Morphine

I started tapering my Morphine use 2 days ago, cutting out my midday dose of 30 mg. I now am on 60 mg BID, 120 mg total. I have been as high as 180 mg daily. I have been experiencing heavy nausea since then, which is one of the reported withdrawal effects. I have my eye on the prize of taking none which should be achievable in 26 more days with a moderate taper. We will see how it goes. I drop 15 mg on Saturday and plan on removing 15 mg every Wednesday and Saturday as long as I can manage the withdrawal.

I do not feel any cravings to go back to a higher dose or have some right now. I have heard the cravings are usually worse in the first 24-72 hours, but can last for years. So far, I haven't noticed any at all.

My pain levels since Wednesday and prior have been 3-4 without any Percocet. I hope to not need any during this time period. My parasthesia is still always present, though is not troublesome. Constant and bothersome yes, but not a big issue.

I started NATTO-K on Thursday morning. 1 tablet TID on an empty stomach. Empty stomach has not been a problem since I don't have an appetite. I have not noticed a major difference, but am in a remission state right now so I don't know what difference it could make. I will take it for a month and see. At $56 a month, it's a little expensive for me, but if this is the ultimate fix, it will be worth it.

Dr. visit yesterday

I saw Dr. Andy Schakel yesterday for a med recheck. We discussed that my Percocet use lately has been minimal and that I have slowly increased my Neurontin dose to 1200 mg TID, 3600 mg total. I continue using the Neurontin gel BID as well and, since I have no active ulcers, have stopped using Morphine gel.

I discussed a possible reason for my sexual dysfunction and, as a test, I will be slowly tapering my dose of Morphine by 30 mg yesterday, and 15 mg every 3-4 days after, watching for signs of withdrawal. Today I am on 60 mg BID, 120 mg total. It is my goal to be off Morphine and hopefully not to have to supplement with Percocet and diminish or even eliminate this problem.

I am presently still experiencing some depressive symptoms, though they are improving. I started Wellbutrin 12 days ago, 100 mg BID and a week later increased to 200 mg in the morning and 100 mg at night. I supplement this with 150 mg of Trazadone at night. I have a side effect that started the day after I started Wellbutrin: excruciating joint pain at night. These pains have been 9-10 level pain. I wake up during the night from this pain and experience it in the morning as well. It spread daily, starting in my shoulder one night, then the shoulder and elbow the next. Now it's every joint in my body except my neck. Once I get up and move around, the pain fades to none, and I haven't treated it pharmaceutically. I stopped taking Remeron at the same time that I started this new regimen. This side effect is rare but reported by some users of Wellbutrin. I am working with Dr. Ibrahimi on a different medication that will have the positive effects of this one, but without the side effects I experience.

I saw Dr. Lietch last Friday and discussed my current plan. I have had no side effects with the Lovenox injections, 60 mg in .6 ml every 12 hours. We will continue that course of therapy for 6 more months. The only trouble I have is finding some fatty tissue in which to inject. There is not enough on my back just above my hips, nor on my thighs. The only spot I have had success is a small patch on either side of my navel. Those 2 areas are now riddled with small bruises. I had an injection last week that bled under the skin, producing a 2 cm diameter dark purple, hard, area on my lower back, that was raised by 1 cm. With some pressure on both side of the injection, we could extract about .05 ml of blood and about the same amount discharged as I slept on my back that night. I will try that again if I get another subcutaneous bleed.

With Dr. Lietch's approval, I am starting NATTO-K, 1 pill TID, and Winstrol (stanozolol) 2.5 mg BID. Winstrol had been effective in the past. I will start these as soon as I receive them. Once I start Winstrol, I will discontinue my use of Danazol due to their similarities.

With these new treatments, I hope to stop some of the others and get my med use down from my present usage.

pain levels and upcoming Dr. Leitch appointment

I have had pain levels of 6 through most of the day today. When they hit 7 this afternoon I took 10/650 mg Percocet.

I see Dr. Leitch Friday and will talk to her about how my Lovenox injections has been going for nearly 4 weeks. I also want to talk to her about starting Winstrol again. I had taken that for 12-18 months back 4-5 years ago, I believe. I stopped taking it because it was no longer available from my pharmacy. I found that it is available without prescription from an anabolic supplementary web site anabolic-steroids.

I also want to talk to her about NATTO-K, which purports to dissolve fibrin. It's a pill taken TID and is available at the local health foods store. More information can be found here.

I hope that these, in conjunction with the other treatments will stop the progression of this condition and eliminate the symptoms, specifically the pain and ulcers.

thoughts about decrease in Neurontin

Today I was thinking that my recent issues with depressive symptoms may be related to my large decrease in daily Neurontin dose. I went from 5400 to 1800 mg daily over the last month or so. In addition to treating neuropathic pain and parasthesia (which is why I take it), it is used frequently as a mood stabilizer, and as a treatment for some anxiety disorders, depression, and also insomnia. It would make sense to me that these symptoms would increasingly present since my dosage has been decreased, especially so drastically.

Under Dr. Shakel's advice, I will start to increase my Neurontin dosage again. The main reason for decreasing my daily dose was to decrease the sexual dysfunction I have been experiencing, which has been only mildly effective. And my pain level and experience of parasthesia has increased as well so increasing my doses to reduce those would make sense also. This reduced dose trial did not produce its targeted goal.

I have been taking 1800 mg daily. I will increase 300 mg every 2 days until I reach 2700 mg and see whether it has an impact on the depressive symptoms.

I am glad that the increase in these symptoms has only minimally affected my abilities to perform my duties at work and home.

depression symptoms

The following are signs which I have noticed increasingly over the last few weeks which I recognize as symptoms of depression:

-Lack of appetite
-Difficulty falling and staying asleep most nights
-Some feelings of hopelessness and despair
-Lack of joy in singing, in which I normally find a source of energy. I have skipped men's choir many times in the last month and haven't been to church choir but once this year
-Feeling tired and restless through the day
-Difficulty concentrating on brain intensive tasks

I know that I have been, over the last few months, having to come to terms with the increase in the severity and frequency of my symptoms of Livedoid Vasculopathy and also its increased treatment. I am also physically and emotionally dealing with some new side effects of some of the medications I am on now and these are contributing factors, as well as are large changes in my living arrangements and family life.

I have been taking Remeron (Mirtazapine) 30 mg at night for treatment of similar symptoms in the past and will meet with my psychiatrist soon to discuss these symptoms, and this and alternative treatments.

I mention this because I believe this is, as part of my overall health, related to my struggles with my medical condition.

Lovenox and insurance coverage

When I received my first Lovenox prescription 19 days ago, it was for twice daily injections for a month. The insurance company only authorized payment for doses for 14 days. Dr. Leitch submitted pre-authorization documentation including case studies of this drug therapy for treatment of this condition to the insurance company for coverage for the balance of the month.

It took a couple weeks but this pre-authorization was finally approved today for the rest of the month's doses and I picked up 10 of the remaining 20 doses today. There was some other insurance issue that prevented me from picking up the remaining doses but I was assured by the pharmacist that I could pick them up tomorrow.

I have an appointment with her before the month is up to discuss how the treatment is working. Assuming there are no issues, I assume we will continue this course of treatment for the foreseeable future.

bruising from injections

I have been injecting Lovenox twice daily for 12 days now and have experienced slight bruising at a few of the injection sites until this morning. My injection bled just a drop when I withdrew the syringe but it has stopped just a few minutes later. I looked at the injection site at noon today and saw an area about 30 mm in diameter, raised about 10 mm that felt hard. I assume I had been bleeding under the skin surface for quite a while this morning.