.  Not sure how I am going to keep going like this.

[LilBit]

Jan 20

 

134.6 lbs (16.3% fat, 56.4% water, 23.0 BMI, 107.4 lbs muscle, 5.7 lbs bone)

 

This morning upon getting up I felt very tense, agitated like I have had caffeine, and restless/anxious. Intense brain fog is also back.  I was thinking it was the morning cortisol spike but it is lasting well into mid morning and usually I feel better by now whenever this happens.  My first thought was please not let this be akathisia... but trying to remain calm and accept what is happening.  My mom called me this morning talking about how she is really stressed and had to take an “anxiety pill” because their car is having problems again.  It turned out just to be the radiator cap!  She is on disability and he doesn’t make very much so her and her husband turn to me and my partner every time they have a problem, which doesn’t really help matters.

 

2050 cal

 

8:00am  loose bm

10:00am  300mg Depakote

10:45am  Enteragam

11:30am  bowl of oatmeal (480 cal)

1:30pm  grilled chicken sandwich (300 cal)

3:40pm  vanilla shake (670 cal)

8:00pm  egg sandwich with avocado (600 cal)

9:30pm  20mg Seroquel, 2mg diazepam

11:30pm  bedtime 

Got a new memory foam pillow to see if this helps with sleep.  Decided I would try sleeping without the cpap machine tonight to see if I sleep better.  Took me a little while to fall asleep and then woke up around 5am so I think I got at least 4 hours of sleep.   Tonight I will try to remember to set my alarm so my app tracks my sleep and I can get a better idea of how my sleep has been, for some reason I’ve been forgetting the past couple of nights.

 

 

Jan 21

 

133.4 lbs (15.2% fat, 56.9% water, 22.8 BMI,  106.9 lbs muscle, 5.7 lbs bone)

 

1970 cal

 

Lost another pound today after gaining 2 back.  Feel tired but maybe a little less tired than yesterday.  I actually had a pretty good day today for a change!  I ran some errands in the morning and then Rory came to visit.  We had lunch at ihop, took my pups to the vet and then did some browsing at Goodwill.  I found a $120 paper shredder for $18... not too bad 🙂  I was feeling a little tired in the afternoon and needed a pick me up, so I got myself a vanilla shake.  Figured at this point it couldn’t hurt anything but I don’t make it a habit.

 

I am trying to stay active and positive even though sometimes it is difficult, but it’s the times when I feel ok that make it worth it.  My primary care doc wants me to have an ultrasound of the abdomen for the pain I am having but I had one of those already.  Not sure if I should schedule an appointment with him or talk to my gastroenterologist first.  I did leave a message with the GI doc so waiting for a call back, will try him again tomorrow.

 

I think tapering the Depakote is a good idea. I have noticed improvements since I have been lowering the dose and I am most afraid of adverse effects from that drug at the moment.

 

8:40am  soft/loose floating bm

9:40am  300mg Depakote

10:00am  bowl of cereal and banana (500 cal)

1:00pm  turkey bacon swiss sandwich with fruit cup (800 cal)

2:00pm  nausea

4:00pm  brain fog

6:00pm  vanilla shake (670 cal)

7:30pm  roast beef with rice, green beans and mac n cheese (600 cal)

10:30pm  20mg Seroquel, 2mg diazepam 

11:30pm bedtime

 

 

Jan 22

 

134.6 lbs (15.9% fat, 56.6% water, 23 BMI, 107.4 lbs muscle, 5.7 lbs bone)

 

2100 cal

 

8:30am  soft floating bm

10:00am  heavy brain fog, tiredness

10:30am  275mg Depakote, Enteragam

11:00am  bowl of cereal (400 cal)

12:40pm  banana and apple juice (200 cal) 

3:00pm  grilled chicken sandwich (400 cal)

6:00pm  protein shake (650 cal)

8:00pm  beef chimichanga (450 cal)

9:00pm  20mg seroquel, 2mg diazepam

 

 

Jan 23

 

134.4 lbs (16% fat, 56.5% water, 23 BMI, 107.1 lbs muscle, 5.7 lbs bone)

 

2350 cal

 

7:00am  small soft bm

8:00am  Enteragam

9:15am  275mg Depakote

10:15am  Oatmeal and banana (300 cal)

10:30am  diarrhea 

11:00am  Apple juice (130 cal)

2:40pm  chicken sandwich and fries (840 cal)

3:20pm  palpitations 

7:00pm  vanilla shake (630 cal)

8:00pm  rice and peas (450 cal)

9:40pm  20mg seroquel, 2mg diazepam

11:00pm  bedtime

Got 3-4 hours of sleep.  Woke a few times, pillow was uncomfortable so trying a new one.  Also am going to try to get to bed earlier starting tomorrow.

 

 

Jan 24

 

134 lbs (17.2% fat,55.9% water, 22.9 BMI, 105.2 lbs muscle, 5.5 lbs bone)

 

2120 cal

 

8:00am Sausage egg and cheese mcmuffin (480 cal)

9:15am  275mg Depakote

11:30am  banana and apple juice (240 cal)

2:30pm  6 inch tuna sandwich with veggies and baked chips (620 cal)

3:30pm  brain fog

5:15pm  banana and apple juice (240 cal)

7:30pm  chicken with rice and brussels sprouts (550 cal)

9:45pm  20mg Seroquel, 2mg diazepam

11:30pm bedtime

Got about 3 1/2 hours of fragmented sleep

 

 

Jan 25

 

134.4 lbs (16.3% fat, 56.3% water, 23 BMI, 107.1 lbs muscle, 5.7 lbs bone)

 

2170 cal

 

9:00am  diarrhea

9:30am  275mg Depakote

10:30am  Enteragam

10:00am  tired, brain fog

1:30pm chicken sandwich with vanilla shake (1060 cal)

2:45pm  gas

5:00pm  banana and apple juice (240 cal)

8:08pm  rotisserie chicken spinach wrap with chips (870 cal)

 

 

Jan 26

 

134.2 lbs (14.7% fat, 57.2% water, 22.9 BMI, 108.9 lbs muscle, 5.7 lbs bone)

 

2100 cal

 

8:30am  diarrhea

9:40am  275mg Depakote 

11:30am  bowl of cereal (450 cal)

1:00pm  brain fog/DP/DR - lasted a few hours

2:00pm  turkey sandwich with lettuce, tomato & guacamole (520 cal)

5:30pm  vanilla shake (630 cal)

7:30pm  burger with arugula, mushrooms (500 cal)

10:30pm  20mg Seroquel, 2mg diazepam

11:30pm  bedtime

Got 2-3 hours broken sleep.