(my original post was too long, so this is the continuation…)
So, here I am. I’m about to quit my six-figure job because of the stress levels, and take a job paying about 1/5th my current income. I have been given a diagnosis that doesn’t completely fit, but have to accept it and do everything that is recommended in hopes that they’re right, and if not, then I can say I’ve honestly tried everything they’ve suggested. And wait. I told the rheumotologist that I had to have 2-3 weeks off of work, in the form of a short-term disability, because my 11-12 hour a day job was only making things worse, and that I need a break to “re-boot”. If I don’t take this time, I will end up being fired because I can’t meet their performance standards; if I DO take the time, I may be fired, with some BS reason behind it, simply because my employer is sick of dealing with this. I was “written-up” about three weeks ago and told that if my performance does not improve, I will be further disciplined, and subject to termination, within 60 days. Even though I’m approved for FMLA for up to 4 days per month (which is 20% of my time), I was told that I’m still expected to meet the full standards, and that our home office personnel people had determined that 4 days per month was not a large enough impact that I shouldn’t be able to meet the criteria. As a result, I have enlisted the help of a state senator, and am trying to get in to see a couple Labor/Employment attorneys to discuss this violation of federal FMLA laws.
My wife has been incredibly supportive, but I fear this is all taking a huge toll on her. She’s the one that told me to quit my job, because of the level of stress it’s causing, and its’ impact on my health, our relationship, our family, etc.
All I keep thinking about is the stories I’ve read here, and how this all sounds so similar to what others have gone through, only to discover…years down the road…that they were right all along, and that they do, in fact, have CIDP. I’m at my wit’s end. The main reason I agreed to start taking the Savella is because of its’ antidepressant abilities, and I recognize that I am starting to become depressed. Meanwhile, the fatigue worsens, my strength continues to deteriorate, and my hopes fade.
Wish I could be more hopeful and positive, but my experiences don’t support that. What I AM concluding is that God is using all of this to convince me that I need to make some serious changes in my life, get back to some values I may have sacrificed when I took my present job, and to help me get things back in perspective.
I don’t know what to ask you all for…probably prayers of strength and wisdom; I’m not the type that asks for prayers for healing…that kind of seems like telling God what to do, which is pretty laughable in my book. I would rather be able to handle HIS expectations, than try and convince him to meet mine.
Thanks for listening, thanks for your support; sorry this is so long and depressing. Any suggestions would be welcome.
The Following side effects have been seen during clinical trials of topamax in preventing frequently recurring migrainnes: The most often reported effects were: tiredness, pins and needles in the fingers and toes, dizziness, lowered sense of feeling in the skin, difficulty with language, nausea, diarrhoea, indigestion, dry mouth, weight lost, decrease in appetite, drowsiness, forgetfulness, difficulty with concentration or attention, difficulty in sleeping (insomnia), anxiety, mood swings, depression, changes in taste and vision disorders.
General: Rarely, blood clots have occurred in patients given topamax. However, it has not been proven that these were caused by this medicine. Rarely, blurring of vision and eye pain have been reported. Rarely and mostly in children, reduced sweating has occurred, mainly during exercise or in warm conditions. If someone taking Topamax becomes flushed or overheated, they should relax in a cool place and drink plenty of water. Very rarely, drug withdrawal convulsions (fits) have been reported.
Rarely, the inhibition of carbonic anhydrase may be strong enough to cause metabolic acidosis of clinical importance.
The side-effects most frequently leading to discontinuation of therapy with topiramate were:
* Psychomotor slowing (4.1%)
* Memory problems (3.3%)
* Fatigue (3.3%)
* Confusion (3.2%)
* Somnolence (3.2%)
The side-effects reported by > 10% of subjects in at least 1 clinical study Listed by prevalence: (*indicates placebo rate [%] is the same or higher than side-effect rate)
* headache (23.8%) *[25.9%]
* paresthesia (numbness & tingling) (23.1%)
* upper respiratory tract infection (17.5%)
* diarrhea (16.8%)
* nausea (15.4%)
* somnolence (15.4%) *[16.1%]
* anorexia (loss of appetite) (13.3%) *[5.6%]
* insomnia (11.9%) *[11.2%]
* memory problems (11.2%)
* dizziness (10.5%) *[10.5]
The Food and Drug Administration (FDA) has issued a notification alerting physicians who prescribe topiramate, and their patients, to the risk of vision loss (blindness). Acute myopia and secondary angle closure glaucoma, in a small subset of patients who take topiramate regularly, may cause transient (reversible), or permanent, loss of vision. The symptoms, which typically begin in the first month of use, include blurred vision and eye pain. If addressed early in its course, discontinuation of topiramate, along with other measures deemed prudent by the prescribing physician and/or ophthalmologist, may halt the progression of the ocular damage, and may reverse the visual impairment. Patients who take topiramate and who feel pain in or around their eyes, or notice a loss of vision, visual acuity, or blurred vision, are advised to seek consultation with their physician as soon as reasonably possible. According to the FDA: “in more than 825,000 patients…As of August 17, 2001 there have been 23 reported cases: 22 in adults and 1 in pediatric patients. It is generally recognized that postmarketing data are subject to substantial under-reporting.”
Another serious side-effect is the development of osteoporosis in adults and children (bones affected break more easily) and rickets (abnormal, deformed growth of bones) in children. Topiramate may also slow the growth of children. All of these conditions should be detected early by performing regular clinical examinations of the patients.
In other postmarketing research, a risk of decreased sweating and hyperthermia was discovered. Pediatric patients (children) are especially prone to this side-effect. It is recommended that children treated with topiramate should be monitored closely for evidence of decreased sweating and increased body temperature, especially in hot weather. All patients, particularly those with other predisposing factors, should be instructed to maintain an adequate fluid intake in order to minimize the risk of kidney stone formation.
Preliminary data suggests that, as with several other anti-epileptic drugs, topiramate carries an increased risk of congenital malformations. This might be particularly important for women who take topiramate to prevent migraine attacks.
* As topiramate inhibits carbonic anhydrase, the concomitant use of other inhibitors of carbonic anhydrase (e.g. acetazolamide) may lead to an increased risk of renal stones.
* Enzyme inductors (e.g. carbamazepine): The elimination of topiramate may be increased, possibly requiring dose escalations of topiramate.
* Phenytoin: Topiramate may increase the plasma-levels of phenytoin.
* Topiramate itself is a weak inhibitor of CYP2C19 and induces CYP3A4. Under topiramate a decrease of plasma-levels of estrogens (e.g. ‘the pill’) and digoxin have been noted.
* Alcohol may cause increased sedation or drowsiness, and increase the risk of having a seizure.
* As listed in the 06/29/2005 label posted at the Drugs@FDA website page 14,’conditions or therapies that predispose to acidosis may be additive to the bicarbonate lowering effects of Topiramate’. Absent from this label is any direct discussion of narcotic (drugs known to promote respiratory acidosis) interactions. This discussion on page 14 is under the topic of Metabolic Acidosis, and is not repeated under the topic of interactions.
* Oligohydrosis and hyperthermia were reported in post-marketing reports about topiramate, antimuscarinic drugs (like trospium) can aggravate these disorders.
In order to avoid early side-effects (e.g. cognitive dysfunction) the initial dosage normally is low and increased in slow steps. The usual initial dosage is 25 to 50 mg daily in 2 single doses. Recommended increments are 25 to 50mg every 1 or 2 weeks. Common dosages for maintenance treatment are 100 to 200 mg daily. The highest dosage possible is 1,000 mg daily in divided doses.
Symptoms of overdose may include but are not limited to:
* Dizziness, drowsiness, tiredness
* Speech problems
* Blurred vision, double vision
* Troubled thinking
* Loss of coordination
* Inability to respond to things around you
* Loss of consciousness
* Confusion and coma
* Upset stomach and stomach pain
* Loss of appetite and vomiting
* Excessive hunger
* Shortness of breath; fast, shallow breathing
* Pounding or irregular heartbeat
* Muscle weakness
* Bone pain
A specific antidote is not available. Treatment is entirely symptomatic.
Hope that helps,
[COLOR=red]Other sources speculate that the number 13 may have been purposely vilified by the founders of patriarchal religions in the early days of western civilization because it represented femininity. Thirteen had been revered in prehistoric goddess-worshiping cultures, we are told, because it corresponded to the number of lunar (menstrual) cycles in a year (13 x 28 = 364 days). The “Earth Mother of Laussel,” for example — a 27,000-year-old carving found near the Lascaux caves in France often cited as an icon of matriarchal spirituality — depicts a female figure holding a cresent-shaped horn bearing 13 notches. As the solar calendar triumphed over the lunar with the rise of male-dominated civilization, it is surmised, so did the number 12 over the number 13, thereafter considered anathema. [/COLOR]
[COLOR=red]On the other hand, one of the earliest concrete taboos associated with the number 13 — a taboo still observed by some superstitious folks today, evidently — is said to have originated in the East with the Hindus, who believed, for reasons I haven’t been able to ascertain, that it is always unlucky for 13 people to gather in one place — say, at dinner. Interestingly enough, precisely the same superstition has been attributed to the ancient Vikings (though I have also been told, for what it’s worth, that this and the accompanying mythographical explanation are apocryphal). The story has been laid down as follows: [/COLOR]
[COLOR=red][B]Loki, the Evil One[/B] [/COLOR]
[COLOR=red]Twelve gods were invited to a banquet at Valhalla. Loki, the Evil One, god of mischief, had been left off the guest list but crashed the party, bringing the total number of attendees to 13. True to character, Loki raised hell by inciting Hod, the blind god of winter, to attack Balder the Good, who was a favorite of the gods. Hod took a spear of mistletoe offered by Loki and obediently hurled it at Balder, killing him instantly. All Valhalla grieved. And although one might take the moral of this story to be “Beware of uninvited guests bearing mistletoe,” the Norse themselves apparently concluded that 13 people at a dinner party is just plain bad luck. [/COLOR]
[COLOR=red]As if to prove the point, the Bible tells us there were exactly 13 present at the Last Supper. One of the dinner guests — er, disciples — betrayed Jesus Christ, setting the stage for the Crucifixion. [/COLOR][COLOR=red]Did I mention the Crucifixion took place on a Friday? [/COLOR]
[COLOR=red][I]It is said: Never change your bed on Friday; it will bring bad dreams. Don’t start a trip on Friday or you will have misfortune. If you cut your nails on Friday, you cut them for sorrow. Ships that set sail on a Friday will have bad luck – as in the tale of H.M.S. Friday … One hundred years ago, the British government sought to quell once and for all the widespread superstition among seamen that setting sail on Fridays was unlucky. A special ship was commissioned, named “H.M.S. Friday.” They laid her keel on a Friday, launched her on a Friday, selected her crew on a Friday and hired a man named Jim Friday to be her captain. To top it off, H.M.S. Friday embarked on her maiden voyage on a Friday, and was never seen or heard from again.[/I] [/COLOR]
[COLOR=red]Some say Friday’s bad reputation goes all the way back to the Garden of Eden. It was on a Friday, supposedly, that Eve tempted Adam with the forbidden fruit. Adam bit, as we all learned in Sunday School, and they were both ejected from Paradise. Tradition also holds that the Great Flood began on a Friday; God tongue-tied the builders of the Tower of Babel on a Friday; the Temple of Solomon was destroyed on a Friday; and, of course, Friday was the day of the week on which Christ was crucified. It is therefore a day of penance for Christians. [/COLOR]
[COLOR=red]In pagan Rome, Friday was execution day (later Hangman’s Day in Britain), but in other pre-Christian cultures it was the sabbath, a day of worship, so those who indulged in secular or self-interested activities on that day could not expect to receive blessings from the gods — which may explain the lingering taboo on embarking on journeys or starting important projects on Fridays. [/COLOR][COLOR=red]To complicate matters, these pagan associations were not lost on the early Church, which went to great lengths to suppress them. If Friday was a holy day for heathens, the Church fathers felt, it must not be so for Christians — thus it became known in the Middle Ages as the “Witches’ Sabbath,” and thereby hangs another tale. [/COLOR]
[COLOR=red][B]The Witch-Goddess[/B] [/COLOR]
[COLOR=red]The name “Friday” was derived from a Norse deity worshipped on the sixth day, known either as Frigg (goddess of marriage and fertility), or Freya (goddess of sex and fertility), or both, the two figures having become intertwined in the handing-down of myths over time (the etymology of “Friday” has been given both ways). Frigg/Freya corresponded to Venus, the goddess of love of the Romans, who named the sixth day of the week in her honor “[I]dies Veneris[/I].” [/COLOR]
[COLOR=red]Friday was actually considered quite lucky by pre-Christian Teutonic peoples, we are told — especially as a day to get married — because of its traditional association with love and fertility. All that changed when Christianity came along. The goddess of the sixth day — most likely Freya in this context, given that the cat was her sacred animal — was recast in post-pagan folklore as a witch, and her day became associated with evil doings. [/COLOR]
[COLOR=red]Various legends developed in that vein, but one is of particular interest: As the story goes, the witches of the north used to observe their sabbath by gathering in a cemetery in the dark of the moon. On one such occasion the Friday goddess, Freya herself, came down from her sanctuary in the mountaintops and appeared before the group, who numbered only 12 at the time, and gave them one of her cats, after which the witches’ coven — and, by tradition, every properly-formed coven since — comprised exactly 13. [/COLOR][I][COLOR=#236eb5][/COLOR][/I]