Re: Nerves and sleepless nights
- From: "Robin" <me5@xxxxxxxxxxx>
- Date: Thu, 6 Aug 2009 16:34:29 -0400
"oldgoat" <oldgoatmail@xxxxxxxxx> wrote in message news:h5faqr$aad$1@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Dear M,I agree. I appreciate any and all advice. You didn't worry me or anything. :)
Never worry about to wrong information or making a calculating mistake. If I had a nickel for everytime, I'd have a lot of nickels. The guys with the medical degrees are the one who are supposed to be the brains, but we prove them wrong and ignorantly superstious all the time. THEY are the guys who believe everything they read in the paper. Drug dosing including equianalgesic conversion is more trial and error than science. Don't believe me, read the prescribing information that comes with Durgesic. Somewhere in that mess it says conversion factors are only guidelines and every patient will have to be titrated individually, therefore they strongly suggest co-administration with a shorter acting narcotic analgesic to cover whatever shortcomings might arise from the switch. I am paraphrasing of course, but it's in there. But that's the reason they'd rather lowball the conversion and work up to an effective dose. So you did good.
Relax.--og
"m." <mxxxxxxx@xxxxxxxxxxx> wrote in message news:h5do9o$1e7j$1@xxxxxxxxxxxxxxxxxxxxxxx
"Robin" <me5@xxxxxxxxxxx> wrote in message
news:h5dk55$3jb$1@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
|
| "m." <mxxxxxxx@xxxxxxxxxxx> wrote in message
| news:h5diqc$13e1$1@xxxxxxxxxxxxxxxxxxxxxxx
| >
| > "Robin" <me5@xxxxxxxxxxx> wrote in message
| > news:h5dgpm$g6c$1@xxxxxxxxxxxxxxxxxxxxxxxxxxxxx
| > | Ok, for the past two days I have had the most awful anxiety and I
can't
| > | sleep. Every time I lay down or be still for a few minutes, my heart
| > pounds
| > | louder and my stomach gets tighter. I have to get up and move. I
| > slept
| > | all of 4 hours last night and I am SO tired.
| > |
| > | I have been taking my meds regularly and nothing has changed except
for
| > the
| > | switch from Kadian to the patch a month ago. I am just wondering
about
| > this
| > | because when I had to suddenly stop taking another med a few years
ago,
| > it
| > | was the same feeling. I am wondering if perhaps the change to the
patch
| > is
| > | causing this or maybe the dosages are wrong and I am not getting
enough
| > | morphine or whatever is in the patches that my body is used to and I
am
| > | going through a mini withdrawal.
| > |
| > | Someone here mentioned that the dosages were a little small. I was on
| > 80mg
| > | Kadian 2x daily. The patch is 75mcg change every 3 days. But, could
it
| > | take this long for the "withdrawals" to start? That's the only thing
| > that
| > | has me wondering if that is the issue. It's been a month and 3 days
| > since
| > | the switch. I was having NO issues at all except for the patch not
| > sticking
| > | a few times so I really don't see how this could be starting now. I
| > plan
| > on
| > | calling my pdoc in the morning if this is still a problem, but was
| > wondering
| > | if anyone here ever had something like this happen, and what I could
do
| > to
| > | maybe get a little sleep tonite.
| > |
| > | Thanks!!
| > |
| > | Robin
| > |
|
> -------------------------------------------------------------------------------------------------------------
| > Robin -- I think I said you might be on a lower equianalgesic dose of
| > fentynal (compared to a total of 160 mg /day of Kadian). I just
checked
| > a
| > conversion calculator and according to it, I was wrong. I'm sorry
about
| > that. According to this calculator http://www.globalrph.com/fent.cgi
| > if
| > you were taking 160 mg of Kadian daily, then your equianalgesic patch
| > strength should = 41.1 mcg. And according to the chart, you should
be
| > using a 50 mcg patch. I just checked another chart from another website
| > and
| > it agrees with the 50 mcg.
| >
| > So it appears that it isn't a problem with being under-dosed. I
wouldn't
| > think so since you have been using the patches for over a month and this
| > is
| > a totally new symptom. Additionally, it sounds like you are on top of
| > all
| > your medicines and the reactions to those medicines.
| >
| > I'm wondering if you are having symptoms of something totally new. I
| > don't
| > want to alarm you but this sounds similar to what I experienced before I
| > was
| > diagnosed with heart problems. And because it was something totally
new,
| > the diagnosis was difficult, at least for some of the ER staff.
| >
| > But you don't sound like you are anywhere near to that. Again, I
don't
| > mean to alarm you. I mean only to raise the possibility of something
| > other
| > than a reaction to medications.
| >
| > I'm sure others will have a better reply to your post. I just wanted to
| > make sure that I corrected what I said about the patch strength and to
| > apologize to you for being wrong.
| >
| > Feel well. Take care.
| > m.
| >
| Thank you for the correction. I do feel better about it. I figured my
pdoc
| wouldn't mess me up like that. He's awesome :) I am very lucky to have a
| doctor like him.
|
| Anyway, about the other thing. I am slightly concerned but only because
now
| I have no idea what could be the problem. I know my hubby has a heart
| problem he has a pacemaker implant. His heart would slow down to a crawl
| then stop and he would pass out. But he would come back after a few
| seconds. They only put the pacer in because they were afraid he would
pass
| out while driving.
|
| Not sure what to do at this point. I don't know if it warrants a call to
my
| primary doc or what I should do. Perhaps I will wait a few days and see
if
| it continues/worsens and then if so I will call.
|
| Thanks again for the reply,
| Robin
|
----------------------------------------------------------------------------------------------------------
Robin -- Boy, do I feel terrible about posting wrong. Being wrong is
bad enough, but to publish something that led someone to doubt their doctor
is -- terrible ! Profusely, I apologize again.
<feebly trying to redeem myself> ..........
I'm sorry to hear about your husband, but it's good to know that you are
familiar with heart disease. Its symptoms are many, and it can mascarade
as other diseases. If one's heart is failing, there can be nausea,
difficulty breathing, and a rapid heartbeat. Symptoms like that might lead
to a diagnosis of stomach problems and anxiety, separately. In contrast,
if there is a rhythm problem, the heart-rate can vary wildly.
You do not strike me as a person who is anxious. Neither am I. But
during the period leading up to my diagnosis, I began to experience waves
of almost overwhelming anxiety. This was so odd that the anxiety seemed
like it was outside of myself, although still part of me. So when I read
in your post that your heart is pounding and you're having severe anxiety,
I thought of the heart.
I am thinking that if this doesn't resolve itself in a few days, then it
most certainly warrants a call to your doctor. Whether or not you want to
wait that long is something that you know best. Just remember that the
weekend is coming up soon so getting a call in early is usually best.
I do hope you feel better. A pounding heart, extreme anxiety, and no
sleep sounds horrid.
Take care.
m.
Robin
.
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