Improving: Is it over yet? Now what?

[Improving]

Hello everyone, 

My purpose for joining this group is twofold.....first of all, I could use some help getting beyond the medications I've been on, repairing the damage done, and secondly, to give some hope.....

 

I was the passenger in a vehicle rollover while at work in 2009....I'll gloss over some of this, because it is only so relevant, but it speaks a bit to my mindset.....I was off work for 3 days (which included the weekend I was supposed to be off anyway). The roof of the truck was touching the headrest....which kinda tells you the amount of impact on my head (no broken bones or obvious acute injuries) I was on light duty for a while, then started back at fieldwork. My neck kept hurting, some days worse than others. Every time I went to a doctor for ANYTHING (a cold or flu, a sinus infection, etc) I mentioned my neck was still hurting. "It'll take time", same thing the physiotherapist said. I had to quit that job and take a HUGE drop in pay (almost half) and leave my career because I couldn't physically keep up.

 

Fast forward several months of a desk job. Neck felt better for a while, sorta, then got worse, I went back to physiotherapy. One day I was doing my physio exercises and felt a "pop". By the end of the week I couldn't turn my head, or even look forwards. It was like Wry Neck but a million times worse. It lasted about 6 months. The doctors were pretty baffled. I have some medical background, did a lot of research, think I have it figured out....not that any of the doctors would listen. I went to two neuologists (one didn't know so he said it was a conversion disorder...um seriously!), several doctors, had imaging, etc. Between the symptoms and medications I was barely functional for those 6 months.....I pretty much had to lay on the couch.

 

Pretty emotionally crushing and thoroughly scary. Doctors first ignored my concerns, then when there was something that they couldn't ignore, they were baffled. During this time the doctor tried me on a TON of different medications....some as "experiments", though all were purely to treat the symptoms. I was on anti-inflammatories (diclofenac...then Celebrex), pain killers (can't remember, some were pretty heavy duty). I was on a plethora of muscle relaxants (Cyclobenzaprine, and some others, a stint of valium, largely for the muscle relaxant qualities). There were other odd ones that were tried....like the L-dopa that lasted about 4 days and felt like I was about to have a seizure. Baclofen helped a lot, but I wonder if I was just actually healing, rather than the drug making a difference. 

 

Then came the day I mentioned I was having a horrible time with highway driving in the winter in particular.....that was over 3 years ago. Full on panic attacks (didn't help that I couldn't quit see straight ahead yet, and shouldn't have been driving, but my choices were limited there), hands numb, wanting to vomit etc. He did the basic GP psych test on me. Also decided that I should try Venlafaxine (Effexor), without trying any other ADs, or anti anxiety drugs of any kind. He said it was the best one because it could have an effect on chronic pain. Started on 75mg, then to 150. Sent me to a psychiatrist, who wanted me on 250, but the GP thought that was a bit too much. Was diagnosed with PTSD, some depression and anxiety (Um....ya think?). Was only given the option of group CBT therapy. No one on one talk therapy, despite the fact I mentioned the scheduling of the CBT really didn't work for me, and it required me to DRIVE on the highway to get there and I wasn't comfortable with the group setting. I have helped myself for the most part when it comes to the driving issue. Still not completely ok with driving in full on winter on the highway, but can survive fine if my husband drives, and am a full on road-warrior during a blizzard for in-town driving.

 

I taught myself some CBT, and the Effexor took me over. Oh....and incidentally, between when my neck got a bit better, and when I started on Effexor, I did get married (I'm incredibly lucky to have an amazing, understanding, and caring husband). Unfortunately, Effexor has taken a toll, my husband is with me still, but it has been VERY hard on him. I lost my empathy, my main emotions became apathy and anger, and rather than being the kind of depressed that probably could have easily been helped by some therapy (I needed to work through the loss of my career, the change in my life and the uncertainty of my physical state...), I honestly think I became clinically depressed, but didn't care enough to bother to get help. I think I've pulled out of that for the most part....but still have to work through some stuff.

 

I ended up moving just about 2 years ago. Started weaning off of Effexor because I was sick of not caring (I finally realized how apathetic I had become), and I was sick of taking them, and the symptoms if I missed a dose made me realize how awful the drug was.  I went from 150mg to 75 (I honestly can't remember if there was a step at 112.5....there might have been), then down to 37.5. Was told to just stop. Well, that didn't work. Finally I got a good family doctor, she got me to go to every second day (it was XR). I managed that, it was tough, but I did it. Started having "normal" feelings (amazing!!!!). She asked me to TRY every third day, then off, but if that was too much, to come back and we'd try a bridge. That is what happened. She gave me Celexa, told me to stop Effexor cold, and start the Celexa the next day. Supposed to be 20mg/day for a month, then 10 for a month, then off of that. I took the 20mg for 3 days, I was non-functional, SO exhausted. She was on vacation by this point, so I couldn't call, so I decided to drop the dose myself to 10mg. It helped, though I stayed tired it was livable (especially short term!). Then I dropped to 5mg for almost a month. I had a day where I had forgotten the Celexa...I felt GREAT....took the next one, and I became a ball of anger....I felt it happening, and decided that although it was a few days short of the month I wasn't going to take another one. That was roughly a month ago. Feeling better overall than I have for years....but not quite right yet.

 

So, that is where I am. I am pretty much med free. I am taking some supplements (as listed in my sig), and birth control, and the odd advil, but otherwise, med free. I am however feeling that I'm not quite "normal" yet. Is it chemical, mental or what, I don't know. Trying to figure out what next. I've sadly realized that although I am off of the drugs, it isn't over. I have a LOT of healing to do it ways that I can't even fathom. Healing from way back that I feel the Effexor prevented me from doing. There is also a major concern that I have.....what did the Effexor do to me long term, such as chemical imbalances it may have caused, issues with serotonin receptors that it likely caused, all of those possibilities. This is the big part of why I am here. What next? I'm not terribly comfortable going to my doctor about this, partially because it is so......non-specific, I don't want to get sent to a psychiatrist who will likely give me more meds before really assessing the situation (sorry, I just have lost a lot of trust). I'm considering some supplements that I consider a little more "heavy duty" than what I am currently on, such as 5HTP, or Tryptophan, perhaps melatonin (my sleep is better now, but still not quite right)....considering going to a naturopath to get some advice on all of that. Planning a trip to my GP to get a full blood panel to see if there is anything else of concern (thyroid etc). Still more tired that I should be, getting occasional VERY mild zaps at bed time, when I'm laying there (I actually had those BEFORE any of the drugs, but it wasn't brain zaps, I swear it concentrated where my neck pain stems from). Just a general feeling of unease/tension as well. My neck causes me some tension headaches that occasionally bloom into migraines....I get some neck tension, and minor pain, but definitely livable....intend on getting pushy with my doctor soon to find the actual source of it rather than the wishy washy "muscle strain" diagnosis that I've gotten so far. I'm still fighting Worker's Compensation for the 6 months I was off of work.....last time around they paid me for 3 days off, and declared the rest permanent disability (it wasn't permanent....I came out of it with some mild, lingering pain and headaches....I can turn my head, my mobility is decent). 

 

Basically, in a nutshell....Yes, getting off of the meds is possible, I've done it, and I've come out the other side of it....I think....my question is this: Now What?

[Meimeiquest]

Welcome! What an ordeal! Someone will be along soon to talk about the meds..I understand Effexor can really kick someone a long time out. Celesta is known as an SSRI (serotonin) whereas Effexor is known as an SNRI (both serotonin and epinephrine). That may be why Celexa left you so tired.

 

But I had a question about your initial injury. Do you think you had a closed head injury or whiplash or something else? Both of those can have long-term fallout that need to be properly addressed.

 

I certainly wish you well, and hope you can get the support here that you are seeking.

[Designerguru]

Hi, Improving!

 

I recognize you from the other site; glad you finally made it to SA! Welcome to the best site for advice.

 

One of the admins/moderators will be around later to help you; but I just wanted to say hi & it hope you are having a good day.

[Improving]

Well hello there!!! I recognize you!!! Good to see you here, and hope you are having a good day too! Getting the feeling that the physical and psychological battering is over, but the real work is just starting. Having a great day all things considered, better than I have for ages. Intimidated a bit by the future, but I do finally see that it has the potential to be much brighter than the past. I just have a lot of work to do. This forum seems to be the best resource to help me gain the perspective on this part of recovery.

[Improving]

Meimeiquest.....the original injury was diagnosed as whiplash (yay, a soft tissue injury, which according to Worker's comp takes 3 months to heal....PERIOD). There is also what is called a Schmorl's node at my C7 vertebrae (in basic terms.... the disk herniated into the body of my vertebrae), which is not recognized as something that normally has symptoms (its a controversial subject....I've done a lot of reading on it). The long term fallout I THINK the Schmorl's node became irritated/inflamed....something that is suggested can cause them to become symptomatic, which would explain that bad 6 months....though no doc has officially touched on it, ignore my questions about it, and no imaging of my neck was done at the worst part of it other than an xray....which doesn't show nerve and muscle well enough, so no evidence of it. An MRI from a couple of months ago showed a minimal, stable Schmorl's node with no neuological effects.The head injury part of it just consisted of a pretty significant bruise on my head, no broken skin, no broken bones. I'm having a tough time to get any further follow up for any of it other than offers of pain killers....it isn't painful very often, and never intensely...usually causes muscle tension. Acupuncture and massage were great when I could go regularly, something I intend on doing again soon. The as-needed muscle relaxant (Cyclobenzaprine) and a hot pack, and being kind to myself when it flares up usually does the job...would still love to get answers.....but no one seems to think it is serious enough to do more than tell me to take more drugs

 

I'm sure you can see why I'm reluctant to seek any help from a doctor on furthering my recovery from Effexor.....I'm positive I'll just get given more drugs for these "minor" and somewhat vague symptoms I've got now....

[Meimeiquest]

It sounds like you have a lot of insight into what happened. All I know is that whiplash can be a very serious injury that goes far beyond the soft tissue injury. But we are all about neuro plasticity here, that the nervous system can and does change.

[Improving]

YES!! the nervous system certainly does change.....and I'm starting to feel like it can heal to a point...in a variety of ways. Helping it along mostly in terms of the damage done by the Effexor is my conundrum. 

[Meimeiquest]

When was your last bit of Effexor? You came off of it very quickly at the end. Your issue is whether or not to reinstate something, and it will help the moderators explore options with you if they know the answer to that question. A lot of people have a delayed reaction to a fast Effexor taper. Beyond that the moderators will be most helpful. You can search this site from search bar in the upper right hand corner for more info while you are waiting. MammaP is a moderator who has had a tough go at the end.

[Improving]

Unless I have an incredibly compelling reason to reinstate I won't do it. The Effexor was 74 days ago. Prior to that I did do a couple of weeks at every second day. It only took about 4 days, and the withdrawals were minimal....they turned more into predictable mood swings: wake up in the morning feeling good, take my Effexor, feel like a zombine for about 6 hours, get cranky for a while (into the evening), then spend much of the next day feeling fantastic, sleep wonderfully that night, wake up feeling good, then.....take the next Effexor.

The day after I took my last Effexor, I stated Celexa 20mg. I had three days of nightmare.....likely caused by the Celexa (HORRIBLE fatigue...as in 5 hour naps those days), no brain zaps, finger tingles. Some digestive upset, but not much. Dropping to 10mg after those first three days I became functional again (thankfully since I had to go to work!!). There was a short period while on Celexa I had what I call "phantom zaps"....just some really super mild brain zaps only when I was laying in bed, about to go to sleep. Those are gone now (other than some similar to those I had before Effexor....concentrated in the neck area where my injury was). I stopped the Celexa  a couple of days early because I'd missed one, and when I took the next I became a ball of anger and I felt awful....I just couldn't bring myself to take another.

 

What I'm considering is whether to try some of the supplements....like 5HTP, SamE, tryptophan, or perhaps just up my fish oil dosage (I only take one or two a day right now). Much of what I have now physically (a little more tired than I think I should be, minor lack of motivation....but more than I had while on Effexor, a bit of tension) I think is due to chemicals being messed from Effexor, and are similar to what I was feeling prior to taking it....honestly, it feels a bit like a hangover without the headache (well...usually without the headache). I'm thinking something to help the receptors along after the battering they've taken from both the SNRI and the SSRI. Oh, I almost forgot.....the week I stopped Celexa I went through a week of bizzarre dreams....those seem to have passed though thankfully. A naturopath is an option I'm exploring to help with supplement choices and dosages, but I'm not sure.... I'm also planning on getting a full blood panel done, but not sure what to insist the doctor request for tests. 

I'm also somewhat considering therapy....though again, not terribly trusting that a doctor isn't going to toss meds at me again and tell me to get out of their office and come back for a refill rather than actually help with some therapy. I have a feeling a lot of the psychological issues are a matter of time and regaining my footing after 3 years or so of experiencing little more than apathy after a fairly life altering incident....

Thanks for the hint on MammaP, I'll look her up.

[Altostrata]

Welcome, Improving.

 

Very sorry to hear you were caught up in a psych drug merry-go-round along with your other problems.

 

It sounds to me like your original "full on panic attacks, hands numb, wanting to vomit etc" might have been an adverse reaction to one of the neurologically active drugs you were on or from a drug-drug interaction.

 

Do you have any symptoms now that seem to come in waves?

 

Many people do better with more fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

Magnesium is a natural muscle relaxer.

 

Have you tried osteopathic manual treatment for your neck problem? Or chiro or acupuncture?
 

[Improving]

Good point on the panic attacks alto!! I do think they were somewhat due to the accident I was in....though it wouldn't shock me in the least that all of those awful drugs experiments the doc's had me on made it WAAYYYY worse. I personally think it was kinda natural to be kinda scared of driving in the winter on the highway in the exact same conditions as the accident was in.....and that was the case right after the accident, it was the following year....once all of the drugs happened when I started having those attacks. Good catch!! 

 

The closest I'd say I have to true, predictable waves is if I am going to have any of those teensy zaps (the ones centered at my neck....that are a little different from the withdrawal zaps), is when I'm tired, still, and on my way to sleep. Other than that, I'm a little more sensitive previously to emotional stuff....get a teensy bit more angry, or sad, it lasts a little longer (not like while on Effexor....something tiny could ruin an entire day or more). If I'm feeling lazy, it takes a little more to get me moving than before Effexor (again, not as bad as while on it!). I get tired faster, mentally and physically. I'm not quite sure about waves and windows on mood yet. I had a nasty week last week, but that I think was a small bout of PMS. 

 

I have done acupuncture and massage by a physiotherapist for my neck...did more good than all of the drugs combined. I haven't gone regularly for quite some time though, and REALLY should start again, and do my physio exercises more regularly. I moved though, and need to find a practitioner I am comfortable with. I tried a chiro once....he did the neck manipulation....I couldn't feel the left side of my head or face for about 5-6 hours afterwards....a little wary now. My current GP shares a waiting room with an osteopath that I've been considering talking to though. 

Magnesium!!!! I'd forgotten about that one. I'll read up on those threads and look at adjusting my fish oil dose especially. Which type of mangesium has been a bit of a conundrum for me, but I'm sure that's covered in those threads. Thank you Alto!

[Altostrata]

Yes, going on and off all those drugs may have made your nervous system more susceptible to upset.

[Improving]

I realized that I have been taking magnesium, albeit not as regularly as I should, and only for a couple of weeks. It is however a Mangesium citrate (250mg), Calcium +D3 tablet. My guts are tolerating this surprisingly well!!

 

I have had something going on for a couple of days though. My legs (hips, down my thighs, sometimes my knees) have been hurting like heck. I did have a rough day on Monday and Tuesday at wok, but usually, when I'm on my feet all day, I'm more prone to sore feet an maybe calves. That hasn't been the case this time. Not sure whether it is withdrawal related potentially (or the after-effects of being messed up....since I believe the drugs are technically out of my system by now), or if maybe I'm coming down with a cold/flu (its that kind of ache....which is similar to the aches I had withdrawing from Effexor), or if I'm just getting older (but I'm only 36.....no fair!).  Frustrating. 

I've been pretty tired lately, emotionally I feel.......not quite great, but very close to normal (a little sensitive, but I'm not surprised....just getting used to having feelings again!). The tiredness is quite irritating though, its putting a dent in my motivation. Again, frustrating, not knowing whether I'm coming down with something, or if it is related to stopping the drugs. I see one silver lining though....if I'm coming down with something I can actually take a cold/flu tablet without worrying about becoming non-functional thanks to interactions (always made me groggy and dizzy, more miserable than without flu medicine). I need to get off my behind and call my doctor for an appointment for blood tests....just to see where levels of everything are. 

[Altostrata]

Please see our topic about magnesium http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/
 

[Improving]

I just reread it Alto. I think I'm getting confused, and not doing as much good for myself by taking the "combo" magnesium/calcium/D3 pill.....though I do think perhaps I'm getting too much magnesium(I'm thinking muscle fatigue is likely the cause of that leg pain), despite the fact that my guts aren't acting up to a noticeable degree (I've always had a pretty "iron gut"). I'm a little reluctant to toss that fairly new batch of supplements, so I might try at least cutting them in half for a bit to see if that helps. I'm also starting to think that an impending cold is the reason for the leg aches (I get that often when I have a bad flu...), the mild sniffles are turning into a full on head-cold. Not sure which is which, but I'm going to try to find a more appropriate dosage of magnesium for myself. The aches have mostly subsided, but are still there a little.....

[Altostrata]

When you take calcium and magnesium together, the calcium cancels out the relaxing effects of the magnesium. You are probably not getting as much benefit from magnesium as you would if you took it separately.

[Improving]

Yeah....I've got to get rid of the combination pills. I went for them so I had less supplement pills to swallow, and my mom has been harassing me to bits to start taking calcium (she has some minor osteoporosis...and wants me to get on some calcium early). I'll ditch the combos, or at least set them aside for a few months and take some straight magnesium. Oh, and I double checked the dosages on the pill (holy cow that writing is tiny, even with good eyes I can barely read it), and it is 250 calcium and 125 magnesium. Emotionally doing pretty good, moods are (except on some occasions) relatively even, but I do think a little extra calming could be a help....had a bit of a bout of anger/frustration yesterday that was a little overblown....I controlled it well, but it would be nice if I didn't need to!!