Well, between the doctor to the pharmacy back to the doctor to the insurance company back to the doctor who is waiting to get preapproval from the insurance company for the pharmacy who is waiting on the doctor............................
I still don't have my prescription for modafinil yet.
Ya'd think I was given a scrip for freakin' heroin.

So, I am in a relatively better mood, which is very good. But little energy and just want to sleep with the kitties most of the time.
Not a totally bad thing, sleeping with the kitties. But I don't get much accomplished.

Meowsnooooooooooooooooooooooooze.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

"No, not real crazy, just more happy instead of depressed".

To which he answered "Then you are not manic. I think what you really mean is that once in a while, you feel normal".

Bingo.

---

The mind is a weird and mysterious place

I'm very happy to read about your progress.

I am absolutely convinced now that my brain chemistry has been out of whack since birth.
And I have joked over the years here about days when 'all of my little brain chemicals were playing nice together'.
And that they were very rare days for me.

I can identify here, too. In fact, my brain's neurotransmitters only play nicely together for moments, not whole days. I'm not an irritable person per se, or deeply in one mood or the other, but mostly just have been blah all my life. Occasionally, though, the brain chemicals mesh in just the right way, and I feel what most people would probably call "normal". I've luckily never been an abuser of alcohol or other drugs or done anything excessively unwise. My degree is in psychology, but I've never been to a doctor about this, partly because as you described about your own situation, I've lived all my life like this, and I'm used to it.

Funny you should use the term 'normal' in describing a good day.
The same term came up when I was discussing my history with the psych doctor. I told him that for most of my life I had been rather "manic depressive, but much more depressive than manic". He said "So you get a little crazy sometimes?" I replied "No, not real crazy, just more happy instead of depressed".

To which he answered "Then you are not manic. I think what you really mean is that once in a while, you feel normal".

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

I'm very happy to read about your progress.

I am absolutely convinced now that my brain chemistry has been out of whack since birth.
And I have joked over the years here about days when 'all of my little brain chemicals were playing nice together'.
And that they were very rare days for me.

I can identify here, too. In fact, my brain's neurotransmitters only play nicely together for moments, not whole days. I'm not an irritable person per se, or deeply in one mood or the other, but mostly just have been blah all my life. Occasionally, though, the brain chemicals mesh in just the right way, and I feel what most people would probably call "normal". I've luckily never been an abuser of alcohol or other drugs or done anything excessively unwise. My degree is in psychology, but I've never been to a doctor about this, partly because as you described about your own situation, I've lived all my life like this, and I'm used to it.

---

The mind is a weird and mysterious place

Chris..........
I think you are drawing a bit too much from my personal experience and painting with a bit too broad a brush regarding the behavior of doctors between your country and mine. I don't think as a whole that they really are.

I am being a particularly assertive patient, probably more than almost any other. I am able to be so because I HAVE done my homework and know that treatment for depression is not an exact science. So even the doctors don't have any clear cut answers. And although I am confident of the course of treatment I desire to take, if any doctor with their expertise and training were to tell me that I was clearly wrong and why, I would not hesitate to discuss it further with them and heed some of their advice. So far, my doctors have not been in disagreement enough with my decisions that I have had to ignore them or fail to follow their direction.

The disease of depression has unknown causes, the medications to attempt to treat it have different results for different people, and positive results can be very subtle. More subtle, I think, than a doctor may be fully able to discern in a twenty minute appointment. I however, live with myself 24/7, and have for 60 years.
So although the doctor may be more well trained on the possible courses of potential treatment, I hold that I am the one best able to determine if they are having any effect and what it is.

This is not a case of me having cancer, doing some reading on the internet, and marching into the doctor's office saying "I have read that the bark of the bobo tree in Yugoslavia has the best chance of me beating this, and that is what I am going to take. Get me some".

And I did not go to either doctor with that kind of attitude. I went with information, knowledge, and conviction. I discussed it with them, not argue with them. And both doctors were apparently sufficiently satisfied with my information, knowledge and conviction that they agreed to allow me to follow my chosen course of treatment.

I have tried two different drugs, worked with the dosages and assessed the results. One I have discontinued.......at least for now. The other I have found to be beneficial. That drug has only been on the market for 15 years. And I am in the process of trying a third one.

I will know if and when this journey arrives at it's end point.
Until then, I am the Captain of my ship.

Meow.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

Well that is quite different to the way that doctors work in the UK. They are fully in charge of your treatment and after examination and diagnosis they will decide what drugs and treatment to give you. But, and this is the big but, they rely heavily upon patient feedback so they can judge which drugs are working or not, or are causing unpleasant side effects. It can take quite some time to get a balance between a number of drugs.

An anathema to doctors is when a patient turns up and says I've looked on the internet and I am sure I have got this wrong with me, or this is the drug you should be using etc. They don't train for 7 years to be a basic doctor for nothing, and if they are not sure, they refer you to hospital for a consultant's opinion. But don't forget we have the NHS here where apart from basic prescription charges, it is free at source. Clearly other countries work in different ways.

Anyhow if the treatment you are getting is working and you are happy with your doctor then that is good news. But yes it would be a very nice thing to do to write a note of thanks to the previous lady doctor.

Best wishes to you and the kitties.

Good for you Mark!

Congratulations on the continuing path to recovery, however slow it might be, taking and doing research on what *might* work best for you - NOT what the DOC "insists" on what is best for you. Sometimes these specialists are to rigid and will not listen to the patient.

These things do take time and a bit of experimenting to hopefully find what does / does not work.

Keep on roaring like a big cat or purring like a little kitten.

I know you can do it - one day at a time.

+1

---

Good for you Mark!

Congratulations on the continuing path to recovery, however slow it might be, taking and doing research on what *might* work best for you - NOT what the DOC "insists" on what is best for you. Sometimes these specialists are to rigid and will not listen to the patient.

These things do take time and a bit of experimenting to hopefully find what does / does not work.

Keep on roaring like a big cat or purring like a little kitten.

I know you can do it - one day at a time.

---

I have to say Mark that I thought your previous Lady doctor was excellent in telling you up front what was what, whether you wanted to hear it or not. Are you sure this new one , wearing 2 hats, will do the same? After all she did for you, I expect she is sad to see you move on.

Yes, the doctor I had been working with was very good to work with. A wonderful practitioner.

How this actually all came about was a bit circuitous.
She was filling in for my usual GP, who is older and was out on extended sick leave. The younger doctor handled my annual physical, and in the course of that, the usual discussion about smoking and cessation came around and she gave me a handout sheet on bupropion, which is also sold as Zyban for quitting the habit.

Well, I would not have asked for the med for quitting smoking, but as I researched it and what it actually is, an antidepressant, I realized that perhaps a door had been opened for me and I decided to walk through it. I told her that I wanted to start it, not for quitting smoking, but to fight my lifelong battle with depression. She was OK with that, and so my journey began. I ditched the whiskey so as not to interfere with the new meds. She also added that if the bupropion alone did not help, that adding an SSRI might. So after some weeks, I asked her about options, she gave me a list, I did my research and made my choice. I started escitalopram (Lexapro), which has proven to be the key to my improvement!
As the bupropion was doing little for me as far as my depression goes and was having side effects that I did not like, I tapered off of it and stayed with just the escitalopram. The result was that as the burpropion slowly worked out of my system I was feeling better emotionally but the one thing that it WAS doing was slightly boosting my wakefulness. So I started to research what might help with my fatigue (which I had been complaining about for many years) and that led me to requesting the modafinil.
Unfortunately, this took me beyond my younger doctor's area of expertise and training, as it is not commonly prescribed, is an FDA controlled drug, and is typically used for treating narcolepsy. So using it as an adjunct for treating depression and for shift work sleep disorder are not rare at all, but are considered 'off label use'. And falls under the heading of psychiatric care, which she is not trained for. Hence, she had little choice but to refer me out to a doctor who had those credentials.
In doing so, she was actually still being very supportive. Because she was, as she did all along, still respecting my choice to chart my own course as much as possible. So I am still very grateful to her for setting me on a potentially life changing journey.

And as things progress, I SHALL write her a personal letter of thanks for having done so.

The new doctor is a bit more 'straight laced' shall we say. Being part psychiatrist, I supposed he is more used to telling his patients what they will do, rather than the other way around. It took some discussion and convincing him on my part that 'I' was in charge of my treatment and was going to determine it's direction under his supervision. And that I was in tune with my body and mind and was better equipped to evaluate the effects of my meds than he was. (Doctor's eyebrows went up a bit....LOL). But, he finally agreed to write the scrip as requested, and said that the modafinil is effective (actually admitted that he has used it on rare occasion when he could not get proper sleep due to work related travel) and said he would trust me to continue my alcohol abstinence. So, I think I have him properly indoctrinated into my playbook. But I shall not BS the doctor nor insult his training or intelligence. This is not about 'getting the drugs I want'. It is about getting where I want to be. If the new med does not work as I suspect it will, I will be straight with him and ask for further advice and direction.
He did also say that if I am seeing improvement in my mood from the escitalopram after 5 weeks, it's effect should continue to get better :). I did not ask him about increasing the dose from 10mg to the full 20mg yet. One thing at a time. I have another appointment with him in a month to evaluate the new med and any progress with the current one.

I can positively say at this point that my mind is more at ease that I can ever remember. More content. Less unnerved by minor setbacks in my life, and instead trying to find rational ways to deal with them. And it only took me 60 years to get here......................

I am absolutely convinced now that my brain chemistry has been out of whack since birth.
And I have joked over the years here about days when 'all of my little brain chemicals were playing nice together'.
And that they were very rare days for me.

I now know that was more true than I realized at the time.

So there you have it, the latest kittyman updates.
Meow meow meow!

EDIT............
I also hope that anybody reading this who has fought with depression as I have for so many long years finds the courage to ask their doctor about getting help.

I hope my discussion of my journey can give you the strength to start yours.

As you can tell from my story, there is no such thing as a 'happy pill' or magic bullet for depression. And it does not go away overnight. If first attempts do not work, there are other avenues. Don't give up.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

Most people in the UK knock the NHS system as being underfunded and to top heavy in bureaucrats, but when you compare it to places like the USA etc we should consider ourselves lucky. I enjoyed my trip to the USA and meeting Americans, but my god, with your politics and your health care, I wouldn't live there in a million years for all the tea in China.

I have to say Mark that I thought your previous Lady doctor was excellent in telling you up front what was what, whether you wanted to hear it or not. Are you sure this new one , wearing 2 hats, will do the same? After all she did for you, I expect she is sad to see you move on.

I hear you on that. I'm due for a colonoscopy in a few weeks. The prep kit is $378.00. For two doses that I need to take. I'm lucky my insurance paid for it.
Back when I first had to have the Hubble telescope treatment, You could buy the stuff right off the shelf for a few bucks.

I had that done last month and the prep kit (3 satchels plus 6 bottles of pre-opp fluid) cost me $73.50aud and I thought that was a bit on the high side. :-O

Cheers.

OK.....new doctor.
Had to go over my situation, as he apparently did not have enough time to go over all my comms with my other doctor.
This doctor is half GP, half phsych.
After much discussion, he agreed that it might help me and he would let me try the new med.
Prescription sent.
Walgreens put a hold on it.
Now they are fighting it out with the insurance company which may cover little or none of it.
Cash price? $573.49 for 28 pills.
OMG.

Meeeeeeeeeeouch.

I hear you on that. I'm due for a colonoscopy in a few weeks. The prep kit is $378.00. For two doses that I need to take. I'm lucky my insurance paid for it.
Back when I first had to have the Hubble telescope treatment, You could buy the stuff right off the shelf for a few bucks.

---

[/quote]

Old James

Instead of regulating any of it, our government walks in lockstep with them and nothing improves.

Oh silly me. I was under the impression that republicans believed that regulation is bad, bad, bad.

Ouch.............quick kick to the groin. Now I'm gonna need some meds for THAT.

Meowmuttermutter.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

Instead of regulating any of it, our government walks in lockstep with them and nothing improves.

Oh silly me. I was under the impression that republicans believed that regulation is bad, bad, bad.

That's a huge price to pay, but hopefully it will be worth it. My prayers are with you on that.

---

The mind is a weird and mysterious place

It's a good thing you didn't need anything really expensive......

Healthcare in the US is broken, but we pay way more than any country on earth.
I would like to see us do what other countries do that don't have these problems.

Steve

Healthcare in the US is broken because our government, the health insurance industry, and big pharma are all in bed together.
Instead of regulating any of it, our government walks in lockstep with them and nothing improves.

And I didn't realize that big pharma was still doing alchemy.
None of my research has uncovered whether this stuff turns to gold before or after I take it............

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

It's a good thing you didn't need anything really expensive......

Healthcare in the US is broken, but we pay way more than any country on earth.
I would like to see us do what other countries do that don't have these problems.

Steve

---

Warning, addicted to SETI crunching!
Crunching as a member of GPU Users Group.
GPUUG Website

OK.....new doctor.
Had to go over my situation, as he apparently did not have enough time to go over all my comms with my other doctor.
This doctor is half GP, half phsych.
After much discussion, he agreed that it might help me and he would let me try the new med.
Prescription sent.
Walgreens put a hold on it.
Now they are fighting it out with the insurance company which may cover little or none of it.
Cash price? $573.49 for 28 pills.
OMG.

Meeeeeeeeeeouch.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

Well..............................................
I'm off to see the shrink.
I weaned myself off of the bupropion because it was doing little for me.
The escitalopram however is showing some progress in elevating my mood :).
However, tapering off the bupropion is now leaving me rather sleepy and low on energy. So I asked my doc if she could change my scrip.
But, the GP says I am now out of her jurisdiction when I requested her to substitute the DRI Modafinil, instead of the NDRI bupropion.
Stuff is crazy expensive. But all of my research indicates it would be exactly what I need right now.

So, I'm off to see the shrink.

MeowI'mnotcrazy.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman

JJ is playing a winery near us in a couple of days. Eric and I are not really fans, so we're not going but I hope she has a fun show.

Joan Jett & the Blackhearts Aug 9 Wente Vineyards.
Oh, meow. Wish I could be there.
Have not seen her live since the very late 70's or the very early 80's down at Summerfest in Milwaukee.

Meowsigh.

---

"Learn from yesterday. Live for today. Hope for tomorrow." Albert Einstein
"With cats." kittyman