YachtRock: My Introduction and Journal

[YachtRock]

Sunday was a fairly chill day. We did get out of the house twice and took a gentle walk again to soak up the sunshine. Otherwise kept things very low key and was able to get back to a normal night's sleep.

 

Sunday, January 9th

9:00am Awake, still awake, can't tell. Just shy of 3 hours sleep. Mild trembling still, brain fog, lightly sedated. Beautiful sunny day outside.
10:00am Took 10mg Propranolol
11:00am Tired, brain fog. Journaling. Ate yogurt and granola with small coffee
12:30pm Mostly minor issues like fatigue as still a little sedated. Left house to pickup something and get some fresh air. Chest thumps picking up while out.
1:30pm Back home riding out light head and chest symptoms (wish I could be more descriptive)
2pm Light walk 1 mile
3pm Took 0.47mg Trintellix (14mgpw)
4:30pm Mild uneasiness still
5:30pm Showered, ate Cauli Yumm Bowl. Feeling internal trembling again, jaw wanting to clench
6:00pm Did 3 short guided meditations, anxiety and unease lowered about 25-30%
7:00pm Reading on the couch, ignoring the movie that is on. Feeling mostly good.
8:30pm Ear pain/pressure rising.
9:45pm In bed, asleep around 10:45pm

[YachtRock]

Monday was another mixed day. Daytime was mostly mild with a small spike in anxiety midday. But sleep was challenging again. I did the right prep leading up to bedtime, ate a healthy dinner, no TV, some light reading and meditation. Unfortunately the meditation I listened to turned out to be Binaural Beats which I think was activating in my brain. It could be a red herring, but my head/brain/ear symptoms ticked up while listening to the video and worsened as I tried to fall asleep. I'm sure that anxiety about it didn't help, but it did not feel like this was the root of the issue. I slept a total of 4 hours last night and struggled quite a bit between sleeping and waking. Still lots of internal trembling and very vivid dreams. My watch says I only got 8 minutes total of deep sleep.

 

Monday, January 10th

7:00am Awake, slept 8 hours uninterrupted
8:30am reading in bed on acceptance. Mild head, neck pain, increased pressure. Breathing exercises.
9:00am Anxiety increasing steadily.
10:00am Took 10mg Propranolol. Still mild+ anxiety (state of the world, working week). No appetite whatsoever
11:00am Ate a piece of egg casserole. Anxiety is surging/spiking and dark thoughts are circling. Chest thumps (blocking adrenaline?). Trying to unwind it now with breathing, positive thinking and changing the channel.
11:30am Simmering down now, playing solitaire, breathing.
12:30pm Feeling less anxious but more "detached" a bit.
1:30pm Snapped out of the funk after talking to a coworker. Mild to no symptoms presently
2:00pm Took a 20 minute walk around the neighborhood, moved to my desk. Still feeling OK at the moment, minor chest rumbles. Eating Snack Mix from Trader Joes and leftover Yumm bowl.
3:00pm Take 0.47mg Trintellix. Work meeting
4:00pm No changes, very mild symptoms
6:00pm Living room, feeling a slight uptick in symptoms (front of head, tingling legs) after sitting down to relax.
7:00pm 10mg Propranolol, ate Duck legs and vegetables.
9:00pm Reading about COVID (not smart), annoying med taste. Anx low, overall symptoms mild this evening. Yawned a lot and mild+ fatigue.
10:30pm listening to binaural beats (didn't realize at first) and started feeling strange during and afterwards. Will avoid these videos since other SA members have found them activating. Sx did increase to moderate levels overnight. And I put cortizone-10 on an itch before realizing it was a corticosteroid (bad?).
** Slept in short bursts, maybe 3-4 hours, lots of head pressure and ear pain and internal trembling **

[Altostrata]

Though it appears you may be having an adverse reaction to propranolol, you reduced Trintellix instead?

[YachtRock]

5 minutes ago, Altostrata said:

Though it appears you may be having an adverse reaction to propranolol, you reduced Trintellix instead?

 

@Altostrata thank you for continuing the offer your support and guidance. Although I think the "chest thumps" (like palpitations) are associated with Propranolol (and some of the clamminess/cold hands/feet), the benefits of blocking adrenaline and racing heart, which accelerate my anxiety, seem to possibly outweigh it? I am not finding direct correlation between the times I take Propranolol (only effective for 4-6 hours) and the symptoms spread across the entire day. Are you suggesting it could be responsible for more of my general WD symptoms?

 

@getofflex and I went back and forth over the past 3 weeks trying to determine if the Trintellix reinstatement was causing problems. Her most recent assessment was that yes it was probably causing an adverse reaction, but suggested I keep the dose the same for another week (not sure why yet). But then when I crushed and weighed new pills on Sunday, I consistently could not get any 0.015g weight pills but rather 0.014g and 0.013g, so I went with the ones closest (by 3.3%). I could try again as I still have more powder. 

 

My heart tells me that the reinstatement was not working but I wrestle with that thought frequently. I have read the posts on RI over and over and like others struggle to define or identify adverse reactions or feeling "significantly worse". 

 

It will be equally difficult to taper Propranolol by only 10%, without going into liquids or having the same trouble with weighing powders. If you feel strongly this is the better path, I will start ordering the supplies for a liquid suspension at 9mg.

 

Thank you (and @getofflex) again.

[YachtRock]

I just checked my BP and it was 147/92 (HR 69) and I am basically "between" my two doses of Propranolol. So also concerned about losing the BP-lowering effects of the drug while anxiety is still high over constantly changing symptoms and stressors. I will take more frequent measurements and note them.

[Altostrata]

If you're getting an adverse reaction from propranolol, reducing it makes sense. I'm sorry it's not easier. Drug manufacturers simply have not provided dosage forms for easy tapering of most drugs.

[YachtRock]

@Altostrata I will go with your recommendation, thank you. I managed to "cut" enough Propranolol pills to get enough 9mg doses through the weekend (106mgpw/fragments vs 118) so will monitor for symptom and BP changes. 

 

Tuesday, January 11th

6:45am Awake. Another bad night of sleep, roughly 4.5 hours over three stretches, mod+ internal trembling and anx between, very vivid dreaming, lots of worry and concern and dry mouth. Watch calculates only 8 minutes of deep sleep? Binaural Beats video (unintentional) may have caused issues as symptoms were low and mood was OK heading into sleep.
8:00am Get up, small coffee and cereal before work meeting.
9:00am Rapidly increasing anxiety, elevated HR
9:30am Full panic attack, accepting and breathing (work, stimulants, lack of sleep)
10:00am Panic almost gone, anx and HR lowering.
10:30am Filled out intake form for possible new PMNHP who appears very tuned into AD withdrawal (thorough PDF on his website). Symptoms mild but tense and uncomfortable.
11:45am Resting on the couch with eye mask and therapy kitty. Unable to sleep due to hypnagogia.
12:30pm 10 minute head and neck massage
1:00pm Headache, head pressure, mild fatigue. Couch/laptop, reading and researching (providers, EFT/tapping, insurance, etc). I was told my feet were clammy.
2:30pm BP reading 147/92 HR 69 while sitting on the couch. Elevated from panic earlier?
3:00pm Ate a small bowl of pozole. Took 0.47mg of Trintellix. Symptoms milder than earlier.
3:30pm Took a very short walk around the block (10 mins)
5:30pm Couch/laptop usual reading. Mild symptoms mostly. Ears/head with some fatigue.
7:00pm 10mg Propranolol. Sx same, watching travel videos (a boy can dream)
7:30pm tried EFT tapping solution for anxiety
8:00pm Same mod ear pain and stuffy head, buzzing underlying anxiety. Ate PB and banana sandwich. Felt a few thumps, are all these from PR dose?
10:30pm Completed two meditations. BP 127/76 HR 73 (on PR). Moderate ear pressure and popping, head a bit "sore".
10:45pm bedtime

 

** Slept 7.5 hours but only 3 minutes of deep sleep per my smartwatch (and 8 minutes the night before). That is concerning. I have stopped relying on the Withings sleep "pad" and gone back to sleeping with the watch on which has VERY different results  **

[Altostrata]

It appears to me that your coffee is activating. Suggest you start cutting it with decaf. Please also track symptoms before and after vaping.

 

How do you feel compared to the last week of December?

[YachtRock]

50 minutes ago, Altostrata said:

It appears to me that your coffee is activating. Suggest you start cutting it with decaf. Please also track symptoms before and after vaping.

 

Thanks @Altostrata. Both the caffeine and nicotine are activating for sure, which is why I am trying to limit them as much as possible. I have been making a small coffee then drinking a little over half of it. If you are looking solely at yesterday AM's panic and elevated HR, it was a combination of drinking the whole coffee and vaping while sitting through a stressful work meeting (old habits I guess) and I got overwhelmed by anxiety quickly. I will definitely pickup decaf and cut it in half, good idea! I am trying to drink just enough to avoid an afternoon or early evening headache, although those can seemingly arise for lots of reasons these days. It tends to accompany the tinnitus sometimes too.

 

As for vaping, I am limiting myself to 20 minute intervals with an app on my phone. It would be near impossible to ascertain specific symptoms before and after those timed "puffs". But I am working to reduce nicotine by half right now, and now have a way to measure my progress somewhat. And I plan to increase the interval time once I can stick to it reliably.

 

50 minutes ago, Altostrata said:

How do you feel compared to the last week of December?

 

Generally worse. The last week of December saw two "good" days (or parts of the day at least) and I haven't had a good day the past two weeks. There is always one symptom or another present, very little relief. I know you don't love the symptom tracker but I averaged 16 symptom points the last 7 days of December, vs 24 points the last 7 days. And the January trendline is going down which is a tiny bit encouraging, though not very scientific.

[YachtRock]

Wednesday, January 12th

7:00am Awake, 7.5 hours of sleep, only 3 minutes of deep sleep per my watch (?) and only woke up briefly a few times. No internal trembling through the night. Average HR 61.
8:00am Working at my laptop. Current symptoms mild/low. Small coffee. Noticing tiny chest thumps (and have not taken Propranolol yet). 
9:30am Ate egg casserole. Feeling anxiety and slight discomfort pick up (mental and physical) 
10:00am Took 9mg Propranolol (cut/fragments)
11:00am Feeling strange, nervous/tense, increased head pressure, slightly clammy hands. We just changed medical insurance an hour ago so possibly anxiety driven?
11:30am Still feeling off, slight increase in chest sensations and discomfort.
12:30pm Was mostly the same for 2 hours, feeling slightly better after a shower and stepping away from the computer for a bit
1:00pm Ate chicken apple sausage with cabbage, pineapple and carrots
1:30pm BP check 133/85 HR 75. Slight nausea but otherwise the same bleh ickiness
2:00pm Consult with new PMHNP. Feeling slightly better after the conversation though may not be able to work with him due to state licensing.
3:00pm Took 0.47mg Trintellix. Went to COSTCO which was a little stressful. Felt light chest thumps, a little chest pain, tinnitus and very anxious overall. 
4:30pm Back home, moderate left ear pain is again the main symptom, light head pressure, slight headache and chest thumps. Baseline anxiety seems low at the moment.
5:15pm BP check 128/81 HR 75
6:45pm eating salmon and brussel sprouts. Feeling chills and body tingling. Increased discomfort.
7:00pm 9mg Propranolol. Still feeling off, light chest pains and oddities. Creeping anxiety.
8:00pm 10 min anx meditation. BP 121/77 HR 69 after.
9:00pm In bed relaxing, same sx past few hours. Tense, chills, unusual light body waves from head to toe. Still ear pain of course. Slight nausea.
10:00pm BP 127/74 HR 74
10:30pm Fell asleep quicker than expected, slept 6.5 hours HR 64.

[Altostrata]

20 hours ago, YachtRock said:

If you are looking solely at yesterday AM's panic and elevated HR, it was a combination of drinking the whole coffee and vaping while sitting through a stressful work meeting

 

You're getting adverse effects from caffeine and vaping. If you continue to do this, it's not something we can fix.

 

Please add the vaping events to your daily notes.

 

I don't see a change in the symptom pattern after you've taken the reduced amount of propranolol, and your blood pressure is fine. You're still getting an adverse reaction from propranolol. It has a short half-life. Suggest you reduce both doses to 8mg tomorrow.

[YachtRock]

Thanks @Altostrata. Will respond with more details later, but FYI I skipped coffee this morning (still vaping 3x/hr) and have felt 75% better so far! Will further taper Propranolol tomorrow. I quit coffee Jan 1st but crazy headaches the evening of the second day so started again. Might just tough it out with Tylenol.

 

[YachtRock]

Thursday was a much better day. The first window in 2.5 weeks. I had no coffee or caffeine at all yesterday, and Tylenol helped stave off headaches, but I don't think that was the primary reason for a drop in symptoms. I did have lots of foods yesterday which are high in magnesium (almonds, pumpkin seeds, banana, avocado) which proves to me that I need to start adding my chelated magnesium glycinate supplement (will start with 50mg and ramp up to maybe 200/day if no sensitivity). I felt noticeably better around lunch and symptoms remained low through the remainder of the day and evening. The symptoms I DID have continue to be unusual, mostly sensations in my brain which I assume to be related to repair and recovery. They caused some tolerable discomfort. 

 

I had some bloodwork done yesterday at Kaiser. My Vitamin D level was 39 (compared to 56 in August and 17 a year ago). So I also need to start adding D back as well, thinking 2000/day to start. My Comprehensive Metabolic Panel was all normal. In chatting with my current psychiatrist at Kaiser, he thinks it is extremely unlikely that I am having an adverse reaction to Propranolol and in fact, suggested I consider taking it 3 times per day, or stopping it for a week for comparison purposes. He said it is very unusual for "side effects" at the 10mg lowest dose. The easiest for me would be to continue tapering down to 5mg and hold there for a while (splitting a 10mg tablet in half). I will be chatting with a new PCP and Psychiatrist in February and would like to hear their opinions as well.

 

Thursday, January 13th

 

6:00am Awake, 6.5 hours sleep, still no deep sleep. Took about 15 mins before symptoms start coming back to mild/low levels. Mostly reading and thinking (and slightly worrying)
8:30am Start working on my laptop. Postponing coffee to watch symptoms. So far still low, but feeling stress and anxiety build as I work. More worry about work situation. Slight headache picking up (no coffee or PR yet). Slight internal restlessness.
10:00am 9mg Propranolol. Ate cereal with a banana (mag from almonds and banana?)
10:30am Moved to my office, slight chest thumps starting
11:30am Still at my desk, no coffee, symptoms mild so far.
12:00pm Slight increase in head symptoms, very light pulses/waves noticed. ear pain noticeable but much better than previous.
1:00pm Veggie Quesadilla and Asian salad. Still mild to low (and still no coffee). ** Window feeling, clearer head/mind, no tension currently **
2:30pm 0.47mg Trintellix. Went to Kaiser for blood test and pickup Rx. Was slightly anxious during the blood draw (normally not an issue) and they had to jab me three times of course.
3:30pm Back home, now feeling some increased head pressure, ears still light but ringing. Discomfort is slowly creeping up, as is a caffeine withdrawal headache. Feeling it behind the eyes.
5:30pm Sx mild+ and annoying. Ears still better than past days but head is tense, painful with more strange sensations, tight jaw. Chest sx are mild to low, even none at times. Took 1000mg Tylenol. Feeling hungry which is good.
7:00pm 9mg Propranolol. Ate a pinwheel and some keto chips. Headache almost gone, but still feels like someone is doing surgery inside my brain. Odd and occasionally disturbing and uncomfortable
7:30pm slight chest thumps. Similar to last night, I feel like I am on the verge of dizziness but it never arrives. The uneasy feeling just prior...
9:00pm Heading to bed, ate a few yogurt pretzels and banana chips. Feeling ok... BP 118/85 HR 71.
11:30pm Asleep

 

Estimated nicotine per hour: 1.6mg, down from 1.9mg (every 20 mins)

[YachtRock]

Another generally "good" day, continuation of the window from Thursday thankfully. Mostly mild symptoms. A few sips of iced coffee seemed to have no impact (though possibly did this morning). I am not sure these recent changes had much impact and I believe this was a natural part of the cycle of waves and windows. But I will take it for now. Any relief is welcome. I have not taken any Ativan in 7 days which is great.

 

The quasi-dizzy-not-dizzy feeling is frustrating but acceptable compared to full blown dizziness or disequilibrium. Being out of the house a few hours was still challenging, but not any worse than previous trips. I think it is better to keep working at it and focusing on coping skills. 

 

Friday, January 14th

6:00am Awake, slept just over 6 hours. Reading.
7:00am Feeling head congestion but not like a cold. Slight pressure in eyes and face. No chest sx and no tingling or trembling through the night.
8:30am Office/working. Symptoms again mild to low. Ate cereal and banana again for possible magnesium bump?
9:30am Mild/low with occasional light palpitations
10:30am Slight increase in head/body symptoms while working. Taking a few sips of iced coffee. Took 8mg of Propranolol
11:00am Stable but tense. Stepping away from work stuff for the rest of the day.
12:00pm Showered, Errand run. Anxiety increased, can't stop obsessing on symptoms. Same uneasy pre-dizzy feeling in stores. Some chest pain just below my collar bone. Getting antsy while wife browses...
1:30pm Ate chicken and veggies from Chucks in the car. Sat out the 3rd stop due to general uneasiness. Breathing and quiet in the car.
2:30pm Back home. Tension easing. Ear pain is now light to moderate, head still very fuzzy.
3:00pm Took 0.47mg of Trintellix, ate some chips and hummus
3:30pm Laptop/reading on the couch. Very tired, symptoms subsided somewhat
5:00pm BP 129/74 HR 67
6:00pm Head and ear symptoms low to none at times. Body chills in small waves and tingling. Mild anxiety and tension.
7:00pm Took 7.5mg Propranolol. Mostly the same all evening with variations of tingling.
9:00 Ate a half PB&J took 500mg Tylenol
10:30pm Bedtime

 

Estimated nicotine per hour: 1.57mg (36mg over 23 waking hours)

[Altostrata]

Are you feeling any benefit from propranolol? If not, you might continue to reduce it by 1mg per dose per day until you're off it.

[YachtRock]

1 hour ago, Altostrata said:

Are you feeling any benefit from propranolol? If not, you might continue to reduce it by 1mg per dose per day until you're off it.

 

That is very difficult to say at this point. I suspect the benefit is to keep my BP and HR under control, particularly in panic/high andrenaline moments (which are rare lately). I do believe there may be a calming effect but hard to correlate.

 

Even harder for me is whether there is any benefit from the Trintellix after 30 days. I was advised to either stop it and "ride it out" or updose back to 5mg until I stabilize (usual med/psych guidance). I have read everything there is on that topic multiple times and I am quite scared of a large reinstatement. But the allure of feeling how I did when I jumped off is agonizingly hard to ignore as well.

[Altostrata]

2 hours ago, YachtRock said:

3:00pm Took 0.47mg of Trintellix, ate some chips and hummus
3:30pm Laptop/reading on the couch. Very tired, symptoms subsided somewhat

 

What symptoms subsided somewhat? Did you get more tired after you took Trintellix?

[YachtRock]

51 minutes ago, Altostrata said:

What symptoms subsided somewhat? Did you get more tired after you took Trintellix?

 

In that case yesterday, it was the ear pain, fuzzy feeling head and anxiety leftover from running errands. But with the 66 hour half-life of Trintellix and the tiny dose, I don't believe those two are a direct correlation 30 minutes apart. I also don't think the tiredness was associated with it. That is more from getting zero deep sleep for god knows how long now and reading on the couch (reading always makes me tired).

 

 

[Altostrata]

Once you get the propranolol settled, my guess is you'd do better with a little more Trintellix, reinstatement having been a bit too low.

[YachtRock]

Saturday, January 15th

6:30am Slept 7 hours. Uneventful, slight issues and bad feelings trying to fall asleep.
8:00am Head lightly fuzzy again, no congestion but still tired.
9:00am Mild anxiety from a stressful discussion, light chest thumps, head tension and light nausea. Ate cereal and banana, few sips of iced coffee.
9:30am Ear pressure/pain and general anxiety increasing. Muscle fatigue (arms) and jaw is very tense. Back of head buzzing. Noticing elevated HR. Will avoid coffee again tomorrow (barely had any).
10:00am HR and anxiety slowing somewhat. BP 127/81 but HR still 93. Took 8mg Propranolol.
11:00am Increased chest tightness but anxiety lowering and pulse is  normal resting range.
12:15pm Did my best to nap for an hour on and off. Anx and chest sx mostly gone but now a little dazed.
1:00pm Showered, ate leftover chicken and veggies. Mild to low symptoms (head/ear/chest/body).
2:00pm Went for a one mile walk. Mild chest thumps after the walk but still low symptoms.
4:30pm Back from a leisurely drive. Low to no symptoms (head/ear/chest/body).
5:30pm Anxiety and body chills increasing significantly. Tight chest, head buzzing. Can't pinpoint why other than general WD.
7:00pm 7.5 mg Propranolol. Most symptoms back to mild or low. But stuffy head and chills have returned.
8:00pm Experienced uncomfortable sensations on the couch when almost falling asleep twice. Ear pain and head pressure increasing.
9:00pm Ate some trail mix. Ear pressure/pain now moderate and general anx also picking up with more chills and tingling (same as earlier evenings this week).
9:45 In bed reading. Sad and frustrated that the window is closing it seems...
10:30 10 min meditation. Stuffed up nose. Asleep around 11-11:30pm

Est nicotine 1.8mg/hour (did not manage it well on Saturday)

[Altostrata]

You need to avoid caffeine.

 

Please include the times your vape and symptoms before and after those times, too. It may be causing your symptoms.

[YachtRock]

1 hour ago, Altostrata said:

You need to avoid caffeine.

Please include the times your vape and symptoms before and after those times, too. It may be causing your symptoms.

 

@Altostrata thank you once again for your caring and diligence. I stopped caffeine again on Friday, other than two small sips yesterday of my wife's coffee but no more. I plan on going forward without it.

 

The nicotine issue is unfortunately way more complicated. It is a 30+ year addiction, the only thing I have ever truly been "hooked" on and struggled with it my whole life. In many ways it has been my primary anxiety drug. I am now recording when I change the cartridges so I can estimate nicotine intake per waking hour. The intake is all day at roughly 20 minute intervals, from wake until sleep. So to record each time I take a draw from the vape, and associating symptoms, would be difficult if not impossible. I realize that ANY stimulant will ramp up potential for anxiety and symptoms. I have used it through windows and waves, and consistently each day. I am focused (as focused as one can be in this situation) on lowering this significantly. But it will not be an easy task. 

 

I remember reading early after discovering this site that some members (or even moderators) suggested NOT putting yourself through any additional withdrawals (that example was smoking) in parallel to AD withdrawal. 

 

As for Propranolol, I am going to hold a while at 7mg as I have had spikes in blood pressure the past two days. And I am still not convinced that it is the direct cause of any particular symptoms. From what I have read, most members experience some variation of these same symptoms, even when not on beta blockers or consuming caffeine?

 

 

[Altostrata]

What do you mean by blood pressure spikes? As I explained earlier, this happens if daily propanolol intake is reduced too fast.

 

The problem with symptoms you may experience after vaping is that they confound your symptom pattern. It doesn't make any sense for us (me) to spend time trying to analyze your symptom pattern if some of your symptoms are from vaping. However, I agree that going off nicotine altogether might be destabilizing.

 

Overall, it appears to me your withdrawal symptoms are mild and you might do with a little more Trinitellix.

[YachtRock]

16 hours ago, Altostrata said:

What do you mean by blood pressure spikes? As I explained earlier, this happens if daily propanolol intake is reduced too fast.

 

139/91, 138/87, 145/80, along with increased chest pain. Think I need to updose the Propranolol.

[Altostrata]

You need to let a reduction in propranolol settle for a few days before making another reduction.

[YachtRock]

I don't know why my anxiety suddenly ticked up again. It was a relatively calm weekend. Possibly because of something we watched on TV that I couldn't get out of my head. Have not taken any Ativan though, but feels like the type of Anxiety I had while on Trintellix a year ago, less related to WD. General worry/dread/concern with increased HR (and sometimes BP). Ironically, as I worry about the chest pain, I am currently reading Overcoming Health Anxiety (paperback to lessen screen time).

 

Sunday, January 16th

3:30am Slept 4 hours, then on and off until 7am in short bursts. Moderate internal trembling, dry mouth, slight headache. Cycle repeating from earlier last week.
8:00am Reading in bed. Mild anxiety and catastrophizing. Head/ear symptoms and muscle fatigue are increasing. Jaw and mouth tense.
9:00am Egg casserole NO coffee. Still feeling a bit fatigued, head/ear/jaw issues gone.
10:15am Took 7mg Propranolol
11:00am BP 139/91 too high. Too much reading and research.
2:00pm Visited a friend. Moderate chest thumps returning home. Otherwise most symptoms have been mild/low the past few hours while I helped with a few things around the house and outside.
3:00pm Took 0.5mg Trintellix. Relaxing on the couch, feeling mild+ head and chest symptoms (no ear pain), mod anxiety and discomfort.
4:00pm Feeling strange tingling/vibrating in my left leg. Chest tightness from anxiety, head also feels slightly strange again.
5:00pm Symptoms slightly better, did a 20 minute meditation and trying my best to relax. 
7:00pm ate Tri Tip and vegetables. Took 7mg Propranolol. Still moderate+ anxiety, lower chest sx but stuffy head, med taste again, leg fatigue and internal trembling. Retired to the bedroom for the evening to read and listen to podcasts.
10:30pm Asleep

Est. nicotine intake 1.71mg/hour (down from 1.89)

Edited January 17, 2022 by YachtRock
Added nicotine

[YachtRock]

Anxiety is certainly getting the better of me these past few days. I truly hope to work with a new provider and build some solid skills for dealing with this post-meds. I regret not focusing more on that prior to tapering (among other regrets). Last night I had an absolutely horrible headache in the back of my head and neck, and I am not sure if it is a result of standard WD symptoms or caffeine withdrawal (or a combination of the two). The mile walks could be activating. I may have screwed up by raising my Propranolol again, will try to keep it consistent. But my current psych thinks I should be taking it MORE frequently and not less to avoid gaps in coverage. Also suggested Metoprolol (more BP focused) or Prazosin (Alpha Blocker) as alternatives. Also prescribed a non-benzo "Vistaril" (Hydroxyzine) as an alternative to Ativan, but I don't know anything about any of these. Will need to research. Lastly, I was able to confirm more precisely the dates that I begun my taper in 2021, and it is looking more like a 3 month taper vs 4 month (May 4th - August 12th).

 

Monday, January 17th

4:30am Awake, 6 hours sleep. Toss and turn until 8am, maybe slept an hour more.
8:00am Reading. Moderate head and facial pressure, indigestion, chest pain and fatigue.
9:00am Ate cereal with banana, symptoms subsided to low/mild. BP 145/90 HR 93 (this was lying in bed not walking around doing anything).
10:00am Panicked and took 10mg Propranolol (updose)
11:30am Slight ear pain and stuffy head (but clear sinuses, which strangely is usually the case with WD and not normal for me). HR still above 90.
12:00pm HR 82. Low to no WD symptoms other than general anxiety (heart related).
1:30pm Ate Cauliflower Yumm Bowl. HR 81
2:30pm BP 113/71 HR 76 (Propranolol working). Usual malaise in the afternoon.
3:15pm Took 0.5mg Trintellix
4:30pm Went for a mile walk. Feeling flu-like symptoms, eating the rest of my cauliflower bowl and some hummus with chips.
6:00pm Feeling headache come on, took 500mg Tylenol.
7:00pm Took 9mg Propranolol
9:00pm Headache and/or head pressure sx significantly worse. Took another 500mg Tylenol, ate PB&J and went to bed. BP 124/80 HR 71.
10:30pm Asleep

Est. Nicotine intake 1.64mg/hour (down from 1.71)

[Altostrata]

As I've said, the amount of Trintellix you're taking may not have completely addressed withdrawal symptoms. But it's best to change only one drug at a time, plus you've have the caffeine and nicotine as confounding factors.

 

Do you hunch over a computer a lot? You need to stretch your back, arms, and neck -- tightness in these areas can cause headaches.

[YachtRock]

Thanks @Altostrata. I do stretch my neck and back throughout the day. I am fairly certain that Sunday night's headaches were straight up caffeine withdrawal. I am also probably in a big wave this week which is compounding my sleep problems. Insomnia is getting worse and I would like to start taking supplements again anyway. Would love your thoughts (or any mods) on the following:

• Vitamin D3 start 2,000iu/day and increase back to 5,000/day. My test result last week was 39, not as bad as I expected but need to start bringing it back up. I haven't read any reports of members having issues with D3.
• Magnesium (Chelated Glycinate) 50mg AM and PM to start, increase as appropriate.
• Omega 3 Fish Oil (I had been taking daily since early 2019). Start with 1,260 EPA/DHA and ramp back up to 2,520 combined daily.
• Melatonin start with 1mg around 9pm. BUT since I am not having trouble going to sleep but staying asleep, it seems that some better alternatives might include Milk Peptides, Adenosine Monophosphate (I can only find Triphosphate) or MSM. Leaning towards the Life Extension product linked above, although the active ingredient is "Casein decapeptide" and not "Lactium".

 

I understand the idea of only changing one at a time, but I am also starting to think I should address the reinstatement dose sooner than later. I am not sure I can afford to spend a month testing each supplement change prior to dealing with the reinstatement dose, which could add the most relief (and take a while to ramp up). Do you think slowly ramping up to 1mg Trintellix is the right approach? @getofflex had also suggested 0.75mg as an interim updose.

 

EDIT: I just re-read your earlier posts suggesting I stay where I am for a while longer. 

 

Tuesday, January 18th

4:30am Awake, 6 hours sleep, horrible headache in the back of my head and neck. Took 1000mg Tylenol.
5:30am Headache fading slowly, not fast enough. 
7:00am Still tremendously painful in the back of my head and neck. Effects of caffeine WD or AD or both? Still not sure. Light massage may have helped a bit.
8:30am BP 138/83 HR 66
9:00am Less head and neck pain
10:00am Ate two egg bites, took 9mg Propranolol. Still worried about tapering it too much.
11:00am Working in my office. Feeling high level of anxiety over work/world issues. Chest thumps/palpitations and tingling. Also some indigestion, maybe the egg bites?
12:30pm Showered, anxiety lowered. Still having chest pain off and on and light tingling all over. No other noticeable WD symptoms at this time.
1:00pm Eating leftover steak and vegetables. Now feeling left ear pain, slight dizziness, strange smells and head pressure increasing quickly.
2:00pm Call with psychiatrist. Began feeling "woozy" just before coming to my office and discomfort and tension increased through the call. Feeling yet more strange and disturbing sensations in my brain (wanting to believe it is healing and repair work).
3:00pm Anxiety and/or physical sensations getting worse. Took 0.5mg Trintellix. Still in work meetings but plan on laying down as soon as I can. HR normal so no panic?
4:00pm Did 20 min deep relaxation video and breath work
4:30pm Feeling slightly better but a bit detached? Still light chest thumps or palpitations, light internal trembling in my legs. BP 137/81 (same as AM).
6:30pm Symptoms increased to moderate+ Head pressure, ear pain, tense face/jaw, headache (again) plus brain feels itchy and pulsatile. Still trying to relax CNS, manage stimulation. Half watching YT videos. Ate chicken, green beans and salad.
7:00pm Took 8mg Propranolol
7:30pm BP 134/85 HR 70.
8:00pm Symptoms now mild, less uneasiness. Light tingling sensation upper body.
9:30pm Symptoms back again, fuzzy head, anxiety, ear pain, overwhelmed by TV
10:00pm BP 107/70 HR 63
10:30pm slept until 12:30am
12:30am awake with moderate internal trembling, mind racing. Toss and turned for hours.
4:30am may have slept another hour or two?

6:00am slept at least another 30 minutes but uncomfortably

 

Est nicotine 1.5mg/hour (down from 1.64)

 

The short dreams I remember were all set against a black background? Only foreground characters (in color) but somewhat one dimensional, like in a darkened theater. Very strange to recollect, slightly freaked me out.

Edited January 19, 2022 by YachtRock
Adding comment

[YachtRock]

And of course I just found and read all the back and forth over D3 dosing so I fully expect you to be concerned with 5,000IU. I have 1,000 gelcaps here at home and will just stay with 1,000 for a while.

[Altostrata]

Take vitamin D3 in the morning. I've found Life Extension 300mcg extended-release melatonin to be remarkably effective.

[YachtRock]

Wednesday, January 19th

First woke at 12:30am, awake until 4:30am, awake again around 6am, etc.
9:00am Getting up after multiple attempts to get more sleep. Head still buzzy with occasional waves, slight body chills, general discomfort. Ate almond cereal with banana.
10:00am Feeling uneasy and a little unstable? Some light inner trembling (different than what I have in the middle of the night) and a touch of nausea. Muscle fatigue from lack of sleep?
10:15am Took 8mg Propranolol. 
11:30am Working/meetings feeling OK but exhausted and slightly detached.
2:00pm Ate Tuna melt, chips and hummus. Took 1,000 IU D3 (will move to AM).
3:00pm BP 118/69 HR 76. Took 0.5mg Trintellix and a short nap on the couch.
4:00pm Woke to internal trembling, light nausea and stomach cramping. Head and ear pressure mild but noticeable.
5:30pm Still feeling icky, head pressures and small pains, again noticing unusually strong sense of smell (both expected and unusual smells). 
6:30pm Ate Keto pizza
7:00pm Feeling slight headache, other symptoms persist. Took 8mg Propranolol.
8:30pm still feeling flu like symptoms pretty much all day (body and head). Just no fever, chills, runny nose, etc. Finished off the keto pizza.
9:00pm In bed reading after a few hours of TV. Yawning which is good. BP 108/71 HR 62
10:30-11pm Asleep

Est nicotine 1.33mg/hr (down from 1.5)

[YachtRock]

Thursday, January 20th

7am Awake, managed 8 hours uninterrupted, badly needed sleep.
8:30am Slight head and jaw pain but feels more "sore" from previous tension. Brain fog cleared. No anxiety or physical symptoms at this time. Ate yogurt and granola.
9:00am Work meeting, feeling OK but increased stress
10:15am 8mg Propranolol, 1000iu D3
10:45am Showered. Feeling increased ear pain again (left) but without any accompanying sx.
1:15pm Ate leftover chicken and stuffed mushrooms. Ear pain the same, still no other symptoms but lethargy.
1:30pm Took Super Omega-3 pill (Life Extension Super Omega-3 Plus EPA/DHA Fish Oil, Sesame Lignans, Olive Extract, Krill & Astaxanthin) yielding 750 EPA/510 DHA. Hope to take 2 pills twice per day yielding 2,520 combined.
2:00pm Ran to the store to return something. Ears still problematic but tolerable. Felt a tinge of emotion listening to music (good sign). Now back home and feeling hunger cravings (new).
3:00pm 0.5mg Trintellix
4:15pm Increasing earache (infection?) and feeling slightly "woozy" again. Head is doing something weird suddenly.
6:00pm Ear issues persist, slight chest rumbles, no other sx at the moment. Ate tuna and crackers, mostly small snacks through the evening (healthyish).
7:00pm 8mg Propranolol and Super Omega-3. Will double in a few days along with Vit D3.
7:30pm Chest rumbling continues, start to feel disoriented. Fades over the next hour but still lots of discomfort on the couch.
9:45pm Bedtime with same level ear pain/ache and fuzzy head and light palpitations.
11:00pm Asleep

[Altostrata]

When did this ear pressure or pain start?

[YachtRock]

11 hours ago, Altostrata said:

When did this ear pressure or pain start?

 

Five weeks ago, December 12th, and one day after I got my Pfizer Covid booster. Not sure if it could be Vax related or just a big coincidence. It felt like it was tied to strange head/brain feelings so I assumed it was a byproduct of nueroregeneration. But it didn't seem to get much better during windows. I was going to have it checked out at Urgent Care this week but then it did seem to hurt less the past few days. It really is more pain and discomfort than it is ringing so not sure I can call it Tinnitus? 

[Altostrata]

You should have an otolaryngologist look at it, in case it's an infection.