[cashart10]

Yes, I was honest with him and

Possible trigger:

yes, I told him Tues night especially that I really thought I could do it.

He apologized for not getting back to me and said he had been under the weather. He said he would like me to stay out of the hospital as long as possible and agreed it was time for the clozaril. I asked him if I did feel as though I needed the hospital where I would go and both of the hospitals he mentioned do not accept state insurance for my age group. I called to check. He told me to call the pharmacist to ensure they had the medication and go from there. I tried that and they only had the 100 MG tablet and not the 20 MG tablet so I have to call my pdoc's office back to see where he wants me to begin.

I did ask about the mix between this and other meds and he said it was low if any and that I should be fine. So, I guess I'm going to take his advice. It is TOTALLY different than what my former pdoc's advice would have been. He must have great faith in my deterents is all that I can figure.

[gayleggg]

I hope the medicine helps. And it's good that you are exploring your options as far as hospitals are concerned. It's better to be prepared.

Sent from my iPhone using Tapatalk

[jacky8807]

I never asked if I should go to the hospital I was in such crisis I just went (if I wasn't sent lol)
So maybe you can stay out and try the med and do ok but if it gets worse I would just go!
I hope you start feeling better soon

[wildflowerchild25]

MAN I can't believe your pdoc! Mine would have locked me up ages ago. I did see what beyond posted in your other thread. Is your pdoc SURE there's no interactions? I would be worried of that. I'd go inpatient just to be sure I was monitored in case there was an interaction. But that's just me, I go IP like it's my job apparently. I hope you are safe enough to give the med a chance to work! I don't know how long clozapine would take to start working.

But I hope it does work for you! PLEASE go IP if you feel you can't wait!!!! I just want you to be safe. As we all do.

[cashart10]

Thank you so much! And, I know, my old pdoc, would have locked me up ages ago. I might of mentioned this but he must have great faith in my deterrents. Plus, I wonder if his "under the weather" is really "leave me the hell alone."

[cashart10]

I feel like I nag the crap out of him.

[BeyondtheRainbow]

Please be careful with the clozaril. If you feel anything weird with your heart or blood pressure it needs checked out. Like I said, my pdoc is very adamant that the "major" interaction is a big deal. But I'm not on abilify so maybe it's different. I know she will not do "major" interactions I think ever but maybe that's because my history with meds is so bad. I don't think that's the reason but I've never asked specifically I guess. Just maybe have a low threshold for concern maybe?

If your pdoc didn't want you to bother him you wouldn't have his contact information. They know when they give that out which patients are going to need to use it. I do think that he should be more responsive or tell you to contact him another way (when my pdoc was getting chemotherapy and radiation I knew that she wasn't going to be answering emails as often and that I needed to call her secretary). But trying to get help for yourself using information he gave you is definitely not nagging. If you looked up his information yourself and kept calling him THAT would be a problem but you didn't so you are fine and are just doubting yourself.

Like others have said when he is being willing to keep you out of the hospital when even you feel you need to be there (and I thought he's always said that was when he would send you?) I think you need to be ready to decide to go in anyway if you need to. Ultimately only you can decide when this is necessary; he isn't in your head. So if you feel in danger you need to go and let the hospital figure out whether you should stay.

I hope the clozaril works for you. Just please be careful with it. It apparently is a drug that you only get one chance; if you stop it it's unlikely to work a 2nd time (from anecdotal reading) and so I think you have to have the support in place to make sure it works the first time.

Also please be careful with that starting dose. I thought 20 sounded high so I looked it up and this is what I found:

Required Laboratory Testing Prior to Initiation and During Therapy

Prior to initiating treatment with CLOZARIL, obtain a complete blood count (CBC) with differential. The absolute neutrophil count (ANC) must be greater than or equal to 2000/mm³and the WBC must be greater than or equal to 3500 mm³in order to initiate treatment. To continue treatment, the ANC and WBC must be monitored regularly [see WARNINGS AND PRECAUTIONS].

Dosing Information

The starting dose is 12.5 mg once daily or twice daily. The total daily dose can be increased in increments of 25 mg to 50 mg per day, if well-tolerated, to achieve a target dose of 300 mg to 450 mg per day (administered in divided doses) by the end of 2 weeks. Subsequently, the dose can be increased once weekly or twice weekly, in increments of up to 100 mg. The maximum dose is 900 mg per day. To minimize the risk of orthostatic hypotension, bradycardia, and syncope, it is necessary to use this low starting dose, gradual titration schedule, and divided dosages [see WARNINGS AND PRECAUTIONS].

[cashart10]

Originally Posted by BeyondtheRainbow

Please be careful with the clozaril. If you feel anything weird with your heart or blood pressure it needs checked out. Like I said, my pdoc is very adamant that the "major" interaction is a big deal. But I'm not on abilify so maybe it's different. I know she will not do "major" interactions I think ever but maybe that's because my history with meds is so bad. I don't think that's the reason but I've never asked specifically I guess. Just maybe have a low threshold for concern maybe?

If your pdoc didn't want you to bother him you wouldn't have his contact information. They know when they give that out which patients are going to need to use it. I do think that he should be more responsive or tell you to contact him another way (when my pdoc was getting chemotherapy and radiation I knew that she wasn't going to be answering emails as often and that I needed to call her secretary). But trying to get help for yourself using information he gave you is definitely not nagging. If you looked up his information yourself and kept calling him THAT would be a problem but you didn't so you are fine and are just doubting yourself.

Like others have said when he is being willing to keep you out of the hospital when even you feel you need to be there (and I thought he's always said that was when he would send you?) I think you need to be ready to decide to go in anyway if you need to. Ultimately only you can decide when this is necessary; he isn't in your head. So if you feel in danger you need to go and let the hospital figure out whether you should stay.

I hope the clozaril works for you. Just please be careful with it. It apparently is a drug that you only get one chance; if you stop it it's unlikely to work a 2nd time (from anecdotal reading) and so I think you have to have the support in place to make sure it works the first time.

Also please be careful with that starting dose. I thought 20 sounded high so I looked it up and this is what I found:

I'm just so confused I want to cry. Thank you, love. I have no idea what I'm doing but I hope it works like so many say it will. I will make it through like I always do, I guess. And yes, he always asks if I need to go in and asks me if it's time. I always thought a yes answer would mean it's time. Maybe because I said "I'm not sure if I'm safe or not" he didn't concede. To be honest, once I mentioned that my family wanted me to go ahead and try the clozaril, there was no more mention of the hospital until I asked where I would go. I've had another bad day. I feel like calling my pdoc and telling him to eff off and I never cuss like that. He didn't even do anything wrong and I know it's the mania talking. But, still

[cashart10]

Okay, so maybe I sometimes I cuss like that but not usually and not usually toward someone and usually only if I am manic. Just to clarify.

[BeyondtheRainbow]

I'm sorry for confusing information. I just want you to have it because I would want to and I guess just because I expect my pdoc to tell me all this ahead of time. In fact the deal really is that I don't read drug profiles anymore because I used to know the lethal doses of most of my meds. (I did not read that far about clozaril but I've read about dosing etc because it helps me understand what the low dose she tells me may help will be).

I only swear when manic too. It's actually a sign that mania is coming if I find myself swearing. Although since last week I've been enjoying "gosh Dammit" b/c my niece said it and when I said that she shouldn't say that word she said "but I didn't say God".....which is true but still not quite right. Apparently she's going through a little crisis of curse words versus impolite for kindergarten words. But I've heard a lot more swearing from my mouth lately than usual.

I hope it works too. I keep reading that when it does it's pretty amazing.

One thing I've read that I hope neither of us experiences but I'm hoping you'd want to know about is that it has 2 side effects that seem to occur fairly commonly and the drug literature doesn't emphasize them: drooling at night heavily and some people have trouble with bedwetting. I just know I plan to prepare in advance for both possibilities with mattress and pillow protectors (I'm going to add a 2nd waterproof cover to my mattress since that's what my sister did when the kids were babies and co-slept and my mattress is memory foam and would be ruined by bedwetting and I'm going to find something for my pillows that doesn't annoy me like a plastic cover.) This seems to be at higher doses than starting doses but not necessarily at extreme doses.

I think your dr WAS wrong. He did not listen to YOU, the patient. You said "I may be need to be hospitalized, I am at the end of my rope and feel in danger". He didn't listen to that either when you texted him or when you said it, he listened to what you said your family wanted. He did not ask YOU, the patient, what you wanted and YOU are the important one. YOU are the only one who knows how unsafe/scared you've felt and whether you feel you need to be somewhere safe for a while. It's not about what your family wants and if that is being considered it should be secondary. YOU are the patient!

I can't imagine my pdoc ever hearing me say I thought I was unsafe and not asking me to go to the hospital voluntarily. I am sure she'd make me go if I didn't. And she never would ignore my saying that to put me on some treatment I said my family was interested in unless she and I agreed that trying it was in my best interest.

It sounds like that session left you with little feeling of control and that just is wrong. Your body, your mind, your thoughts=your treatment that should be guided by YOU.

It's true clozaril can be great. But it's not instant and in fact takes a while to get to a therapeutic dose and asking you to just wait that out is beyond what any pdoc should expect of someone saying they feel in danger.

[BeyondtheRainbow]

oops, duplicate content sorry

[cashart10]

Yes, I agree. And I am a little terrified...but waiting. I suppose that's life right now.

Here is my song for the night.

Patty Griffin - Sweet Lorraine

[BeyondtheRainbow]

What happened to that 2nd opinion you were going to get? I assume you didn't since you were doing so much better. Could you get back on that list? I know it won't help now but it seems like whenever you really need your dr's help it's almost like he gets overwhelmed and starts throwing meds at you, in this case at a higher dose than they strongly suggest and with the potential of re-over-medicating you (my new word) with just a new drug. All you needed today was for him to help by being the "responsible party" for hospitalization. My therapist and pdoc both would do that in a heartbeat for me, even without my asking. My therapist and I think my pdoc too have offered to give me written excuses for not attending holidays in the past. My therapist says that my mom already doesn't like him so just go with that. And I've used it, that "they see" something that worries them and so I'm going IP or doing whatever and that puts less emphasis on my desire to hurt myelf.

Wait if you can but if you feel you can't just do what you need to do and don't worry about what the pdoc or anyone else thinks. His heart may be in the right place but I just don't think he's necessarily the best with your complex disorder; I think he wants to help so badly that he almost panics and starts throwing meds at you without discrimination or following standard practice. Which isn't so good with most meds. My understanding is that clozaril is rarely if ever used in conjunction with another AP because of the interactions and because it's not needed so it will be interesting to see if he gets you off the abilify soon.

I hope you have a good night. I'm sorry everything went a little weird today.

[Nammu]

Your pdoc may think you have great support but I'm thinking about your staring a major new drug and being alone with kids all day. It time for your family to step up and find alternatives while you get adjusted to this medicine. Sorry to harp on this point but gees, they really can't be expecting you to just muddle though without a break. They can take a vacation day for Friday and take your kids for the weekend at least.

[Georgia Bridge]

Originally Posted by wildflowerchild25

MAN I can't believe your pdoc! Mine would have locked me up ages ago. I did see what beyond posted in your other thread. Is your pdoc SURE there's no interactions? I would be worried of that. I'd go inpatient just to be sure I was monitored in case there was an interaction. But that's just me, I go IP like it's my job apparently. I hope you are safe enough to give the med a chance to work! I don't know how long clozapine would take to start working.

But I hope it does work for you! PLEASE go IP if you feel you can't wait!!!! I just want you to be safe. As we all do.

I don't know your situation well, Cashart10.
I agree that you should march yourself right on into an emergency room or an MH inpatient facility if you don't feel you're stable.
Try to take care of yourself; I know it can be hard.
We do all want you to be safe! 💝

[cashart10]

It gets harder and harder Lorainne, to believe in magic, honey when what came before you is so very tragic...Lorainne, Sweet Lorainne.

Patty Griffin

[cashart10]

Originally Posted by sidestepper

Your pdoc may think you have great support but I'm thinking about your staring a major new drug and being alone with kids all day. It time for your family to step up and find alternatives while you get adjusted to this medicine. Sorry to harp on this point but gees, they really can't be expecting you to just muddle though without a break. They can take a vacation day for Friday and take your kids for the weekend at least.

Honestly, although I won't be starting this tomorrow due to the availability of the drug, I will discuss this with them. It just makes me sad. I know I am passive. I know I should be more assertive. But, it just feels like no one, except you guys, are in my favor.

[Nammu]

:grouphuga:

[Yoda]

I have been taking clozaril since 2007 and it works well for me. I hope it is as good for you. It (and neurontin) are particularly helpful with my insomnia.

A small dosage should be safe. I have had a small dosage with no ill effects.

[cashart10]

Thank you both!