I have a medical condition which will be tough to treat, and it means the end of radio (for now)

[MumblesBadly]

Hope whatever happened goes away, Mumbles.

I actually hate the ER and am kinda reluctant to go there. My last ER visit was in January 2014 when I had symptoms very similar to a ruptured spleen, a week after I broke 3 ribs. Ignoring that could mean death within 24 hours, so obviously I had to go.

I know you're older than me, so showing caution isn't all that bad. Hope your insurance is good. ER is expensive.

Or you could take the Master Scalir route and just stiff them.

Re insurance: I got super lucky. The closest hospital, which the EMTs strongly recommended I go to, was within my network. Only a $200 deductible. And except for them having trouble getting my name correct on the paperwork and stickers, they seemed pretty competent and efficient.

And speaking of stiffing an ER, I have done that once after realizing that they were completely predatory about rounding up customers (they used to be an ‘urgent care’ facility, which in Texas are usually very inexpensive to go to, and had minimally changed their signage indicating that it was an ER, which is a legal ticket to charge a hell of a lot more, including access to billing Medicare/Medicaid).

And they ridiculously over billed me for about 10 minutes of just talking with the doctor and a minimal examination of my back, which I had throw out and knew how to treat (muscle relaxants, which he gave me a prescription). I paid an immediate $100 upon leaving, and later got a bill for an addition $1400.

I almost paid it, but thought “Screw it! They cheated me!” So I ignored it. Then about a year later, they lowered the remainder to about $250, which I actually tried to pay online, but for some reason, their system wouldn’t accept the payment, so I said “Fuck ‘em!” again. A year later, I received an offer from a collection agency to settle for about $140, then about a year later one offering a 40% discount off that bill. Here’s how I responded to both of those offers:

[BCR]

Druff I was thinking about your anxiety and thought you might try a bit of nicotine gum or oral spray, a lot of the reason people smoke it is relaxing, some how nicotine has some calming affect.
I am not sure of how addictive it is but seriously what’s the worst that could happen.

Relaxing to people already addicted to nicotine because craving nicotine causes anxiety to a nicotine addict. It’s a stimulant. With anxiety, not a good idea to introduce it. It isn’t like caffeine where he was already addicted.

[limitles]

This video speaks about anxiety's affect on our bodies, epinephrine related.



The following is from the Mayo Clinic re: Thyroid disorder symptoms

Most thyroid nodules don't cause signs or symptoms. Occasionally, however, some nodules become so large that they can:

Be felt
Be seen, often as a swelling at the base of your neck
Press on your windpipe or esophagus, causing shortness of breath or difficulty swallowing
In some cases, thyroid nodules produce additional thyroxine, a hormone secreted by your thyroid gland. The extra thyroxine can cause symptoms of hyperthyroidism such as:

Unexplained weight loss
Increased perspiration
Tremor
Nervousness
Rapid or irregular heartbeat

When to see a doctor

Although most thyroid nodules are noncancerous (benign) and don't cause problems, ask your doctor to evaluate any unusual swelling in your neck, especially if you have trouble breathing or swallowing. It's important to evaluate the possibility of cancer.

Also seek medical care if you develop signs and symptoms of hyperthyroidism, such as:

Sudden weight loss even though your appetite is normal or has increased
A pounding heart
Trouble sleeping
Muscle weakness
Nervousness or irritability

[Dan Druff]

Went to a special ENT today who specializes in vocal issues.

He did something called a videostroboscopy, where they stick a long, flexible tube up your nose and down your throat, strobe a light down it, and have you say a few things to get a good idea of your throat movements. It also provides a good look at (and high def video of) the entire area.

Here's what was found:

- No cancer (I didn't suspect it, but it's nice to have that diagnosis)

- Inflammation in portion of my nasal passage is indicative of reflux damage, but this isn't 100%, as some people naturally have the appearance of that inflammation with nothing actually wrong.

- Mild inflammation of mucus membranes (this is typical for LPR sufferers)

- I seem to be unintentionally creating a vocal strain when I talk. It is unclear if I always did this, or if I've been subconsciously doing it since the LPR showed up. The doctor said that this is very possibly the reason for my voice getting fatigued quickly nowadays, whereas I could do 8 hour radio shows with no problem before the LPR showed up.

- Does not seem to be evidence of damage or nodules on vocal cords


So despite the negative Peptest results, I'm back to thinking that this is most likely due to reflux.

I may go with vocal therapy and see if that helps. Some LPR sufferers have dismissed it as useless, only to actually try it and find that it helped. So I might do the same.

He also suggested some difficult and highly unpleasant esophogeal tests which I think I will avoid for now, since that stuff is just shooting in the dark, anyway.

Next up: I will try D-Limonene, an orange peel supplement which has been a miracle cure for some, and useless failure for others. Pills are pretty big though, so hopefully I can take them. Since I was a kid, I always had a hard time taking pills larger than medium-sized.

[Forum Wars]

Good. Glad you keep trying things.

Here's what Dr Hack, er, Axe, says about Acid Reflux. Key point, your Acid Reflux (if you have it) is caused by not enough Stomach Acid:





It's why I recommended ACV to you (but I don't think you've tried it yet).

Doubling down on my recommendation now because lately you've said you think your LPR is actually caused by Acid Reflux...

(also, Dr. Mercola, just because this video popped up for me right after the one above...reiterates the too little acid reason for reflux too.)

[JohnCommode]

Went to a special ENT today who specializes in vocal issues.

He did something called a videostroboscopy, where they stick a long, flexible tube up your nose and down your throat, strobe a light down it, and have you say a few things to get a good idea of your throat movements. It also provides a good look at (and high def video of) the entire area.

Here's what was found:

- No cancer (I didn't suspect it, but it's nice to have that diagnosis)

- Inflammation in portion of my nasal passage is indicative of reflux damage, but this isn't 100%, as some people naturally have the appearance of that inflammation with nothing actually wrong.

- Mild inflammation of mucus membranes (this is typical for LPR sufferers)

- I seem to be unintentionally creating a vocal strain when I talk. It is unclear if I always did this, or if I've been subconsciously doing it since the LPR showed up. The doctor said that this is very possibly the reason for my voice getting fatigued quickly nowadays, whereas I could do 8 hour radio shows with no problem before the LPR showed up.

- Does not seem to be evidence of damage or nodules on vocal cords


So despite the negative Peptest results, I'm back to thinking that this is most likely due to reflux.

I may go with vocal therapy and see if that helps. Some LPR sufferers have dismissed it as useless, only to actually try it and find that it helped. So I might do the same.

He also suggested some difficult and highly unpleasant esophogeal tests which I think I will avoid for now, since that stuff is just shooting in the dark, anyway.

Next up: I will try D-Limonene, an orange peel supplement which has been a miracle cure for some, and useless failure for others. Pills are pretty big though, so hopefully I can take them. Since I was a kid, I always had a hard time taking pills larger than medium-sized.

Glad to read that you are getting closer and closer to a solid diagnosis and course of treatment. I'm not exactly Ben Casey or Marcus Welby, but can't you just cut the pills in half?

[Dan Druff]

These are softgels, so you can't cut them in half. Otherwise, that's what I do.

Fortunately, these D-Limonene softgels are half the size of the super-horse-pill 1000mg Jarrow brand (the most common, which is notorious for the pills being HUGE).

The ones I bought are basically the same thing, except they are 500mg, and therefore half the size. Still large, but not huge. I take two.

Just tried it today. No noticeable side effects. Had some mild orange burps, but fewer than I expected. Won't know if this works until about 10-14 days pass. You're supposed to take them every other day.

I had no problem taking them because they float in my mouth, meaning they don't sit on the back of my tongue and gag me. Also, since they are softgels, they slide down my throat more easily than regular pills, so once I swallow them, I don't have that scratchy feeling of a big pill going down.

Anyway, we'll see if it helps. As I said, it's a miracle cure for some, and a complete failure for others.

[Ryback_feed_me_more]

Good. Glad you keep trying things.

Here's what Dr Hack, er, Axe, says about Acid Reflux. Key point, your Acid Reflux (if you have it) is caused by not enough Stomach Acid:





It's why I recommended ACV to you (but I don't think you've tried it yet).

Doubling down on my recommendation now because lately you've said you think your LPR is actually caused by Acid Reflux...

(also, Dr. Mercola, just because this video popped up for me right after the one above...reiterates the too little acid reason for reflux too.)

It can be but I know a guy whos had indigestion and reflux issues since he was a kid (started having to take Mylanta like 10-11 yrs old) and has nothing to do with lack of acid.. It does cause some cases but a damaged muscle where the esphagus and stomach meet was damaged in his case apparently to do with having some tube in his stomach as a preemie they used for feeding initially I think is what he said.. Got an ulcer in HS even because of it.. will be on PPIs for life

[Dan Druff]

Anxiety continues to stay low in days following the Xanax, even though I'm only taking 0.25mg once per week.

I'd say the decreased anxiety lasts for about 5 days following taking it, which isn't supposed to happen, but whatever.

Unfortunately the LPR remains worse ever since the videostroboscopy on Wednesday. I'm guessing this was from the nose/throat anesthetic. I think cheering at the Dodgers last night also hurt things.

Hoping the LPR imrproves (or at least returns to what it was prior to Wednesday), and the anxiety at least stays how it's been recently.

[Crowe Diddly]

i will suggest once more that meditation will do an even better job with the anxiety than the pills, will last longer, will improve your mood, and lots of other benefits.

Just give it a shot, dude. You can still keep taking the pills if you feel like you need them, but you soon won't, I'd be willing to bet.

[Dan Druff]

Update:

The anxiety continues to be controlled by the Xanax, for longer than it's supposed to.

It seems I get about 5-6 days of very reduced anxiety after taking the low-dose (0.25mg) Xanax. Then it seems to abruptly return, though not at a really high level.

I'm typing this from Harrah's in Vegas right now. I'm about to pack up and leave. It was my first trip since these health issues started in mid-August. I took along a bulky but manageable wedge pillow (it's like a giant foam wedge, about 3.5 feet long and 3.5 feet wide), which simulates the bed propping I do at home due to the LPR. Worked fine, and I was able to sleep.

My last Xanax was on the 24th. Anxiety was so low since then that it was almost undetectable. On that front, I felt virtually cured. Then late last night, I felt it come back abruptly, for no apparent reason. Started feeling uncomfortable being in the hotel, the body tension, etc. I was here two nights. All the way up until late last night, I was 100% fine anxiety-wise, with no trace of any problem.

At home last week, I also had a return of the anxiety around 5 days after taking it. I don't think it's a placebo effect, as the anxiety seems to return abruptly, and only when I count the days do I realize it's been more than 5. So it's not like I see it's been 5 days and start worrying about it changing.

Anyway, I want to take one now, but I can't since I have a 300+ mile drive ahead of me. Will probably take in the morning tomorrow.

I am seeing the psychiatrist on the 8th, and will ask him if one low dose pill per 5 days (instead of 7) is doable for the long term.

I swear, for 5 days after taking it, I really feel like the anxiety is pretty much gone.

This trip was partially to redeem some freeplay I had waiting, but also a test to see how I'd do. I couldn't have done this last month, and especially not 2 months ago. The hotel part would have been too tough. It's not agoraphobia, as I have no problem leaving the house and going places, but staying somewhere else would have been a very different story. But aside from last night, when I had some medium-level anxiety, I was fine.

The next "test" for myself will be taking a flight. I will probably take Xanax right before doing that one. It will be a short flight, either to SF (and I'll visit my brother) or Vegas. I would be taking the flight just to see how it goes, as otherwise I would drive that distance.

So stupid that I have to put effort into being able to do simple things which I could easily do all my life, but that's the way it goes when your brain gets fucked up.

LPR unfortunately has gotten worse since last week. More vocal issues. Gaviscon and D-Limonene, two well regarded LPR solutions, have not been giving me much noticeable help, though sometimes improvement is delayed by a month (since your throat has to heal, and it's slow doing so).

As we stand right now, the long term prognosis for my LPR is bad (good chance I'll be stuck with it forever), while the prognosis for the anxiety seems good (provided the Xanax every 5-7 days keeps doing what it's doing).

The anxiety is more debilitating than the LPR, provided that the LPR isn't interfering with sleep. Right now the LPR is kind of on the borderline between interfering with sleep and not interfering with sleep. Prior to last week, it had improved enough to where I could fall asleep fairly easily again, so that's disappointing.

[limitles]

Update:

The anxiety continues to be controlled by the Xanax, for longer than it's supposed to.

It seems I get about 5-6 days of very reduced anxiety after taking the low-dose (0.25mg) Xanax. Then it seems to abruptly return, though not at a really high level.

At home last week, I also had a return of the anxiety around 5 days after taking it. I don't think it's a placebo effect, as the anxiety seems to return abruptly, and only when I count the days do I realize it's been more than 5. So it's not like I see it's been 5 days and start worrying about it changing.


I swear, for 5 days after taking it, I really feel like the anxiety is pretty much gone.

You do understand a medications half life? It's the amount of time a medication clears from your system.
Makes a lot of difference if it's a short vs. long half life especially with benzos
Push yourself one step from the lowest dose, as an experiment, and report back.
You'll never know until you try

Think of it like medication for a migraine. Someone suggests baby aspirin. You give it a try and move on

[Username]

Update:

The anxiety continues to be controlled by the Xanax, for longer than it's supposed to.

It seems I get about 5-6 days of very reduced anxiety after taking the low-dose (0.25mg) Xanax. Then it seems to abruptly return, though not at a really high level.

At home last week, I also had a return of the anxiety around 5 days after taking it. I don't think it's a placebo effect, as the anxiety seems to return abruptly, and only when I count the days do I realize it's been more than 5. So it's not like I see it's been 5 days and start worrying about it changing.


I swear, for 5 days after taking it, I really feel like the anxiety is pretty much gone.

You do understand a medications half life? It's the amount of time a medication clears from your system.
Makes a lot of difference if it's a short vs. long half life especially with benzos
Push yourself one step from the lowest dose, as an experiment, and report back.
You'll never know until you try

Think of it like medication for a migraine. Someone suggests baby aspirin. You give it a try and move on

thespartan’s flat earth conjectures > Todd believing a micro dose of Xanax has “special effects” on him.

lol @ arguing science.

[Username]

Todd, to Les’s point - it is literally impossible for you to “feel” the effects of a single Xanax dose after 8-12 hours. That’s the way IR drugs work. BY DESIGN.

[BCR]

While yeah, a Xanax can’t last 5 days, so much of anxiety is just a bizarro firing off by the body’s fight or flight mechanisms, that it would seem the only thing you can reasonably say is that his anxiety has moved from GAD to acute episodes. So the Xanax takes him out of an acute episode, and it returns when it returns. I agree 5 days is arbitrary and more coincidence to this point, and I think he’ll at times require it on consecutive days, and then may go a month, he’s incredibly fortunate that it is requiring so little.

You need to see the glass as half full Druff. I understand that’s hard when you’re still in the middle of it, but I think you’ll eventually come to that point. I agree it feels stupid to have to worry about the routine, but ffs, look where you were two months ago. I understand the frustration at the LPR and that it might be permanent, but I’d be optimistic on that front also. It may be, but you also may find ways to mitigate it so much through trial and error that it becomes a relatively minor issue. It also may, through diet modification, add five-ten years to your life, which considering you didn’t have kids young, may allow you to see grandkids come into adulthood. I’d try to remain optimistic and view the time spent having to deal with it as time possibly added to your overall lifespan. You may also kick it completely and enjoy a much healthier lifestyle permanently to prevent a reoccurrence. I’m not trying to pump sunshine up your ass, but you have made a really significant improvement in a quick time.

[Dan Druff]

Todd, to Les’s point - it is literally impossible for you to “feel” the effects of a single Xanax dose after 8-12 hours. That’s the way IR drugs work. BY DESIGN.

I believe what's happening is that the Xanax gives my brain a "break" from the anxiety, and it takes that long for it to "get there" again.

Keep in mind that I had no anxiety for 46+ years prior to 2 months ago.

I'm also not just making this up. In early September. 2 different doctors, including the psychiatrist, encouraged me to take the Xanax when necessary, claiming that these breaks could actually help me, since the anxiety is a vicious cycle, and because I haven't had the problem for very long.

So far, three weeks in a row have seen about 5 days of marked improvement after taking Xanax.

You also can't state what's "impossible" here because the brain is very complex and different for each person. It's not at all unreasonable to think that breaking the anxiety-begets-anxiety cycle allows me a several day break from the symptoms.

[Username]

Todd, to Les’s point - it is literally impossible for you to “feel” the effects of a single Xanax dose after 8-12 hours. That’s the way IR drugs work. BY DESIGN.

I believe what's happening is that the Xanax gives my brain a "break" from the anxiety, and it takes that long for it to "get there" again.

Keep in mind that I had no anxiety for 46+ years prior to 2 months ago.

I'm also not just making this up. In early September. 2 different doctors, including the psychiatrist, encouraged me to take the Xanax when necessary, claiming that these breaks could actually help me, since the anxiety is a vicious cycle, and because I haven't had the problem for very long.

So far, three weeks in a row have seen about 5 days of marked improvement after taking Xanax.

You also can't state what's "impossible" here because the brain is very complex and different for each person. It's not at all unreasonable to think that breaking the anxiety-begets-anxiety cycle allows me a several day break from the symptoms.

Scientifically speaking, long term use of benzodiazepines to treat anxiety - results in degenerative effect of the drug and a more pronounced likelihood for dependency (because you invariably end up “chasing” a drug’s initial effects.) What you assert above is a categorically incorrect approach/mindset approach for sustaining long term relief of anxiety.

FACTS.

[Dan Druff]

I believe what's happening is that the Xanax gives my brain a "break" from the anxiety, and it takes that long for it to "get there" again.

Keep in mind that I had no anxiety for 46+ years prior to 2 months ago.

I'm also not just making this up. In early September. 2 different doctors, including the psychiatrist, encouraged me to take the Xanax when necessary, claiming that these breaks could actually help me, since the anxiety is a vicious cycle, and because I haven't had the problem for very long.

So far, three weeks in a row have seen about 5 days of marked improvement after taking Xanax.

You also can't state what's "impossible" here because the brain is very complex and different for each person. It's not at all unreasonable to think that breaking the anxiety-begets-anxiety cycle allows me a several day break from the symptoms.

Scientifically speaking, long term use of benzodiazepines to treat anxiety - results in degenerative effect of the drug and a more pronounced likelihood for dependency (because you invariably end up “chasing” a drug’s initial effects.) What you assert above is a categorically incorrect approach/mindset approach for sustaining long term relief of anxiety.

FACTS.

The biggest concern for long term benzo use is addiction.

There are both physical and psychological elements to this addiction.

If you have a personality type which can lead you to alcohol or substance addiction, as I know you and les have, telling that person to do benzos "once per week" long term will usually lead to disaster.

For someone like me, who is the opposite, I believe the approach is reasonable, provided I don't raise the dose or increase the frequency.

I do think it's possible that eventually the 0.25mg will stop working as it has, and I might need to revisit.

I'm going to ask the psychiatrist about this plan and see what he says.

I'm also hoping that eventually the once per week need for it vanishes.

I would be a fool to just toss away what appears to be a partial solution just because it's unconventional.

[Username]

You are missing a major point.


The effectiveness of benzodiazepines, over time, diminishes for all human beings - regardless of whether you are predisposed for addiction or not. If I sound like a broken record - it’s becuase you’re not arguing with me - you’re arguing with science and science will relentlessly return you to the same answers over and over again. That’s why it’s science.

[Dan Druff]

You are missing a major point.


The effectiveness of benzodiazepines, over time, diminishes for all human beings - regardless of whether you are predisposed for addiction or not. If I sound like a broken record - it’s becuase you’re not arguing with me - you’re arguing with science and science will relentlessly return you to the same answers over and over again. That’s why it’s science.

Yes I know it diminishes.

However, what effect it does give me might be enough, even if diminished.

Also, you argued earlier that it couldn't be helping me for 5 days, again citing "science" as your reason.

I also recall you once telling me that it was impossible that I was feeling next day tiredness as a result of taking it the first time, because it was only 0.25mg. At least I think it was you. But that's definitely a real thing.

I'm not even understanding what you're advocating here. That I should stop?

What do you think is going to happen? That after enough time I'll need 0.5mg to work instead of 0.25?

Because I'm not going to ever let this get to abusive or addictive levels.

It seems to me that, at worst, this method will stop being effective and I'll have to give up on it.