Giulietta

[Giulietta]

1 hour ago, Gridley said:

This seems to be a good conservative approach.  

 

I feel comfortable with .4 mg, which you had suggested. Thank you.

 

What a relief to have made this decision made. I feel like an anvil has been lifted from my shoulders.

 

• Plan A: Compounding pharmacy (new one!) will repackage beads into .2 mg (1 bead) capsules. I will take 2 capsules a day for the .4 mg - and have extra .2 mg capsules on hand  if I need to increase.
  
  Tomorrow I will confirm and get pricing (gulp) to weigh and repackage beads. Pharmacist will be in tomorrow. 
   
• Plan B: Pharmacy will not compound beads and I have to do this. But I'm hoping for A.

I am elated.

 

[Giulietta]

October 21  Log 

 

4 a.m. Awakened - fell asleep without trouble

6.45 a.m. Awakened
7 a.m. Breakfasted and meds (dulox liquid, gaba 300 mg, clonaz .5 mg, crestor 10 mg, lisinipril 2.5 mg) + calcium/magnesium + fish oil
11.00 a.m. Stomach is upset
12.30 p.m. . Ate lunch
2 p.m. Gabapentin 300 mg and dulox
4 p.m. Anxiety
6 p.m. Ate dinner. Took 600 lamotrigine ER
9:20 p.m. Headache
10:00 p.m. Fell aslelep -
4.30 a.m Awakened with tremors, anxiety and chills but got back to an uneasy sleep (this starts 10/22)
 

[Erell]

Big hugs To you 😚

[Giulietta]

Thank you, Erell. Will check your post shortly. Hope you have had a nice day in lovely Brittany. 💗

 

 

[Giulietta]

On 10/21/2019 at 12:33 PM, Gridley said:

This seems to be a good conservative approach.  

 

Hello Gridley

 

I hope everything is going well with you.

 

I contacted the compounding pharmacy today for pricing. I can't afford them to do this so will have to count beads myself. The price estimate jumped from $150 last month to $400+ this month.

 

Given the finger motor skills deficit and tremor - I am not particularly confident about putting beads in a capsule, especially after previous failed attempts.

 

I am thinking of doing applesauce per Lilly research paper but I don't now if SA advises this or not.

 

Thanks,

Giulietta

 

p.s.

On a related note - this pharmacy  will be compounding duloxetine from powder for another person (their first attempt). They offered this to me and I declined.  I advised that this other customer  do  beads and 10% a month drop - not 5mg. 

 

[Gridley]

1 hour ago, Guilietta said:

I am not particularly confident about putting beads in a capsule, especially after previous failed attempts.

Is there someone who could help you with this, or if not, even someone you could hire?

 

If not, I see nothing wrong with the applesauce.  

 

 

[Giulietta]

Hi Gridley

 

I will try the capsule approach again - I found a link on youtube, which may be doable. It is done by a member of FB's group, Cymbalta Hurts Worse. https://www.youtube.com/watch?v=a4Gd_GBO-Ec

 

I can I think pull the capsule apart using tweezers if I can keep my left fingers quiet.

 

It looks like I may be able to flatten the capsule to keep it from moving (so I don't need to use tweezers?) to push the beads in.

 

36 minutes ago, Gridley said:

If not, I see nothing wrong with the applesauce

 

Good to know.

 

Also - question please.  I posted something I wish I hadn't - and don't know how the lines may be struck through or post invalidated. My only other option is to quote myself and indicate NOT to use this pharmacy OR have your cymbalta compounded into a liquid (which is already stated by Alto).

 

I posted this before I knew that this method was essentially destroying all of the drug before aborption.

 

On 7/28/2019 at 1:49 PM, Guilietta said:

A compounding pharmacy located in Worcester, MA (and ships to many US states) compounds duloxetine into an oil based suspension, which I take with an oral syringe. My insurance does not cover compounded prescriptions so I pay out of pocket. The approximate cost for 12 oz of duloxetine prescription written as 15 ml/5 mg (I was starting from 20 mg), is about $135 (I think).  Since duloxetine liquid must be kept at room temperature - consider that if you have this shipped.  Their website: https://boulevardcompounding.com/.

 

I am so grateful to have found these folks. I've had a lot of bumps with my taper along the way and they've been patient with my questions about dosage calculations, etc.

 

Currently on 9.75 mg as of this morning. Duloxetine journey - been on this toxin for about 5 years - was up to 60 mg and then down to 20 mg. Started tapering in December 2018 from 20 mg.

 

 

 

https://www.survivingantidepressants.org/topic/283-tips-for-tapering-off-cymbalta-duloxetine/page/4/?tab=comments#comment-440135

 

Thanks,

Giuilietta

[Gridley]

4 minutes ago, Guilietta said:

My only other option is to quote myself

I would quote myself then say the price has gone up to $400 and you won't be using this pharmacy.  It wouldn't hurt to repeat the info about not using liquid.

[Giulietta]

Thank you. Excellent idea about adding price increase.

[Rhiannon]

Hello G! Sounds like you're soon going to take the leap to the beads. You've been very sensible about all of this I think, and following Gridley's excellent suggestion to keep track of your daily diary of symptoms for a few days before you make the change. Have you picked the day when you're going to take your first two beads yet? 

 

I think this seems like a really good, conservative approach, given your circumstances. You can always go up or down a little if you decide you need to, and you have lots of support here for making those decisions.

 

Holding your hand as you jump into this new adventure!

 

Rhiannon

 

 

[Giulietta]

2 hours ago, Rhiannon said:

Have you picked the day when you're going to take your first two beads yet? 

 

Hello Rhiannon,

 

I keep moving the date forward - but latest it will be is Saturday. Maybe tomorrow.

 

After ruling out a compounding pharmacy due to $$$ - I found a youtube video method yesterday afternoon, which I hope to be successful with.

 

I posted a link about cymbalta "Occupancy of Norepinephrine Transporter by Duloxetine in Human Brains Measured by Positron Emission Tomography with (S,S)-[18F]FMeNER-D2". I found this today. (Aug 2017)

 

 Study sample n=8. "The results showed approximately 30% to 40% NET occupancies in the brain by the administration of 20 to 60mg of duloxetine." Note: in one of their tables a dosage of 20 mg with plasma concentration of 4.1 ng/ml = 30.2% NET Occupancy. WOW!!!

 

My lab finding was <0-5 ng/ml and dose we estimate could be in the vicinity of .4 mg.

 

Hope you are well and thanks for stopping by. 🤗

 

[Giulietta]

Hello Gridley @Gridley

 

I meant to tag you in this as well...thought you might find this of interest as I was trying to equate dosage with lab value (and SERT). It is in the SA page on SERT.

 

 

 

On 10/24/2019 at 2:43 PM, Guilietta said:

 

Hello Rhiannon,

 

I keep moving the date forward - but latest it will be is Saturday. Maybe tomorrow.

 

After ruling out a compounding pharmacy due to $$$ - I found a youtube video method yesterday afternoon, which I hope to be successful with.

 

I posted a link about cymbalta "Occupancy of Norepinephrine Transporter by Duloxetine in Human Brains Measured by Positron Emission Tomography with (S,S)-[18F]FMeNER-D2". I found this today. (Aug 2017)

 

 Study sample n=8. "The results showed approximately 30% to 40% NET occupancies in the brain by the administration of 20 to 60mg of duloxetine." Note: in one of their tables a dosage of 20 mg with plasma concentration of 4.1 ng/ml = 30.2% NET Occupancy. WOW!!!

 

My lab finding was <0-5 ng/ml and dose we estimate could be in the vicinity of .4 mg.

 

Hope you are well and thanks for stopping by. 🤗

 

 

 

[Giulietta]

October 20

3.00 a.m Awakened with anxiety but got back to sleep

6.45 a.m. Got up
7 a.m. Breakfasted and meds (dulox liquid, gaba 300 mg, clonaz .5 mg, crestor 10 mg, lisinopril 2.5 mg) & supplements

12 Ate lunch.  Took gabapentin 300 mg and dulox liquid

4 p.m.- 4.20 p.m.  Blurry vision. Unable to read text or see in distance. High anxiety, fluttering in chest, unable to focus/quiet mind, elevated repiratory rate

6 p.m. Ate dinner. Took 600 lamotrigine ER

7 p.m. Tinnitus most of the evening
9 p.m. Took gabapentin 400 mg & clonazepam 1.5 mg
10:00 p.m. Fell asleep

 

October 22  Log

4.30 a.m Awakened with tremors, anxiety and chills but got back to an uneasy sleep

6.45 a.m. Got up  with sharp pain in L ear (TMJ?)
7 a.m. Breakfasted and meds (dulox liquid, gaba 300 mg, clonaz .5 mg, crestor 10 mg, lisinopril 2.5 mg) & supplements

10.30 a.m. Auras
12.30 p.m. Ate lunch
2 p.m. Took gabapentin 300 mg and dulox liquid
6 p.m. Ate dinner. Took 600 lamotrigine ER

7 p.m. Tinnitus most of the evening
9 p.m. Took gabapentin 400 mg & clonazepam 1.5 mg
10:00 p.m. Fell asleep

 

October 23  Log 

4.00 a.m Awakened feeling hot, perspiration (cortisol spike?) but got back to an uneasy sleep

6 a.m. Awaken again; Sharp pain in L ear (TMJ?)
7 a.m. Breakfasted and meds (dulox liquid, gaba 300 mg, clonaz .5 mg, crestor 10 mg, lisinopril 2.5 mg) & supplements
12.30 p.m. Ate lunch
1 p.m. Took gabapentin 300 mg and dulox

2.30 p.m. Took duloxetine liquid

3.30 p.m. Anxiety
6 p.m. Ate dinner. Took 600 lamotrigine ER

7 p.m. Tinnitus throughout evening

7.30 p.m. Start medidation/relaxation exercises. Sort of fell asleep at 8.30. Awaken around 10.
10 p.m. Took gabapentin 400 mg & clonazepam 1.5 mg
10:00 p.m. Fell asleep
 

October 24 - lousy day - emotional roller coaster

4 a.m. Awaken with tinnitus. Bad leg cramp. Restless sleep until up at..

5.45 a.m. Get up. Leg still sore.

7 a.m. Breakfasted and meds (dulox liquid, gaba 300 mg, clonaz .5 mg, crestor 10 mg, lisinopril 2.5 mg) & supplements

7 a.m. Anehedonia and fatigue. Dizziness. Changed plans not to go out.

8.15 a.m. Pushed myself to walk on the treadmill.

10 a.m. Anhedonia lingering.

10 a.m. Snack with sugar and decaf. No improvement.

11.30 a.m. - Despair and anger and sad. Self-loathing for bad decisions in life that brought me to current situation. Asking self, Why am I here? How did I get here in life (not just AD but life but personal situation).  This lingered throughout the entire day.

12 lunch

1 gabapentin

2.30 dulox liquid

4.00 Anhedonia and emotions some relief

6 dinner and lamotrigine

7 tinnitis – rest of evening.

9 evening meds

10p.m.  bed

 

[sunnysideup69]

Good morning Guilietta, came to your thread to say hello and to answer your questions and to share.

 

Well, I won't run today. My usual schedule is jog 5k twice per week. Illness/WD has prohibited that over the last two weeks, and I've really missed it, but have walked instead.

 

I was taking Magnesium Citrate 150mg in the mornings, and also having an epsom salts bath every day, PLUS eating a lot of cashew nuts, so I think I've been getting magnesium overload. It only started to show itself last week; suddenly got dyspepsia, bloating, needing to move bowels more often (too many times in one day, 5 or 6!) And then stomach cramps.

I also realised I wasn't very systematic about introducing  supplements. So. I'm holding them all for a few days. Will have some magnesium in the bath every other day. Will wait some days and reintro 1 capsule fish oil.

 

 

How are you doing this morning?........although not morning for you, it's 830am here in London as I type and is a blustery Autumnal day. Tonight the clocks go back an hour, and so as from tomorrow, we will have early darkness in the evenings.I'm quite looking forward to it. It makes me feel cocooned and safe. Are you tapering at the moment?

[Giulietta]

@Gridley@brassmonkey Need your advice please on beads....

 

Hi Gridley and BrassMonkey

 

Today is to be my first day of taking beads (.4 mg - what is 2 beads)!  I am stuck because while I calculated an average of 100 beads per capsule in December - when 5% of an average 100 beads had less of an impact. However - now that I am down to 2 beads (.4 mg) of 100 beads  - what impact does this have on my daily dose?

 

If (likely with) the amount of beads varying from capsule to capsule - even from 100 to 105 to 108 (hypotehtically speaking) - would the difference of a single bead be significant?  (I would think that my daily dose could vary from .4 mg to .6 to .8. in such an instance). 😕

 

What do I do? 🤔

 

Thanks

 

Giuilietta

 

p.s. The SERT occupancy for cymbalta is about 30% for cymbalta at (<0-5 ng/ml). 

 

 

 

[Gridley]

1 hour ago, Guilietta said:

would the difference of a single bead be significant? 

Brassmonkey would be more knowledgable on this but my thinking is that because so much of each bead is filler, not active ingredient, it's not going to make any difference.  You're going to have some variance but it, in my opinion, will not be significant.

[Giulietta]

7 minutes ago, Gridley said:

because so much of each bead is filler, not active ingredient, it's not going to make any difference.

 

Brilliant.    I will await @brassmonkey comments

 

So  I could potentially get 50 days out of capsule.

[brassmonkey]

Hi Guilietta-- Gridley knows more than he lets on. Yes there will be some variation between the beads but it will be so small that it should not make a difference in your dose. 

 

The slight differences in size of the beads is something we are stuck having to work with.  It all comes down to the manufacturing process and the concept of manufacturing tolerance.  This is the amount that you can be off but still have a good product. The brand name drug manufactures do a very good job of keeping thing as accurate as possible, but there is going to be a small variety in the weight of each bead and because the capsules are manufactured by weight and not by strength the number of beads can be slightly different.  Each bead is meant to contain a specific amount of active ingredient for a specific weight of bead, the rest is filler.  When you look at just how small 1mg of a bead is, it is really quite amazing that they can make thousands of them a minute and keep them so accurate.

 

When we get to the last doses of a taper things always get tricky.  Using a liquid is the only taper method that can maintain accuracy at this level. For all the other methods we are stuck with the accuracy of the scales or the number of beads.  All the idea of doing a 10% taper goes out the window and we have to do the best we can with what we have.  Two reductions ago you would have done a 25% cut, last time was 33% and your next one will be 50% and the following 100% as you stop taking the beads all together.  This is where it is really important to listen to your body, take your time and roll with what happens. If all goes well there shouldn't be any increase in symptoms, but if you've been sensitive to changes in the past there might be a increase in symptoms and a longer hold at each level is called for.

 

The SERT occupancy has more to do with blood serum levels than with day to day dose levels.  Depending on the medication used it can take from four day to several weeks for the drug to come to a steady state concentration in the blood. That would be the (<0-5 ng/ml) that you mentioned.  So the slight variations in the strength of a daily dose won't have any real effect on the concentration.  This is why we tell people to wait at least four days after making a change to decide if anything is happening.

 

The drug receptors in the body don't turn on and off like light switches.  When the blood serum concentration reaches a certain level they don't just start or stop functioning.  Rather the body adjusts to the new level of drug by slowly turning them on or off as needed to maintain an optimum level of neurotransmitters.  The presence of the drug has in fact caused the "chemical imbalance" that many doctors are so blame for psychological problems and the body has to sort it all out and try to reach a balance referred to as homeostasis.  The correct balance to make the body function properly. 

 

When a receptor hasn't been used for a while it starts to lose it functionality and has to be repaired or healed before it can start working again.  This healing happens during the hold periods of a taper and its completion is signaled by the decrease of symptoms as the hold progresses.  All of this can take a lot of time, from weeks to months.  All this is to say that the small differences in the dose strength of a single bead that may be a little bigger or smaller than the rest isn't going to make a lot of difference.

[Rosetta]

Guilietta, Hi.  Good luck with your beads.  I'm betting you won't notice any difference.  Don't forget that this syndrome has us up and down so much anyway.  It will might take a few weeks for you to gauge whether the change has had an affect.  What I'm saying is don't panic if one day is pretty yucky.  Keep good notes.  It's how you feel over time -- big picture with hindsight that tells you if there was a significant change.  Not one day or one week.  So don't be scared and don't read too much into any one day or week.  I hope you track your cycle, too.  That helps me keep perspective.  I can avoid panic if I keep an eye on the calendar.  You may not feel anything from this change, but you may think you do.  I'll be thinking of you, R

[Giulietta]

Hello Brassmonkey @brassmonkey and Gridley @Gridley

 

Thank you for the thorough explanation and time you took to write it up. I now understand much SERT occupancy and the clear statement that neurotransmitter functionality is gradually restored.

 

1 hour ago, brassmonkey said:

This is where it is really important to listen to your body, take your time and roll with what happens. If all goes well there shouldn't be any increase in symptoms, but if you've been sensitive to changes in the past there might be a increase in symptoms and a longer hold at each level is called for.

 

It seems like than I can take two beads out of commercially filled capsule - repackage it and then I'm going to go. Tonight I'm going to give it a go to create a few capsules. I hope there are no more symptoms.  

 

On Monday morning I see the MD. I hope support my efforts.  If he does not support my bead counting effort - I have 21 (20 mg)  capsules  - several months' supply. They will 'expire' in November.  I've had these capsules for about a year.

 

@brassmonkey @Gridley

• About how long long is their shelf life?
• Can I store the beads loose in an empty pill vial - or do they need to be put back in another capsule? 

Thanks to you both,

 

Giuilietta

[Giulietta]

Hello Rosetta @Rosetta

 

Thank you for stopping by and encouraging me on the beads!

 

I appreciate your confidence that I may not experience any additional symptoms than I am already. I do have a lot of yucky days (still). In fact the past week has had a lot of ups and downs within a day 😕-

 

(anhedonia, GI, visual disturbances, anxiety from low to very elevated levels, palpitations (significantly more),  unrelenting tinnitis, tremors, awakening with jitters (not sinc emonths), etc.  Brain and neck zaps (not since June), auras. Been a bit of an emotional roller coaster since Thursday/Friday.)

 

Would one expect different WD symptoms (including not experienced since earlier phases of WD) within a single day?

 

I am apprehensive about the beads - and that a wave may be coming on based on the past week's (and this evening's zaps) syptoms - and I'm trying to be a bit mroe functional. Even though I am apprehensive about beads - I'm glad and grateful to everyone who's helped and held my hand along the way  to be at this point.

 

I hope you are well and I will pop by your t hread to see how you are doing! 

 

Big hugs,

 

Giulietta 🤗

 

 

 

 

 

 

 

 

 

 

 

 

[Gridley]

1 hour ago, Guilietta said:

• About how long long is their shelf life?
• Can I store the beads loose in an empty pill vial - or do they need to be put back in another capsule? 

 

 

The official shelf life would be the expiration date on the bottle.  How much longer the drug would retain its full potency is unknown.  

 

You could store the loose beads in an empty pill vial in a cool, dark, dry place.

[Giulietta]

2 hours ago, Gridley said:

How much longer the drug would retain its full potency is unknown.  

 

Thank you. Makes sense.

 

2 hours ago, Gridley said:

You could store the loose beads in an empty pill vial in a cool, dark, dry place.

 

Good to know. I am all set for storage then.

 

See how slowly things come together for me? 😉

 

Thanks, Gridley. Have a pleasant evening. 🤗

[Giulietta]

Good day Gridley @Gridley @Rosetta@Rhiannon @brassmonkey@Erell

 

I hope you are alll well. 

 

I thought you would all like a bead update since you have all been shepherding me through this process and I would like any advice  and comments for moving forward.

 

This morning was my first attempt since December 2018 opening casules and even trying to put them in applesauce. t was a struggle and took 30 minutes - for one capsule.So for one week this is 210 minutes - 3 hours. Would you give me your advice or point me in direction of people who do this? There must be legions. The method was found on youtube by a member of the FB group on surviving cymbalta. 

Biggest issues are below.

• Frist - my hands are unsteady. Have butter fingers to boot. Cost for compounding pharmacy to do this prohitive. No one I would ask to do this - one person I asked said it was utterly ridiculous.
• Opening the  capsule (20 mg) and in the process I ended up denting it to accomplish. Did this by gently twisting.  Is there a better way? Most of the beads came out in an messy fashion and thankful they stayed on the black t-shirt. Others were stuck in the bottom of the other 1/2 of the capsule. How do I know I got all these damn things out of the capsule?
  • Hard to see this - took off eyeglasses, used magnifying glass...tough when your eyes are at 'that age'
  • Beads hard to control - concern is them rolling off the safe space and onto places where pets can get them.
• Am I better off using applesauce??? Is this really OK to do? Lilly paper syas it is it OK -but can one trust anything they say?
• Getting beads into the capsule using toothpick to take.  Used a toothpick to separate two beads and push them into one of the capsule halves (didn't have the larger size capsule).
• Putting the halves back together. Didn't find anything on youtube?
• Getting beads into new vial for storage. My method was to slide these into the vial, which I had lying down on the t-shirt.

 

Not feeling nifty this moring - legs weak and hard to walk.

 

Major bummer. Church at 9.30. 

 

Thanks and hugs to everyone on the USS SA. 🤗

Guilietta

 

 

 

 

[Gridley]

43 minutes ago, Guilietta said:

Opening the  capsule (20 mg) and in the process I ended up denting it to accomplish. Did this by gently twisting.  Is there a better way? Most of the beads came out in an messy fashion and thankful they stayed on the black t-shirt. Others were stuck in the bottom of the other 1/2 of the capsule. How do I know I got all these damn things out of the capsule?

•  

 

48 minutes ago, Guilietta said:

• •  
• Am I better off using applesauce??? Is this really OK to do? Lilly paper syas it is it OK -but can one trust anything they say?
•  

 Gently twisting is the best way I know of.  Denting the original capsule doesn't matter since you won't be using it again anyway.  Do you have a bigger black cloth? Or two or even four black T-shirts to obviate the possibility of rolling onto the floor.  Tap the bottom of the capsule to get the stuck ones out.  

 

Getting the capsule back together is going to be tough if you have motor problems.   That's why the applesauce may be the only option.  I have a hard time myself getting the capsule back together.  It may help to get size 00 capsules, which are the biggest. They may be easier to twist back together.

51 minutes ago, Guilietta said:

• Getting beads into new vial for storage. My method was to slide these into the vial, which I had lying down on the t-shirt.

 

 

If you way is working, that's great.  

[AuntieBea]

Hello @Guilietta

 

I’m stopping by to let you know I am thinking of you. You have such a lot going on right now...just physically handling the beads is a major undertaking!!! I can only imagine that a whole lot of your time is taken up right now just thinking things through and strategizing with the moderators. If you’re like me, you’re probably not doing all this with your most clear headed self either....🤔

Dealing with the on-going, ever-changing symptoms is quite a challenge in itself, so I can understand your feelings of apprehension going forward.

 

I've been reading through your thread...you sure are getting an education that you didn’t ask for! Well, maybe that’s true for all of us here...getting an education in Antidepressant Withdrawal Syndrome. I don’t know anything about Cymbalta and bead counting, etc but it seems to be a science in itself understanding the manufacturing process, and deciphering and dissecting the beads so you can effectively taper them. I was reading Brassmonkey’s long post explaining everything to you. I don’t understand most of it, but I do understand it enough to appreciate how knowledgeable the moderators (and lots of other folks as well) are on this forum. It’s a wonder, really!

 

My personal situation seems utterly simplistic compared to what you have going on. Although I guess no one’s situation is simplistic considering the complex workings of our brains are involved. Which reminds me of one of the posts I saw earlier on your thread, it might have been from Gridley, comparing the recovery process to the restructuring of the fallen World Trade Center...I think that’s what it was.🤔 Oh, now I better go back and find it in there...it was such a great analogy! 

 

You have all this going on and you got to church this morning as well.... Good for you, you are so brave to persevere the way that you do. And still have the energy to go around helping other people to have a brighter day as well. I so appreciate that about you, Guilietta.

 

I hope you feel better as the day goes on. I’ll be thinking of you.

AuntieBea

 

 

 

 

 

[Erell]

Dear Guilietta, 

 

This capsule issue really seems To be annoying ! I don't understand all of it, but I'm so glad that you have great support from our dear experts!

 

You really are a very spécial woman : even with all what you're going through, you have so much kind words of support for all of us, and I  Feel blessed for meeting you.

 

Still holding your hand my friend ❤

[Giulietta]

Hello Gridley @Gridley

 

Thank you for responding so promptly. I know you are busy. Sorry about the typos.Having trouble typing today.

 

I will order large capsules but would rather do applesauce if we think pellets remain viable.

 

Would you mind sharing your thoughts?   Part of this are gaffes I think in thes tudy unless I am overthinking this.

• How do you think a bolus of applesauce stays together with the beads until reaching the duodenom so pellets are protected through stomach acid.
• How might pellets survive peristalsis of stomach and esophagus (which I realize is not thesme as crushing or chewing)?  I don't know if peristalsis - muscle action - would damage the enteric coatig. Article says nothing about simulation of this.(study gaffe? )
• Resarch conducted at room temp (study gaffe? )

Research says nothing about points 1 & 2 - so it's about intelligent guessing.

 

Thanks again,

 

Giuilietta

[Gridley]

34 minutes ago, Guilietta said:

if we think pellets remain viable.

Good questions.  I am stumped and don't know what to tell you about whether the naked bead would be protected.

 

I guess I would get the 00 capsules and try to make that work.  That's the closest approximation to the original formulation.

[Giulietta]

16 minutes ago, Gridley said:

Good questions.  I am stumped and don't know what to tell you about whether the naked bead would be protected.

 

Did some more research. I ordered some 00 capsules and should arrive on or by Wednesday. I thought I could reccycle the 20 mg without problems using the simpler method I found on youtube.

 

Here is what I learned on a paper posted on SA on tips for tapering cymbalta - which I hadn't looked beyond the title before.🙄 It is a safety report by FDA that citres throat irritation when beads are taken by themeselves (date of report: 2007). I skimmed the cases. Note tht one of these casees (I didn't read them all) was a case of a woman who used applesauce!!!

http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm103473.pdf

 

The liquid did burn on some days when I swallowed it.

[brassmonkey]

Hi Guilietta-- I hope your day has been improving and you got to church alright.

 

I have a few ideas that might make things easier.  First off, once you get the beads out of one capsule you should have enough for several weeks if you only take two beads a day. And it won't take all that long to pick two beads out of a vile and put them in the  applesauce.  Yes applesauce is a good way to do it, probably better than trying to fight two beads into a capsule and tastes better too. That way you don't have to order any capsules or fiddle with getting the beads into them or closing them. 

 

The beads are made to survive going through the stomach with all the acid and churning, just be sure not to chew them.

 

How about putting a pie tin or baking sheet that has edges under the black tee shirt.  It would make a contained space that would help keep the beads from spilling all over the place.

 

Instead of twisting open the capsules maybe try cutting off the very end with a sharp knife or razor blade.  That way the beads wouldn't go flying all over. You could collect the two that you need and then use the capsule to pour the rest into the storage vile. If any of the beads get broken or crushed it would be best not to use them.

 

To move the two beads try dipping the end of the toothpick into the applesauce and use the wet end to stick to the bead.  You could also try licking the tip of your finger and picking them up by just touching the moist tip to them. Don't do this if you are putting the two beads into another capsule, unless you are going to take it right a way.  The moisture will start to break down the beads and that will cause problems if you wait several hours.  Have a small spoon full of the applesauce ready to go and place the beads right on top so you know that they are there, and then enjoy that applesauce and a few more spoons full. 

 

Hope these ideas can help, let me know.

[Giulietta]

Hello Erell,

 

Thank you for the sweet and humorous note. Capsules are a challenge for me (and I'm sure others) for sure. I can't fork out the $300-400 a month to have a pharmacy compound for me. They are crooks.

 

I would be up a creek without a paddle if it were not for the team of mods and contributors and supporters.

 

Glad to have you stop by my thread.

 

Hugs,

Giulietta

 

 

[Erell]

Oups..what is the humorous note ? I did'nt do it on purpose..Well if I'm able To do humour in English, this is an improvment, so why not 😄

 

Hugs !

[Giulietta]

Hello BrassMonkey @brassmonkey

 

Thank you for the wonderful suggestions.

 

8 minutes ago, brassmonkey said:

The beads are made to survive going through the stomach with all the acid and churning, just be sure not to chew them.

 

Good to know. I wasn't sure about the activity of the stomach's muscle contractions other than the stomach doesn' t have teeth or a jaw and gums.  

 

I did skim the FDA piece posted on tips for tapering cymbalta and found the case of one woman visiting an ER for burning in her esophagus with the applesauce.

 

Do you now how a bolus of applesauce survives to protect the beads from the stomach pH. I am curious about how this works. Nonetheless I'll have tot ry this for the next few days.

 

For the applesauce - after opeoning a jar -  it needs to go in the fridge so it is no longer room temperature. Will this still work - or should I warm it in the microwave?

 

I have ordered 00 gel capsules and will try your suggestions about cutting the capsule and putting the shirt over a pie tin.

 

12 minutes ago, brassmonkey said:

You could also try licking the tip of your finger and picking them up by just touching the moist tip to them. Don't do this if you are putting the two beads into another capsule, unless you are going to take it right a way. 

 

Thanks for this wisdom. I had thought of trying this earlier today and nif I do the capsules - a few days at a time - I'll know not to do this.

 

Kindest wishes

 

Giuilieltta

 

 

 

[Giulietta]

19 minutes ago, brassmonkey said:

I hope your day has been improving and you got to church alright.

 

Thank goodness I was able to get to church. It is a good way to start the day for me.

 

The entire church prays for those who are sick (and battling WD )

 

 

[Giulietta]

1 hour ago, Erell said:

This capsule issue really seems To be annoying !

 

That the capsules are annoying. They really are pesky little things. The beads are pretty jumpy too. 🤣