I want to send good vibes out there to all who’re starting new medicines. It can be a difficult and scary time. I hope your medicine does what it’s supposed to, and the side effects are manageable (if they exist).
has anyone had nausea/being sick on aripiprazole/abilify. I’m due to start taking it and I’m so terrified of being sick. I’m supposed to be taking 1mg a day and slowly increasing it. any help is greatly appreciated
Barbiturates INDUCE lipid soluble drugs metabolism, meaning, its effect last less than normal. Example of lipid soluble drugs: Oral Contraceptives (OCP), warfarin, phenytoin, carbamazepine.
OCP DECREASES BZD metabolism.
Anticonvulsants DECREASES OCP efficacy, bc of Cyt p450 induction, eg: Phenytoin, Carbamazepine, Phenobarbital.
Women & Anticonvulsants: if pt wants to get pregnant, change to Phenobarbital (safest bc >protein bound); if pt don’t wanna get pregnant and is taking OCP, change to Valproic Acid (bc is a Cyt p450 inhibitor!)
Avoid abrupt withdrawal of Anticonvulsants bc it can precipitate seizures and increases risk of status epilepticus!!!
Carbamazepine SE: increased ADH secretion & Steven Johnson Sd.
Valproic Acid SE:
Valproic Acid & Ethosuximide: abscense seizures.
Atracurium, Mivacurium: drugs used in anesthesia as muscle relaxants, Nicotinic Antagonists, non depolarizing competitive drugs.
Laudanosine is a metabolite of Atracurium (spontaneous inactivation) crosses BBB and can cause seizures.
Meperidine: is also antimuscarinic, pt won’t have miosis!!!!! (pt will also be tachycardic, no GI, GU gallblader spasm) Metabolized to Normeperidine (serotonin reuptake inhibitor, caution with Serotonin sd)
NEVER GIVE O2 WHEN GIVING OPIATES -UNLESS YOUR PT IS MECHANICALLY VENTILATED- BC YOU TAKE AWAY THE HYPOXIC DRIVE (that thing that tells the body: “hey dude, you gotta breathe more cause your O2 is falling”) AND SINCE PTS TAKING OPIATES HAVE A DECREASE RESPONSE TO ↑PCO2, YOU’LL LEAVE PT WITH NOTHING
When giving opiates as a long-term tx, it can cuase norepinephrine levels to decrease. As a response, the body makes more alpha1 & beta1 receptors. When long-term tx is stopped, a massive sympathetic response can happen, so, to prevent that, give clonidine (alpha2 agonist) that will decrease NE and cancel the sympathetic response.
Methylnaltrexone: for opioid induced contispation (cancer pts)
I feel old. One of the LARPs I play has a game end at 2am, hard stop, and begins again at 9am. We all drop out of game, then go to our cabins and go to bed. In another LARP that I will be playing, it was mentioned that there is a simple rule regarding when you need to step out and take care of yourself rather than doing the thing that your heroic or badass character would do.
I’ve heard a lot of debate. The game should be 24 hours! There should be no way to go out of play! Private conversations erupted on my phone via email, text, and a chat program. Why can’t we game 24/3? What is this namby pamby nonsense? On the other side, what is this person’s problem? Why is this person being ableist and ignoring that people have physical needs?
I can answer that, so I felt like writing about it.
Once upon a time, I was a huge LARPer who gamed every weekend I could. This began when I was eleven years old, and continued for fourteen years after that. For most of that time, I played at least two games, staffed one or two, and contributed time, effort, and props for others. My life was based around what was going on next weekend. My room was a disaster of half-packed luggage and bins, because unpacking was a wasted effort when I was going to put most of it back into bins in four days. My laundry process consisted of coming home, shoveling the contents of a bin into the wash, and shoveling it back into the bin after it came out of the dryer. My social life was based around my hobby. I could sort the people I knew from LARPers and non-LARPers, and I didn’t really let anyone in the second group in. They didn’t understand. This was my life. I dated, loved, lived, and entirely existed in that world.
The problem with that lifestyle is, it isn’t viable for everyone. I found out soon enough that it wasn’t viable for me. I was undiagnosed Bipolar II, along with an annoying and frustrating connective tissue disorder. This means that for most of my teenage years into my twenties, I went from crushing lows to manic highs, careening from game to game while picking up injuries and stress. I used LARPing and MMOs and gaming hobbies as a focus for my mania and neglected my personal life. Pushing to 6 am only to wake up at 9 am for three days a week over a span of months has a cost. I began to feel the wear.
The thing is, until I hit the wall, I could honestly say that I thought mind over body was a thing. It seemed totally reasonable to me that I could push myself for three days and have a KICKASS EVENT OMG and then crash be physically unable to move on Monday morning. That was the right way to LARP, right? That’s how we do it. I could do it all, until suddenly, I couldn’t.
I had fluid extracted from both of my knees six times over a span of four months. I developed a cough that persisted over eight months. Student health started putting me on increasing doses of Lithium and Aripiprazole to try and get my sleep under control. I became non-compliant with my meds because they made me sleep like a normal person, and I had to be awake for 19 hours a day on the weekends.
Eventually, I stopped. I quit. I had to. Not forever, but I needed a break. I had to get my life in order, find a medication course that worked, get myself in one piece. I had to reevaluate my priorities and fight to keep myself in order. I had to accept that self-care is not a sin and my focus should be on life before my hobbies. It wasn’t easy. I come from a family with a strong focus on gaming and fun, and I was involved with so many games. I had to withdraw. I shut down everything and started over. I still have regrets about the things I missed out on as a result, but I don’t regret stepping back. I had to. I was not okay.
I checked into a facility for round-the-clock care, and signed a power of attorney over to the hospital so I could receive health benefits as a ward of the state. I was twenty-six years old, and I can honestly say I would not have survived to twenty-seven if I hadn’t. I self-harmed, I smoked, I drank, and I took pharmaceuticals in entertaining ways. I drove fast, laughing and joking that I might have an “Ethan Fromme” impulse at any moment. I was not okay.
So, when I came back to the world of LARPing, I realized I had to limit myself. I couldn’t be everywhere. I had to maintain my real life. I had to make something of myself. I needed to finish my degree, get my medication under control, and get my life back on track.
Four years later, I’m happy to say that with help, I have. I cannot stress enough how thankful I am for the people who had my back while I was trying to figure out how to be an adult and run my life instead of being run over by it. I have trusted, lived with, relied upon, and sometimes let down the people who were there for me because I was shitty at having my life together. I’m learning, and getting better. The people closest to me have been patient, and understanding, and picked me up when I fell down more times than I can count.
I can pay back favors, give it forward when it’s needed, but the only way I have to honor that help is this: To maintain my life and keep being a functional adult who can make her way in the world.
That means I have to get six to eight hours of sleep a night. It means I have to remain meds compliant even while LARPing. It means that I have to throw some elbows to say, “No, I cannot consent to doing this thing, because it is dangerous, and I do not feel safe.” It means I have to make a proper self-care choice, and I can’t live my life by staggering from weekend to weekend anymore. Sometimes, it means I have to let go of something I want to do because it’s not possible to take proper care of myself while doing it.
When you approach any physically arduous hobby, it’s easy to say that hardcore is the only way. We show off how badass we are, the bruises we’ve accumulated, laugh about the hilarious injury stories and the time I got electrocuted and then duct taped to a sarcophagus lid. It’s easy to glorify the grueling, sleepless, sweating, crashing exhaustion and look on it with pride.
I’ll tell you this, though.
Leaving that mindset and learning how to take proper care of myself is the hardest thing I have ever done in my life. It also saved my life. Self-care is not a sin, and sleeping less or being more injured does not make me more awesome. I make me awesome, so arguably, I should go into anything (life, hobbies, love, family) with all the fuel and sleep and resources I need to be awesome.
I get it. You can do it all, until you can’t anymore. And until you can’t anymore, you can’t see any other way to live. For the people who can still game that way, I’m jealous, and I hope you can keep on keeping on. For the people who can’t - I’ll make sure you get safely back to the cabin, any time.
Had a pretty nice day today! My parents are visiting so I had breakfast with them at their hotel. (: AND HAD A BATH IN THEIR HOTEL ROOM. GOD I MISS HAVING A BATH TUB. ; A;
And I went to the psychiatrist. That went pretty well too! I’ve been prescribed Aripiprazole instead of Olanzapine now. Hope it’ll work! (: I’m quite optimistic about it at the moment, but I am not looking forward to the few weeks of feeling HORRIBLE while my body gets used to the stuff ughh.
Back when I started taking Fluoxetine I had to stay in bed for like two weeks it made me so ill gdi. HOWEVERRR, I still believe it saved my life. Good stuff. Was worth the suffering. :9
So I just left my room after waking up and being on Tumblr for a while to say good morning to my mother. The TV is on, her bag is still on one of the living room chairs and her mobile phone is on one of the bookshelves in the hallway but she is nowhere in the apartment. She usually never goes anywhere without her phone and/or bag. I’m obviously convinced she’s seriously ill or about to die somewhere because I’m that logical about how my life works.
In other news, my new medication does not like me. I’m supposed to be on 5mg of Aripiprazole (or Ablify) a day. I took it for two days in a row and it already caused almost constant nausea/stomach uneasiness. This is apparently normal but that doesn’t stop it from being inconvenient. Then I started feeling like I was on the verge of developing a fever. That “hot behind the eyes” feeling coupled with a slight off-balanced feeling and drowsiness. These can also be side effects of the medication but if you develop a fever from it then that’s technically quite bad. Of course, the symptoms are also identical to the flu so I could just be getting ill at a really unfortunate time. Either way, my hypochondria had me so paranoid about the medication doing me harm that I skipped my dose last night and refuse to take any more until I’ve spoken to my therapist on the phone about it.
Honestly, I just miss my Risperidone. It gave me muscle problems but I was starting to develop quite a good relationship with it mentally and having to go through all of this stress with the Aripiprazole is not making me a happy bunny. I mean it’s made me miss three full days of college already and I still might have to miss IT this afternoon if I can’t get something sorted.
I knew something was going to upset the good streak I was on. It always does.