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finally got myself to make an appointment with the disliked GP. as usual he wasn't caught up on my case, spent most of the time in front of his computer, and then told me the same things the internist had already told me. just before he disappeared out the door i managed to tell him that my biggest problem is really not my heart, but the depression, and would he please try to add an SSRI to the wellbutrin, or i had to stop it because it was gonna end badly otherwise.
and yay, he gave me samples of cipralex (escitalopram) to try. i'm taking 5 mg for now, for the next 4 weeks. i don't want to get my hopes up, but something better work, *sigh*.
as always the most amusing thing are the possible side effects. aside from self harm and suicide risk, i might also suffer from akathisia [1], agitation, heart palpitations (for extra laughs), emotional lability (yeah, like i am not labile now), aggression, hostility, depersonalisation. i might become a real bundle of joy to be around! the doc's biggest concern seemed to be the possible weight gain; *rolls eyes". i rather have a happy life as a really fat person who dies early of heart problems than an unhappy life as a somewhat less fat person who commits suicide, ya know. he is so fucking clueless -- and it's not like he actually even checks my weight; he's not weighed me again after the first time, and he doesn't ask whether i had any weight loss or gain, so WTF.
escitalopram is supposedly more potent than citalopram, which i took before in the form of celexa, but which didn't do anything for me, and i don't know that the GP even remembered the celexa, so i need to do some more reading on that. as usual, it might take 4-6 weeks before i'm supposed to notice any positive change (the side effects i always get within days, but "fairness" does not enter into this, *wry grin*).
and because i don't trust the good doctor to check for interaction with other meds, i did it myself, and a good thing -- the internist is considering putting me on warfarin, and it does not play well with escitalopram. i am not much in favour of the warfarin anyway, because the dosage is so sensitive and requires constant blood tests to assess, i can't deal with even more lab and doctor stuff than i do now, and i don't actually trust the GP to do a good job for me there. the alternative as a blood thinner is dabigatran, which is brandnew, very, very expensive (3.95/75mg capsule, might have to take 2/day), and for which we don't have long-term studies yet. (blood thinners are necessary because the arrythmia can result in blood clots, which can cause a stroke).
i have an appointment for an echo cardiogram on the 11th, have a slew of blood and urine tests still to do at the lab, then i'll see the internist again to talk about blood thinner meds, and what's next.
at least i like the internist, and he's young, so not likely to retire before my next visit like the last one. maybe he'll just move to victoria, *snrk*. i am such an optimist.
[1] about akathisia the GP said that was involuntary body movements (and i don't think he was talking about hard-ons), but when i looked it up, it's more along the line or jitteriness/restlessness affecting the knees, and sitting is apparently difficult.
and yay, he gave me samples of cipralex (escitalopram) to try. i'm taking 5 mg for now, for the next 4 weeks. i don't want to get my hopes up, but something better work, *sigh*.
as always the most amusing thing are the possible side effects. aside from self harm and suicide risk, i might also suffer from akathisia [1], agitation, heart palpitations (for extra laughs), emotional lability (yeah, like i am not labile now), aggression, hostility, depersonalisation. i might become a real bundle of joy to be around! the doc's biggest concern seemed to be the possible weight gain; *rolls eyes". i rather have a happy life as a really fat person who dies early of heart problems than an unhappy life as a somewhat less fat person who commits suicide, ya know. he is so fucking clueless -- and it's not like he actually even checks my weight; he's not weighed me again after the first time, and he doesn't ask whether i had any weight loss or gain, so WTF.
escitalopram is supposedly more potent than citalopram, which i took before in the form of celexa, but which didn't do anything for me, and i don't know that the GP even remembered the celexa, so i need to do some more reading on that. as usual, it might take 4-6 weeks before i'm supposed to notice any positive change (the side effects i always get within days, but "fairness" does not enter into this, *wry grin*).
and because i don't trust the good doctor to check for interaction with other meds, i did it myself, and a good thing -- the internist is considering putting me on warfarin, and it does not play well with escitalopram. i am not much in favour of the warfarin anyway, because the dosage is so sensitive and requires constant blood tests to assess, i can't deal with even more lab and doctor stuff than i do now, and i don't actually trust the GP to do a good job for me there. the alternative as a blood thinner is dabigatran, which is brandnew, very, very expensive (3.95/75mg capsule, might have to take 2/day), and for which we don't have long-term studies yet. (blood thinners are necessary because the arrythmia can result in blood clots, which can cause a stroke).
i have an appointment for an echo cardiogram on the 11th, have a slew of blood and urine tests still to do at the lab, then i'll see the internist again to talk about blood thinner meds, and what's next.
at least i like the internist, and he's young, so not likely to retire before my next visit like the last one. maybe he'll just move to victoria, *snrk*. i am such an optimist.
[1] about akathisia the GP said that was involuntary body movements (and i don't think he was talking about hard-ons), but when i looked it up, it's more along the line or jitteriness/restlessness affecting the knees, and sitting is apparently difficult.