166 replies to this topic

[greyeyed123]

She did well most of the day Friday.  Saturday was mostly bad with dry heaves now and then.  Today has been good all day so far (well, she did say she had the dry heaves once, but outwardly she looks fine today).  I guess I'll just go slower tapering both nortrip and lorazepam, not doing either at the same time as the other.  I don't always know what is causing what, but I do know as we reduce both of them, over time, she is improving.  I just have a tendency to second guess everything when she is initially worse after a drop.  (I may have gone too fast with the lorazepam initially this time, as I dropped a quarter of a percent every day for 3 days because she had no reaction. Waited a few days with no reaction, then dropped another quarter of a percent.  It wasn't until 3 or 4 days after THAT that she seemed to start having a reaction--probably because I had paused the lorazepam taper for 3-4 weeks prior to that.)

[fishinghat]

Just to give you something to think about, I am very sensitive to lorazepam withdrawal (this is my third time, long story) and I have been dropping by 0.7% every 3 days without any withdrawal effects. At 1% every 3 days I get a little symptoms after a couple weeks at that rate. Just something to compare to.

[greyeyed123]

You could be right, but since I'm trying to reduce both it's hard to tell. (I'm trying not to reduce both at exactly the same time, but alternate.)  Over a year ago she was on 3 and 1/2 mg of lorazapam a day.  Her neurologist wanted us to cut it by 1/2 a mg every week, which we did for two weeks.  Her main reaction to that was agitation and irrational certainty she had a urinary tract infection (she didn't; and over the next year of weaning she was certain she had an infection at least 12 times, probably more, and was tested every time, and only once late in that year was it actually positive--a few times she was so upset about it we took her to the ER, and after her next dose of lorazepam kicked in, she calmed down and didn't seem to care about why she went to the ER in the first place).  She had no vomiting. (In fact, the only gastrointestinal issue I remember was that her chronic constipation improved for the first time in two years.) Once we got to 2 and 1/2 a day, she had extreme agitation and flashes of rage, demanding her "medication", etc.  Then I managed to eliminate another 1/4 mg just by slowly cutting the pills over several weeks/months.  Then from December 2016 to June 2017 I used the water taper on another 1/4, getting her down to 2mg a day.  Now for her 6pm dose of 1/2 mg, I'm using the water taper so she's at 95% of that 6pm 1/2 mg.  The only time she ever had vomiting was when we reduced the nortrip from 75 to 50 to 25 over a two week period. I would have dropped straight to zero but right after we dropped to 25, she fell in the bathroom and bruised or cracked a rib.  She was/is already in chronic pain from her back, so I was afraid to go straight to zero after that as she was already having difficulty walking and with pain after the drops.

...

Also, after starting the nortrip was the first time she complained of headaches at all, and strangely enough, on top of her head.  She still has that complaint occasionally now, but she's still on a tiny bit of nortrip also. Her family doctor recently thought it was from tense muscles from the Parkinson's, but she's had tense muscles for way over 10 years, long before being diagnosed with Parkinson's, and never had headache complaints at all.

[fishinghat]

The human body is a puzzle for sure. The digestive issues are classic for benzos but each of us are very different. That is one of the reasons I always recommend that each person keep a journal. It is a lot more accurate than our memories (or at least mine,  lol) and it helps many go back and establish patterns and much more. Keep up the good work. You are an inspiration and a shining example of what can be accomplished with patience.

[greyeyed123]

I have a question you might be able to answer. Mom is on the very last bit of nortriptyline. I'm mixing her 25mg capsule with 6ml of water, removing all but 20 drops (and the residue in the plastic dixie cup), adding 30 drops of water, and removing 27 drops of that.  She's had a few dizzy spells, nausea/dry heaves, and intermittent confusion as I have just decided to drop every day until we're off the stuff (at this point I can barely see anything in the water and am amazed she seems to have SOME reaction every time we drop).  The complication is that there is only 15-20 pills left.

...

My workaround idea was to take the mixture I remove in the first step and just keep it (refrigerated with plastic wrap covering it) for the next day. I can then remove all but 20 drops from THAT, having residue in the bottom of that roughly equal, etc, and stretch what I have until we get to zero. I really, really don't want to ask the doctor for a refill on this stuff just for the tiny, tiny amounts she's using at this point, especially when I expect to be completely off of it in a month. The only reason I don't go straight to zero from here is because she is already a bit wobbly from the Parkinson's, other meds, not really eating enough because of the nausea, etc, and is prone to falling. Maybe I'm being too cautious, but that's how I feel.

...

Just wondering if you know if nortrip will keep in the frig, in water, for 24 hours, or over a few days. I know it is (or was) available in a liquid form, but I'm not sure if that's the same as just mixing the powder in the capsules with water. I intend to try it for the first time tonight as I kept the mixture from last night.

[fishinghat]

The only thing I found was several clinical labs that nortriptyline was stable in blood sam0les for 14 days when refrigerated. I would think there would be no problem with the method you described.

 

By the way the liquid form contains sodium benzoate as a preservative and has a shelf life of 6 months.

[greyeyed123]

Well, she had a moderate crying spell and an hour or two of odd confusion yesterday, so I must be going too fast again. She's also having a moderate amount of sleep disturbances--screaming once or twice a night, and some talking. At least I have given myself 2 or 3 more months to get to zero (if we need it) by stretching the pills I have. I've paused her lorazepam taper for the last 2 weeks or so, but I sometimes feel one pill masks the withdrawal from another...until suddenly it doesn't, and I have to pause the taper again.  (Her confusion was again of the sort where she starts a story that might be true--about a family member, something that happened years ago, or some celebrity gossip on tv--and slowly it becomes something else where I know that didn't happen and it makes no sense. Almost as if she is starting to dream a little bit while she's talking and just keeps talking.  She's had that before, but not in a while, and she did have it in the run up to 75mg of nortrip in the summer of '16, and when we did the initial drops to 50 and 25.  It's weird having similar reactions when she's on 2.5 or 3mg and dropping 10-20% over a few days, but I'll pause again and see.  It's disheartening because she mostly had a very good summer this year, although I tapered very little of anything this summer out of my own fatigue. I wish I could get her to a better place health-wise more quickly.)

[fishinghat]

It is the "...more quickly." part that is tough. There just isn't anyway to make the nerves recover quickly. You are doing the right thing and it may take a year or more to finish up but you will get there.

[greyeyed123]

It's 2:30 and she seems better today. A little wobbly once, but no falls, no crying, no severe confusion. It seems the smaller dose she's on, the faster she recovers from any problems in dropping too fast. I'm hoping she stays ok for the rest of the day. I'll keep the nortrip paused for a couple days before I try to drop again.

[greyeyed123]

Well, mom had her appointment with her neurologist this week. I told him she was down to between 1 and 2 mg of the nortrip, and that she seems worse after even small drops. He said this was not possible--that it was like 1/10 of an m&m spiking someone's blood sugar. He told me to go straight to zero from here, but I had already been dropping her 3-5% a day, so I just continued.  (I didn't see it productive for me to ask for a refill as he just told me what I was telling him wasn't possible.)  In the middle of dropping she got dizzy and hit her head, so now has a lump. And her confusion is worse--sometimes it just seems she can't find the right words, whereas other times she seems to be saying the wrong words and thinking the wrong thoughts with them--but my sense is we can get to zero over 2 or 3 weeks. Now I don't know if her confusion is because of the daily drops of nortrip, or because she hit her head...or both.  We had a family doctor appointment for this Friday, but apparently that got changed to Tuesday today.  And so it goes.

...

She also needed a refill on her Movantik, but it wasn't filled until Tuesday so she missed a couple doses. Since I'm paying over $300 a month for the stuff, I thought we might as well test to see how she does without it for a while since she had already missed 2 doses before the refill. This is the 4th day and I don't see much difference. She takes Amitiza for constipation as well, and it seems to be working. I know Movantik can cause some withdrawal symptoms by blocking part of the pain medication that causes constipation, so maybe stopping it may have a reverse effect, where a bit more pain medication is causing more confusion?  I don't know.

...

After mixing the nortrip and diluting it, I now have 28 drops left for each dose. I might start reducing by two drops a day. It does seem like a tiny, tiny amount now, but when she is only dizzy and extra confused after each drop, it's hard for me to believe there isn't a connection.

[fishinghat]

It seems hard for a dr to realize that these nerves take so long to recover. Even a small drop can cause them to be set off. They only know that a certain amount is necessary to have any effect when going on a drug so that amount or less shouldn't effect the nerves when coming off. The problem is that going on a drug involves healthy nerves and coming off involves sensitized nerves. Totally different. Don't worry, I would think you are doing the right thing by continuing the slow drop.

 

Concerning the bump on her head, I assume you checked the pupils of each eye to see if they are reactive to light and that there is no slurred speech or weakness on one side of her body.

 

Hang in there. She will soon be off the Nortrip and you can give her few days to rest up and recover before you adjust anything else.

 

This must be very exhausting for you. Be sure and set aside a little time for yourself each day to let your 'batteries' recharge.

 

God bless and you are doing great.

[greyeyed123]

I did check her pupils and they were fine. She's had many falls before (I bought her a bicycle helmet a year ago, but she refuses to wear it--she takes calcium supplements with vitamin D, vitamin D gummies, and a prolia shot every 6th months...otherwise she would have had some broken bones by now...although she probably did crack a rib over a year ago). I had "teacher training" today, which was only 1/2 a day, so I'm home now and her confusion seems much better. Again, I don't know why. The confusion over the last couple days could have been from the bump, or stopping the movantik, or tapering the nortrip.  (Her constipation seems to be about the same as it always is today, and this is the 5 or 6th day off the movantik, so I'm just going to keep her off of it for now. We have a whole bottle in case she needs it. I hate to spend $300+ a month on it if it's doing next to nothing.  She had such horrible constipation for a while there that she ended up in the hospital a couple of times, but that was more than 18 months ago, and much of the medication/withdrawals she was having then have been greatly reduced.)

...

Also I didn't remember the number of drops correctly in my last post. She's only got 18 drops left (16 now since I dropped two last night).  I was thinking that it might be less the amount I'm dropping now, but simply the accumulation of the drops over the last few months that cause her intermittent confusion now.  I've read about people having problems two or three months after stopping, so perhaps it's a delayed reaction.  Anyway I'm grateful that today, right now, she seems fine and isn't confused.

[fishinghat]

I thought you might find this interesting reading. They are all supported by medical research. The dandelion tea and prunes seem to help the best.

Support your feet with a small step stool [about 6 in. (15 cm)] when you sit on the toilet. This will help flex your hips and place your pelvis in a more normal "squatting" position for having a bowel movement.

Try a rectal glycerin suppository. Follow the directions on the label. Do not use more often than recommended on the label.

Sesame oil works better than any other oil in moisturizing stools.

Mint and ginger are both proven home remedies to help alleviate a slew of digestive problems. Peppermint contains menthol, which has an antispasmodic effect that relaxes the muscles of the digestive tract. Ginger is a "warming" herb that causes the inside of the body to generate more heat; herbalists say this can help speed up sluggish digestion. In tea, the hot water will also stimulate digestion and help relieve constipation.

The citric acid in lemon juice acts as a stimulant to your digestive system and can help flush toxins from your body. Squeeze fresh lemon juice into a glass of water every morning, or add lemon to tea; you may find that the refreshingly tart water not only acts as a natural remedy to your constipation but also that it helps you drink more water each day, which will improve your long-term digestion.

These fiber-rich fruits are a go-to home remedy for getting your digestion back on track. Three prunes have 3 grams of fiber, and they also contain a compound that triggers the intestinal contraction that makes you want to go. Another great dried fruit choice is figs, which may not cause as much bloating as prunes.

Fennel seeds are useful in treating issues like indigestion, bloating, constipation and irritable bowel syndrome as they encourage smooth muscle movement in the digestive tract.
1. Take one cup of fennel seeds and dry roast them.
2. Then, grind them and sieve the mixture.
3. Store this tasty and digestive powder in a jar.
4. Take half a teaspoon of this powder daily with warm water.

Triphala powder or churna
This consists of three fruits – amla or Indian gooseberry, haritaki (Chebulic Myrobalan) and vibhitaki (Bellirica Myrobalan). It is a great laxative and helps to regulate digestion and bowel movements.
How to use:
⦁ You can either have one teaspoon with warm water or.
⦁ Mix the powder with honey either before going to bed or early in the morning on an empty stomach.

Spinach
This has properties that cleanse, rebuild and renew the intestinal tract. You can also reap in these 10 amazing health benefits of palak.
How to use:
⦁ You can have about 100 ml of spinach juice mixed with an equal quantity of water twice daily.
⦁ This home remedy is the most effective method to cure even the most stubborn cases of constipation.

Pure olive oil is more than just a healthy and tasty fat, it can also help relieve constipation. It’s not surprising really when you consider what olive oil’s texture and consistency is like- it’s practically the poster child for constipation home remedies. It stimulates your digestive system, which helps get things moving through your colon, and taken regularly it can prevent constipation as well.
You will need…
-1 tablespoon of olive oil
-1 teaspoon of lemon juice (optional)

Aloe is known to soothe minor cuts and burns, but it can also soothe your tummy. It’s best to use pure aloe vera gel from the plant. The gel straight from the plant is more concentrated than commercial aloe juice so don’t use more than 2 tablespoons. If you don’t have an aloe plant, than drinking aloe juice can accomplish similar results.
You will need…
-2 tablespoons of pure aloe gel or 1 cup of aloe vera juice
Directions
Mix two tablespoons of pure gel with fruit juice and drink in the morning, OR drink one cup of aloe vera juice as needed.

Grapes can overcome constipation pretty effectively. The combination of the properties of the cellulose, sugar, and organic acid in grapes make them a great laxative. Grapes also tone up the stomach and intestines and relieve the most chronic constipation. One can consume up to 350 gm of grapes daily to achieve desired results. Alternatively, in absence of grapes, raisins can be soaked for twenty-four to forty-eight hours and eaten early in the morning, along with the water in which they have been soaked.

Bile acids help to soften the stool and move it more quickly through the colon. Dandelion root stimulates the production of bile and can help relieve constipation in a natural way. Just boil 2 tablespoons of fresh dandelion root to have it as tea. Alternatively, you can have its extract (250-500 mg) with meal.
 

[greyeyed123]

The constipation hasn't been a big problem in a while, but both her Parkinson's and Oxycodone cause constipation, along with a few of her other meds.  She was taking 1-2 capfulls of Miralax every day, but stopped that in the last few months (it wasn't needed any more).  She's also stopped taking her fiber powder. When it was really bad, she used prune juice, prunes, "smooth move" senna tea, prescription lactulose, stool softeners, glycerin suppositories, and dulcolax (if nothing else worked).

...

Three or four years ago, before taking any of this, she ended up in the hospital for constipation. If memory serves, it was after starting one of the pain medications. They told her to drink a bottle of magnesium citrate and sent her home.  She drank a whole bottle and 12 hours later still nothing happened. I had to get another bottle for her to drink and slowly things began to move. (They told us it was too harsh for her to use on a regular basis, but we had to use it a few times more after that. I still keep a couple bottles for emergencies, but we've had those bottles for way over a year. Maybe two years.)  I think they simply had her on too many medications.  Reducing her lorazepam seemed to help the constipation, especially when we first started reducing it from 3 and 1/2 down to 3, and from 3 down to 2 and 1/2. That happened very quickly over 2 weeks. The rest of the reductions have taken way over a year, and we're now down to 1.95mg/day.  I think the addition of the nortrip didn't help the constipation any either.  (And the cymbalta...and her myrbetriq...and probably a couple of others don't help it any either.)

...

Her family doctor added Amitiza to her meds about a year ago. I think it has been doing all the heavy lifting in resolving her constipation.  Not sure the Movantik was doing much of anything. I guess I'll know soon if it becomes a problem again.

...

I read somewhere on the net about boiling prunes in water, cooling the water and drinking that. I never had her try that one, but I'll add your suggestions to that list in case it becomes a problem again.

...

Thanks for all your help.  She is actually doing much better than she was two years ago, and I think getting off the nortrip will be a big step in the right direction.  Your help with the water taper of the lorazepam has also helped her a lot.  There was more than once in the last few years where I thought things would never get better and only get worse.  But even the bad days now are 1000% better than the regular days were a year or two ago.

[fishinghat]

That's is great. Patience is a great tool. By the way diarrhea is a withdrawal symptom for lorazepam so that may have helped. lol

[greyeyed123]

We're two or three days away from zero, and she's having more dry heaves and more complaints of burning pain, but otherwise I think she's doing pretty good. I'm glad I didn't drop it all at once like the neurologist said. Spreading it over two weeks has been bad enough (almost no reaction until the last 2 or 3 days). I do expect her to stabilize over the next few days, hopefully sooner. Every time a doctor says "that's not possible," I second guess myself. And every time her reactions are like clockwork. The best feeling is knowing that once we get to zero, there is no more "dropping," lol.  So no more reactions to the dropping. Fingers crossed.

[fishinghat]

Hang on. You are close. Drs seem to think that all human bodies act the same under all conditions. NOT!!

 

If the dry heaves are bothering her you might try a half dose of Imodium. It helps relax the GI muscles but don't use it if constipation is an issue. In the case of constipation you can have her suck on a peppermint lozenge. This relaxes the esophagus/stomach  but does not affect the lower intestines and does not aggravate constipation or diarrhea. Be sure it has real peppermint not peppermint flavoring. I have occasional  esophageal spasms (a weaker form of dry heaves) and they work well for me. I buy mine at a health food store for about $3 for 10 lozenges.

 

Ley me know how it goes.

[greyeyed123]

Gave her the last dose of nortrip on Friday night, which was just the residue in the cup.  She got none Saturday night.  It's been a year and almost 4 months since we started this.  She had dry heaves once this morning, seemed like she was going to have a rough day for a half-hour or so, and snapped out of it. Right now she seems fine. I hope things stay this way. Fingers crossed.

[fishinghat]

Fantastic. One down and how many to go?  Easy for someone like you.

[greyeyed123]

Her pain doctor wants to increase her oxycodone from 4 of the 5/325 per day, to 4 of the 7.5/325 per day.  I haven't been keen on the idea of increasing anything, especially since her confusion gets worse with more pain meds, and because we've just come off the nortrip, and because we're still weaning the lorazepam, and because she takes several hours to get ready for the doctor so she's exhausted and anxious by the time we get there and they think this is the way she always is. But he insisted we should try it and if it doesn't work, to go to 3 of the 7.5/325 a day, which is close to what she's taking now.  I don't know what to think of this. I just wish they would give her a chance to stabilize before jerking her around again.

[fishinghat]

Is she having a lot of debilitating pain and if so how does this compare to say 2 years ago before you started doing all the weaning?

 

If her pain is not too bad and her fatigue is an issue than I fully agree with you. An increase in oxycodone would certainly increase the fatigue let alone the fact if she has to come off the oxycodone in the future it will just be that much more withdrawal to deal with. Your call but I would wait until all this weaning stabilizes unless things change.

[greyeyed123]

She has 5 slipped disks, so she always has pain, but it gets worse when weaning off something.  (And the Parkinson's is like three dimensional chess.  When she's too far into withdrawals, her Parkinson's meds aren't effective all the way to the next dose--so she has "off" time, which not only causes her movements to freeze up, but also causes anxiety and depression...and pain.  When we first discussed this with her old neurologist and her family doctor a few years ago, they told us Parkinson's isn't associated with pain or anxiety. Soon after the neurologist admitted it IS associated with anxiety, especially during "off" time, and when I didn't believe them about the pain, my research showed that some Parkinson's patients ONLY have pain as a early primary symptom before any others.  The home health nurse she had for a while even said Parkinson's is often very painful--and she was a nurse who often worked with Parkinson's patients.) Today she was much better, so I'm hoping the last of the nortrip withdrawals are behind us. Yesterday she wasn't doing so well, but she took several hours to get ready for the doctor and usually pushes herself too hard.  By the time we get to the doctor, she's exhausted and anxiety-ridden, and so the doctors want to start changing things (and when I explain, they tend to ignore me and go by how she appears at that very moment).  They only gave us a prescription for the 7.5/325's now, so I think I'll just start her on 3 a day and see how that goes since it's just a little more than what she's taking now.

...

I'll have to watch her for a few more days, but right now I think her increased pain was due to the nortrip withdrawal and the "off" time between Parkinson's doses, which were exacerbated by the nortrip withdrawal (she had the same phenomenon with the lyrica withdrawal previously--only it lasted much longer).  She proudly told me she didn't get sick today at all (for the first time in a couple of weeks as far as I can remember), and I made her a giant baked potato for dinner...and she ate the whole thing.  I hope tomorrow goes as well.

[fishinghat]

Great. I am sure you are both looking forward to a little stabilizing time before adjusting any mire meds. What is next on the med list to deal with?

 

My wife has had 1 cervical fusion, 2 lumbar discectomies, and artificial disc implanted and considerable scar tissue on the nerves along her spine. I understand how you must feel dealing with someone in constant pain. Because of love we are glad to help though.

 

Congrats on the nortrip.

 

God Bless

[greyeyed123]

We've tried to work on the lorazepam also, but we've only reduced about 1 percent in the last few months. Two years ago, her sleep doctor had her on clonazepam for her REM behavior disorder (common in Parkinson's). But in the wake of her lyrica withdrawal, she stopped taking the clonazepam because she said it made her dizzy at night when she needed to go to the bathroom. This was back when she was still in charge of her own meds, so I wasn't aware of all the side effects, withdrawals, interactions, etc.  But she soon went into withdrawals from stopping the clonazepam, ended up in the hospital, and they started her on the lorazepam.  (I only knew it was clonazepam withdrawal much later, when she had the same set of symptoms during lorazepam withdrawal.)

...

Now some of her sleep disorder is re-emerging so we might need to go back to the sleep doctor. My guess is he'll want to put her back on the clonazepam, which may eliminate the need to keep weaning the lorazepam (if she simply switches). My fear is the switch may be less than smooth. But it might be unfounded. I don't know.

[fishinghat]

GE, you say she has a REM sleep disorder? You do know that benzos block REM sleep right? Let me know if you need some info on that.

[greyeyed123]

Clonazepam is the "go to" drug for REM Behavior Disorder (RBD).  She also takes 10mg of melatonin at bedtime.  RBD is not well understood, but it is a common early and continuing symptom of Parkinson's.  (Doing a few searches for alternative medications to clonazepam for RBD just gave me melatonin and "some antidepressants."  So that's kind of a dead end.  The sleep doctor she was going to was one of the best in the state, which is rare in our area.  But it didn't seem like there was much advice they could offer besides clonazepam, melatonin, a CPAP, and sleeping in a bed--not her chair--every night.  They did prescribe a low dose of ritalin for her daytime sleepiness at one point, but we stopped that a couple years ago during the lyrica withdrawal.  It seems the more doctors we go to, the more medications they put her on--and both the doctors and the medications start to work at cross purposes. The pain meds make the Parkinson's worse, the Parkinson's meds make the pain worse, the Parkinson's causes anxiety, the anxiety meds make the Parkinson's worse, the clonazepam is supposed to help her sleep, the ritalin is supposed to keep her awake, etc.)

[fishinghat]

I hope you don't mind but I am going to dig into the medical journals on this one. I just don't understand the clonazepam issue.. It may take me some time as I am spending the day with the wife today but I will get back to you.

[fishinghat]

"Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep. Patients appear to “act out their dreams,” in which the exhibited behaviors mirror the content of the dreams, and the dream content often involves a chasing or attacking theme". NCBI

That is why they give these patients benzos, particularly clonazepam, is to help avoid REM sleep so the frightening dreams and complex behavior never develops. I learned something today. I never dreamed that REM sleep could be bad for a person. Live and learn.

 

By the way I found a couple articles that mention that sometimes the antidepressants make the RBD even worse in some patients.

[greyeyed123]

She had intermittent RBD years and years before her Parkinson's diagnosis (mid to late '90s). Once she got out of bed and ran across the room, but every other time it was just talking, screaming, yelling, and thrashing about.  Often she could have conversations with you in her sleep and she'd see you as a character in her dream.  (The clonazepam helped reduce that quite a bit, and now I suppose the lorazepam is doing that.)  If you told her to wake up because she was dreaming, she'd yell back, "I'M NOT DREAMING!"  Actually she did that again the other night, but that's pretty rare anymore.

...

Regarding some antidepressants making RBD worse...  A year ago, in the summer of '16, her RBD gradually got worse with each higher dose of the nortrip. When we finally got to 75mg per day in the 3rd week, she was talking/yelling in her sleep from 10 or 11PM to 5AM  nonstop (I tried waking her because usually that had a good chance of quieting her down, but not on that dose of nortrip--she'd go immediately back to sleep and immediately start talking/yelling again).  We toughed it out for about 8 days hoping it would improve, until she was screaming at 4PM each day that her pain was unbearable (mornings, strangely, were usually fine).  Her family doctor didn't want to overrule the neurologist, so told us to continue for a week and then reverse course back to the cymbalta if things didn't improve...but in the car on the way home she started screaming in pain and anxiety, so that's when we started weaning back off of it.

...

FYI, I gave her 1 and a 1/2 of the 5/325 oxycodone at noon today (the pain doctor said to use up our old ones in this way after I filled the new 7.5/325 so that the timing will allow the insurance to cover the refill next time--whether we switch back to 5/325 or stay on the 7.5/325).  It's been 4 hours and she does seem a little better, but at this point it is hard to tell if it is just her normal ups and downs throughout the day.

[fishinghat]

What an ordeal. You should be nominated for sainthood. Keep up the good work and have a good Sunday.