Abella: Preparing to taper off doxepin

[Abella]

Hello, I just found this site a few days ago. I've never done anything with forums before so I'm still figuring out how to navigate--I feel a bit lost. If I post on a thread that no one's been on for a few months, will people see it? So...this is a question about tapering and melatonin, I guess, so not sure if this is the right place to put it...

 

I've been working with a naturopath for a few years which has been very helpful in various ways. Early this year I wanted to get off meds, and I did get off Klonopin and Wellbutrin (yay!) but trying to taper off doxepin by 25mg steps was terrible--major sleep issues and anxiety/emotional stability. My naturopath gave me melatonin and a chamomile-based supplement called Babuna. She OK'd me  going up to 9mg on the melatonin and I did and between those and going back up on the doxepin (eventually to 75mg) my sleep recovered and has been good since June for the most part. I know elsewhere on this site people have said that over 5mg of melatonin is pretty high. I have not done much research on it, partly because it's working for me.

 

OK, so I want to start my taper, once I see my psychiatrist and can hopefully get prescribed 6mg tablets of doxepin. He won't be able to advise me on anything else (I'm on the waiting list to switch to another doc that was recommended to me, but won't see her till April.) But the question is what to do, if anything, about the melatonin? I thought it would be wise to try to cut back first, so that if I have trouble with sleep when I cut back on the doxepin (sleep is my bane), I could have the option of increasing the melatonin. I've not asked my naturopath how high she thinks is OK. So I did cut back on the melatonin for the past two nights, 6mg or so instead of 9mg (it's by droppers, not very precise) and had an awful time getting to sleep the first night--better last night. But I'm feeling crappy moodwise--so hard to know what begets what. I also do a lot of energy work which in general has been amazing for me, but it does mean I end up doing a lot of processing. I really hate messing with meds and all the upheaval and analysis of what's working and is it improving....but I want to get off.

 

Other things about me--I do a lot of alternative/integrative health exploration and am really into nutrition right now--have learned a lot and made some changes that I feel really good about, my body likes it. Still learning, finding out what works.

 

Should I post this in a melatonin thread instead?

Edited July 19, 2016 by scallywag
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[Altostrata]

Welcome, Abella.

 

You are taking an unusually high dose of melatonin but -- if it works for you, it works, and that's what's important.

 

I would stay consistent with the melatonin while tapering doxepin, don't decrease it. That way, your body still has one crutch while the other is slowly being withdrawn.

 

Given that sleep has been such a serious issue, I would taper doxepin very slowly, no more than 10% a month and maybe less. Here's our topic about tapering doxepin http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/

[Abella]

You know, that is a good point about keeping the melatonin the same. I'm just worried about what might happen if I can't sleep when I cut back on the doxepin and I want to know I have options. However, I am really encouraged by the idea of tapering slowly, except for the fact that it might take forever! Well, 4 years or so if I only do 10% a month. But I guess if it keeps me from going off the deep end, it's worth it. Thanks for the feedback!

[Altostrata]

You want to taper at a rate that it doesn't affect your sleep. Withdrawal insomnia is stronger than melatonin -- don't go there if you don't have to.

[Abella]

Wow, not affect my sleep? That would be awesome. Thanks for the caution on trying to avoid withdrawal insomnia--I just haven't read that much yet and am glad to learn about strategies, etc. because i think I've had some limited assumptions. Did I read that here somewhere, that withdrawal should be slow enough to not have side effects? I am learning a ton here and finding many things I want to read more about, like the thread on the myth of the chemical imbalance theory. Just discovered GiaK's website--cool! This site is so great, I am so glad to have found it!

[Abella]

Just saw my psychiatrist. He doesn't get the slow taper thing and he doesn't particularly think I should get off, but he did prescribe me 70mg of doxepin, down from 75. I had asked him to prescribe me 68mg--a 50mg pill and 3 6mg pills of sinequan, but  he said there's no such thing. He thinks I can just drop by 10s--he said the vast majority of people just drop by 25s on doxepin. Well, I've already tried that and it didn't work so well. Maybe I can handle 10mg drops, but I'd rather start with the 10% pace and go from there. So either I invest in a scale for measuring out correct doses or I find a different psychiatrist. Any tips on where to find another doctor? I thought I saw something in here on that.

[mammaP]

Hi Abella, we have a list of doctors on the tapering board. I'm sorry, I would post a link but am away out in a mo. 

MOST psychiatrists and doctors are clueless when it comes to tapering!  

The 70mg sounds like a good start, only a 5 mg drop which is less than 10%. 

 

I hope it goes well for you. 

[Altostrata]

The list of doctors is here http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/

 

You can always cut up tablets or make a solution.

[Abella]

I have not tried to get in touch with that doctor that was recommended. He does not take clients, only refers to doctors who are knowledgeable about tapering.So difficult to separate out causes sometimes...I cut back to 70mg doxepin from 75mg on Friday, so it's been 5 days. Slept OK the first couple of nights, and now for 2 or 3 (I can't remember) I'm waking up around 3, eventually getting back to sleep. Went to a potent energy work sort of session on Saturday from which there's always fallout. One of my chronic struggles that got me on medications in the first place this round is the way I "crash" emotionally. I have studied this from every angle and tried everything. I think it has a lot to do with how ruthless I am in self-judging and how I don't listen to myself and my experience, you know, because I'm somehow trying to do it "right" and then I crash. Or I get triggered. Sometimes I feel like my life is a mine field and I'll never get to the other side.Anyway, I had an almost crash on Sunday but talking to a close friend helped me out. That was triggered by an external event. Then yesterday a full-out crash triggered by nothing I could pin down. I had the most awful feelings of despising myself, feeling like a failure and a detriment to my family. I felt so awful, like I couldn't possibly get through it or face it inevitably happening again, over and over. And I started thinking about suicide. I tried to tell myself I had to stop the thoughts, that they would only lead to death. I don't know if i"m making any sense. I just don't know if my propensity for self-judging is the problem or if cutting back is influencing...I don't know. The crashing is a major issue for me. I wouldn't say thoughts of suicide generally is but I do end up there when things get unrelentingly challenging. 

[Abella]

Somehow I feel like I didn't explain myself very well. But anyway, I have been wanting to ask, maybe this sounds stupid, how to navigate the forums and end up having something akin to real time conversations. Does this happen? Because I read lots here but does a post on an old thread get read and responded to? I would like to feel a little more connection with people in my situation, since there is no one in the rest of my life with a similar situation.

[tezza]

If you post in someone's intro thread, they may or may not respond...IDK.

 

We don't really have real time conversations but this is a very active forum.

[mammaP]

Hi Abella, I'm sorry that you are feeling so bad. I can relate to what you are feeling as

I've been there and still end up there sometimes but not so often now.

Some of the drugs made it even worse for me, and withdrawal too. 

 

You've done well distracting yourself, that is the best way in withdrawal. I don't know if you

ever suffered any great trauma, but this article came to mind when I was reading your post.

Gia K posted it this morning and I found it really insightful. I never thought of myself as 

having PTSD but now I am sure that I do! I can relate to what you are saying and was also

very critical of myself, even before meds, but meds made it much much worse.

 

Take a look and see what you think, I found it really good. 

 

http://survivingantidepressants.org/index.php?/topic/5412-the-body-keeps-the-score-part-1-trauma-and-the-body/

[mammaP]

I'm sorry, you are probably wondering why I posted that!

 It helped me to see why I am the way that I am, once we understand

what is happening it becomes easier to  deal with things that are going on in the mind and body. 

[Meimeiquest]

If you go up in the upper right hand corner near your name, you can send a private message to someone that they will get in their regular e-mail.  If you write on an old thread, it bounces that topic to the top of the forum and it also comes up when someone presses "new content".  Welcome and good luck!

[Abella]

No, mammaP, I get why you posted that. It is very interesting. I especially liked the comment about CBT and why it doesn't work. My understanding of trauma is that it's caused by any experience that overwhelms your system and that you don't have enough support to process in the moment, so it gets stored. I don't really have the capital T Trauma, but I think it's just myriad experiences of feeling unsupported, scared, judged, etc., in childhood. It's like I can feel my brain go down that path and I wish I could uninstall the program that runs. I guess every tidbit helps. Today I am telling myself it is enough to breathe. As long as I am breathing, there is still hope.

 

Thanks for the tips, Meimei. I'll check it out.

[mammaP]

You could be having some withdrawal that is making you feel worse just now,

it's 6 days since the drop from 75 to 70 Doxepin. so it could have been too large

a drop for you. It may be better for you to micro taper tiny amounts. It can take longer

but is more gentle on the  nervous system. 

[Altostrata]

I have not tried to get in touch with that doctor that was recommended. He does not take clients, only refers to doctors who are knowledgeable about tapering.

 

If he refers you to someone who is knowledgeable -- wouldn't that be helpful? I'd love to add such a doctor to our list.

[Abella]

Yeah, right? Don't worry, if I do happen to find any knowledgeable doctors I'll be sure and let you know.

 

MammaP, I might try micro tapering depending on how this continues. I'm finding it hard to separate out causes since I did the energy work Saturday, which always has fallout, and I'm so prone to crashes anyway. Could be it would have been worse without the energy work, who knows...Anyway, I'm planning to use some version of that symptoms checklist from Glenmullen that's in the tapering thread. Doxepin has a short half life--somewhere around 24 hours, I think, so I don't know if that tends to make decreasing more challenging, at least on the front end.  

[Abella]

Just checking in. Nothing much to report on meds. I'm finding interesting reading here and elsewhere about withdrawal. Taking a look at the whole symptoms and self care forum. I'm kind of in info-gathering mode, as I hope to cut back a notch this month. I've been increasing my magnesium and omega 3s (which I was already on) and I already take D3 and a B complex. 

So here is the question. I see my psychiatrist this month, and his opinion is that you don't need to taper really, just come down by 25mg at a time, so I don't think he buys the withdrawal stuff...but he was fine with my trying to cut down by 5mg last time. The question is, should I cut back by 10mg like he suggested, or by 5? Was at 75mg, now at 70mg, so 10mg would be more than 10%. I know I talked about suicidal thoughts possibly being triggered by my decrease last month (short lived, about a week or so)...Maybe that answers my question, I am just SO not a patient person and would like to be done already. And maybe the suicidal thoughts were brought about the energy work, as that definitely happens at times as I clear different layers of trauma, etc. So...

[mammaP]

Doctors rarely get the whole withdrawal thing! Mine just shrugged and told me to just stop 

because it was a low dose! 

 

I would stick with the slow taper, it takes time yes, and you want off it, we all do, but 

going too fast leads to upping the dose and being on even longer. Withdrawal gets thrown

into the mix too and that is NOT a good thing! If I could turn back time I would do a very

 slow micro taper, believe me withdrawal sucks! 

[Abella]

This morning I was like, what am I doing, trying to convince myself it's OK to drop by 10mg, when I don't really know that? Is it that awful to go slower, and then IF it goes well, speed up a little? So yes, I am back on board with the gradual taper, but just knowing how my crazy thoughts work, I may run this little debate another time or two. Or more. But I know I'll get sensible reminders/input here, so thanks for that.

[Altostrata]

If I were you, I'd be more cautious and, at this point, decrease by NO MORE than 5mg.

 

If you read other Intro topics, you will find that psychiatrists know very little about getting people off drugs and routinely give bad advice to people who are sensitive to dosage decreases.

 

Please see this topic about tapering doxepin http://survivingantidepressants.org/index.php?/topic/3914-tips-for-tapering-doxepin-sinequan-zonalon/

[Abella]

I forgot that doing liquid solutions is an option to get the right dosage (if/when I need to drop by less than 5mg). That sounds easier to me than emptying and filling capsules. Thanks!

[Utahgal]

Doxepin comes in a liquid form. You can order it that way.

 

I'm currently tapering off gabapentin. I got it in liquid form. It is much easier and I can go as low and slow as I want!

[Abella]

Doxepin hydrochloride oral solution USP (concentrate), a clear colorless liquid, is available in 120 mL glass bottles with an accompanying dropper calibrated at 5 mg, 10 mg, 15 mg, and 25 mg.

Each mL contains doxepin hydrochloride equivalent to 10 mg doxepin. Immediately prior to taking this medication, dilute each dose with approximately 120 mL (4 ounces) of water, whole or skimmed milk or orange, grapefruit, tomato, prune or pineapple juice.

 

From http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=54ad0284-c32d-4904-ae9a-5384ee53b2d8

 

That is an interesting option. It seems to be getting simpler the more I learn! I wonder if my psychiatrist would go for switching to liquid? So all I'd have to do is get an oral syringe to get the precise dosages I need. I'll ask him when I see him in a couple of weeks. Thanks!

[Utahgal]

How are you doing on your doxepin taper?

[Abella]

Thanks for asking, Utah. I have not done any further tapering since late December. January was super intense for me healing-wise. I do energy work with a practitioner, the most healing thing of anything i've ever done. It gets at really old, submerged stuff. So anyway, I'm feeling much better and ready to take another step. I've been working really hard at countering deep old messages, very pervasive shame and self-judgment. Loving yourself, ALL of you, is not easy! I've been adding magnesium, and I cut back on my melatonin from 9mg to 6mg, 1mg at a time, because I didn't feel like i was needing it. That was no problem for me.

 

Thanks for asking! How's your taper going?

[Altostrata]

Hello, Abella, it's been a long time. How are you doing?

[Abella]

Hello, I'm returning after a long hiatus. I'll update my meds history when I have more brainpower, but briefly, my last attempt at tapering didn't work and instead of 2 meds I'm now on 3 (plus a couple non psych meds), but now I'm ready to look into microtapering and take however long it takes to prepare and begin.

 

I hope to find a doctor locally that I can work with. Someone was recommended to me who is out of network but she sounds promising. In the meantime I'm trying to thoroughly educate myself, and do everything I can wrt self care and wellness. For the past year I've been working with a new therapist with lots of experience dealing with trauma. She's amazing. So hopefully I will be back here more regularly. 

[Abella]

So the doctor I want to work with is a holistic psychiatrist trained in functional medicine. What I know of her seems very promising, has experience with tapering psych meds. The stumbling block is she's not covered, but I kind of feel like I need to take the leap.

 

I actually have several reasons I want to work with her. Earlier this year, I had extended menstrual bleeding that resulted in my hemoglobin dropping to 7.6 by late May. But despite rigorous supplementation and super healthy eating, by 9/8 I was only up to 9.4 (normal is 12 - 16). This is WAY slower than my doc originally suggested.

 

I've been walking around in a brain fog. I lost my job in June (contract terminated) and have been unable to start a job search. My sleep is erratic despite really good sleep hygiene, my energy is low...I suspect my adrenals and thyroid are involved, but my doc only did a TSH test which she said was normal, but I've read differing opinions on what level would be indicative of hypothyroidism.

 

I'm really interested in functional medicine right now, and how it's supposed to try to get at root causes. I've worked really hard in therapy and self care, supplements, etc, and I'm wondering if something else is going on. Maybe if I got to the root I could get off my meds. That's the hope anyway.

[ChessieCat]

1 hour ago, Abella said:

The stumbling block is she's not covered, but I kind of feel like I need to take the leap.

 

When it's your health and wellbeing that is being dealt with and because you have been unsuccessful with other medical professionals, it may well be worth paying the money to see if she can work out going on.  You could explain to her that you aren't covered and that you would appreciate it if she could keep consultations to the minimum.  This would also give you a good indication if she really wants to help you or she wants to make money.  That sounds harsh but unfortunately it is a reality.

 

You could also go once and then make your decision after that consultation.  At the moment you are trying to make a decision based on what you have heard/read about her.

[Abella]

Hi again, it's been a long time again. I'm working on tapering. Again. I'm not very good at connecting here in any remotely consistent way, but here I am...I guess last time I posted I was dealing with my low iron. That's resolved thankfully.

 

Here's what I take currently:

Wellbutrin, 300mg (extended release)

Doxepin, 75mg

Prozac, liquid form (2ml=10mg), .6ml, so that would be equivalent to 3mg 

Various supplements, per my holistic doctor. Maybe I'll go into that later. Not sure they're doing much for me.

 

I've been tapering off the Prozac since last fall, .2ml every two weeks since I was only noticing mild symptoms that didn't last (some moodiness/anxiety, a little difficulty sleeping, headaches). But since the last decrease on 12/22, I've had a lot more trouble with anxiety, self hatred, and some dissociating, and more consistent sleep issues, and it's not getting better. There are plenty of other factors right now so it's difficult to sort out... I'm trying to focus on getting myself back into a little more equilibrium. Tonight's the first night in a long while of being completely unable to fall asleep, high anxiety kept triggering feelings. 

 

So I've been meaning to check back in here for a while as I get ready to do the rest of my taper, but right now my main question is whether to stick it out a few more days at .6ml and then reevaluate, or just go ahead and go up to maybe .7ml. And then maybe switch to a 10% taper when I'm feeling more stable?

 

The other thing I'm wondering is whether the Wellbutrin is too high. I had been at 150mg of Wellbutrin a couple years ago and was struggling so I went up to 300mg and was still struggling, so we added the Prozac (20mg), and I feel like that numbed out some of my difficult feelings and made my life more manageable, but I have felt sort of cut off from parts of me as result. I decided to start my taper with the Prozac mainly because it's the lowest dose. Maybe I should have started with the Wellbutrin because it's more activating?

 

I don't keep a very good journal of symptoms but have been thinking about trying it to help me sort things out.

 

I'll check out the tapering forum, but would appreciate it if anyone had any feedback here. 

[Abella]

Well, for now I've decided to stay at .7ml Prozac, for maybe a month and see how my sleep and anxiety do. I'm also investigating histamines. 

 

I do wonder if it would be better to taper off the Wellbutrin first since it's more activating. I read the tips on tapering Wellbutrin on this site. I wish I would have checked in here first though. I always end up wanting to go too fast. And not paying enough attention soon enough to how it's affecting me. I think I'm really ready though this time. Even if I can't get all the way off things, I want to at least know I did everything I could to get at low as I could.

[Abella]

Talking to myself here I guess, ha ha. I have this feeling like no one is going to respond because I've flaked out so many times on this site, but I suppose that's just my own paranoia. I know you get a ton of traffic here, lots of posts to read/moderate. I get a little overwhelmed by the vast number of topics and forums, so I haven't ventured to post anywhere else...

 

How do I update my signature and how is that different than the info under my profile, the stuff that says it's private? I thought I'd update my signature, but don't see my own to even know what it currently says. I searched how to change it but what I found didn't make sense. Does it matter whether I'm on my phone out a computer?

 

OK, since I can't sleep maybe I'll write a little more. Like I said, I've been tapering off Prozac (10mg or ?ml) since last fall. I thought I was doing a good job going slow. It's such a low dose to begin with. I had easily dropped from 20 to 10mg early last year, and then using the liquid last fall and dropping .2ml every 2 weeks seemed to be going ok, though I've since read that you should taper slowly enough to have no WD symptoms. What I was experiencing seemed fairly mild and short lived, just a few days each time so I continued...as I said above, I think things got more difficult when I tried to go below .6ml, at least that's when I noticed it. It's hard to separate out what is caused by the holidays, stress, time of year, diet, work in therapy, etc. So it took me a while to notice I guess.

 

I was on a round of antibiotics in Dec too. I can't remember the last time I did that--20 years? 40 years? Anyway, took more probiotics than usual during and after to compensate, and then got back into making my fermented veggies again, which I hadn't done for a while. Didn't notice digestive issues. My food cravings tend to get really bad this time of year with all the sweets, so that was happening too...

 

Then, on Thursday I think, I was having painful bloating and gas. At first I attributed it to  a helping of sunchokes which can have that effect, but it didn't subside. I spent most of Friday on the couch with a heating pad and didn't eat much. Then I started reading about histamines here and realized that although I generally eat healthy, my diet currently has a lot of high histamine foods, and I remembered that my blood work last fall had shown somewhat elevated histamines.

 

So I've been trying to compile a list of high/low/antihistamine foods and give it a try. Gianna Kali said she noticed a difference in a few days. Maybe I should be posting in the histamine topic? Anyway, I slept better Fri night than I have in a while, but was still really tired and brain foggy yesterday. Tried eating low histamines all day, went to bed early, so tired...and have slept terribly, awake a lot. My stomach feels crappy. Bloated, I guess? Gas? I keep getting hot, not like fever hot though. My heart gets loud/fast and wakes me up which is not new for me though has been pretty infrequent for at least several months. Not sure what I ate that caused this and can't think of another trigger... I've not really experienced stomach symptoms like this before. Should I take my probiotics? I haven't for the past couple days in case they're triggering...

 

Once I figure this out, my plan is to finish the taper of Prozac, but do the recommended 10% taper.

[ChessieCat]

7 hours ago, Abella said:

How do I update my signature and how is that different than the info under my profile, the stuff that says it's private? I thought I'd update my signature, but don't see my own to even know what it currently says. I searched how to change it but what I found didn't make sense. Does it matter whether I'm on my phone out a computer?

 

The drug signature shows below every post you make.  Drug signatures cannot be viewed when accessing the site from a phone.  I think you can update your drug signature from a phone but I think it would be easier to do from a computer.

 

This is your current signature:

 

1998-2002 Zoloft 200mg and Doxepin (75-100mg?). Tapered off of both without issues that I can recall.

6/2007-8/2007 Various meds tried.

8/2007-12/2012 Switched psychiatrists. Started Klonopin (1-3mg), Wellbutrin 150mg - 300mg) and Doxepin (100mg)

12/2012 -2/24/2013 Tapered off Klonopin (very difficult!)

3/1/2013-3/15/2013 Discontinued Wellbutrin in two decreases

4/1/2013 - 9/2013 Tried to get off Doxepin by cutting down by 25mg at a time. Sleep, anxiety, and general emotional state too challenging, so went up to 50mg. Still challenging with suicidal ideation; went up to 75mg and stayed; things eased

9/2015 Added Wellbutrin, 300mg

10/2016 - 9/2017 Increased doxepin to 85mg, added Prozac, 20mg, Wellbutrin still at 300mg

 

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

Tips for tapering off Prozac (fluoxetine)

 

If we go too fast we can experience withdrawal symptoms.  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Many members find that the lower their dose gets the slower they need to go, by reducing less and/or holding for longer.  Why taper paper: dose-occupancy curves

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

 

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.  These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.