Phase 2: Clinic Visit 3 (Lexapro plus "mystery pill")

I guess I haven't told you guys how my clinic visits have changed since I got randomized and put in phase 2 of this study.

Well, I have had 3 of them so far, and they've gone about the same way:

1. Fill out forms I filled out for phase 1, plus a whole new set of forms that ask some different questions and have me rate different things (different side effects, mood effects, pain levels, etc.).
2. Sit with Research Assistant (been seeing Research Guy lately for some reason) and they ask me the same set of questions as from Phase 1, plus a whole new set of questions about different side effects (like the twitching....weeeee!).
3. Sit with RN to talk about how I am doing on the medicine and tell them about any side effects I am having as well.
4. Have my blood pressure/pulse rate taken and step on the scale for a nice dose of weight loss motivation.


I also had another EKG at my 2nd clinic visit, but they said I won't have to have another one of those til right before Phase 3.

So I had one of these visits today, and basically they want me to keep doing what I am doing and just see how it goes. twitching is getting less intense, but dizziness is still pretty intense for a few hours, so hopefully they both go away. SOON.

I'm still waking up at 8:30...which is fun. Also, last night I lay down for a nap at about 4:30, set my alarm for 6....and woke up at 1:30am. yup. also fun.

Beginning to wonder if all this crap is worth it (even though I haven't felt depressed in like 2 weeks). I'll give it a few more weeks to see if things even out.

weight: 201 (*sigh*)
depression symptoms: a little bit irritable with people...
possible medication side effects: twitching, dizziness, blurry vision, erratic sleep patterns

Clinic Visit #4/ Day 28 (Lexapro)

I always find it interesting how people ask sensitive questions. One of the things they ask me during my clinic visits while asking about different side effects I could experience is if I am still as interested in sex as usual. Which is kind of awkward, for obvious reasons. RL just does in nonchalantly, one in a string of side effect questions which also include gas and belching. I like that about her. For as personable as she is outside the question asking, the questions are just a list, I just give answers, and we move on. I like it. makes it not awkward if I have to tell her that yes, I did have some gas this week, and I am indeed as interested in sex as I usually am.

The male nurse (saw him yesterday instead of lady nurse for some reason) is not so good at this. He asks me all his questions, how I'm feeling, how my irritation is, blah blah blah, don't be discouraged that you are back to feeling like you did in the beginning...and then he lays this on me "oh, i guess one thing I should ask you is if you are as interested in sex as usual." *awkward pause as he looks at me and not his clipboard of note* "um, yeah."

I like how RL does it a LOT better. lol

Both RL and male nurse gave me a talk about not getting discouraged because the medicine isn't working as well as they like it to at this point. This is week 5 of the study, which means come clinic visit #5 I will be half way done with Part 1. RL reminded me that if the Lexapro doesn't work then there is a second part.

I know this, but it is nice to be encouraged, and especially to be told that it seems that RL's patients are all either (like me) not really responding to the medicine right now, or they are feeling better than they have ever felt. So I guess that makes me feel more normal.

Alright, off to shower, take my pills, and go to work! Another day on 20mg of Lexapro.

weight: 192
depression symptoms: feeling "blue", lack of motivation, trouble concentrating, easily irritated, feeling that I am worth less than my peers
possible medication side effects: gas

Day 17-27 (Lexapro), Clinic Visit 3, I suck at updating

I'm sorry if you've missed my daily (or not so daily) updates. I'll try to do them at least a little more frequently.

Third clinic visit was last Tuesday. I answered the questions, and generally told them that I have been feeling like my base level mood has been better.

Nurse asked me when the last time I felt not depressed was. I told her it was for a while when I was on prozac...before the apathy set in and I didn't really feel anything unless I felt it in a huge way. RL thought it would be cute to share with me that people ask her all the time how she can work with depressed people all day, and that she tells them "they aren't always depressed, they get better." Instead of making me feel better it made me feel the fact that I'm one of those depressed people.

The week leading up to third clinic visit I did feel like my general mood was lifted a bit. It was for the days following the visit as well. Friday was sooo good. I got off work early, I went to a party, I had a great time, met some new people, had good conversation...I felt great. Until Saturday night. I don't know why. Maybe it was a few rude customers, maybe it was just the end of a tiring week, but Saturday night my mood crashed. Today has been rough.

Nurse has upped my dosage to 20mg of Lexapro a day. For some reason she gave me my samples in a different package than the previous times. Since I have to take two of them now (2 10mg pills= 20mg a day) plus my birth control it's easier to get them sorted at the beginning of the week into one of those day of the week pill box things. Well I was doing that a few minutes ago and noticed that the package she gave me has the contact information for some society or association with the term "mental illness" in its name. Seeing that stung. made me remember stutter man, weepy waiting room girl, and sobbing woman. I'm in a catagory with them. My medication just told me so.

I think tomorrow when I go for my 4th clinic visit I'll have to circle a different answer under the question about my feelings of self worth.

weight: 192
depression symptoms: feeling "blue", lack of motivation, trouble concentrating, easily irritated, feeling that I am worth less than my peers
possible medication side effects: sedation

Clinic Visit #2/ Day 15 (Lexapro)

Today I overheard someone at the desk in the Psychiatric services waiting room that made me very glad the only disorder I suffer from is depression. He sounded exactly like this guy, except he was setting up his next appointment and asking about his medicine (and he wasn't British):




Other than listening to him try to discourse with the receptionist, and wondering briefly what he does for a living (he was dressed in khaki's, white button down, tie, jacket, and fedora type hat...any guesses?), Clinic Visit #2 was business as usual:

Told receptionist I was there to see RL, went back to the tiny waiting room, RL came and got me, filled out 2 page survey, was asked the same questions as last time, sent back to tiny waiting room, waited 30 minutes, Nurse came to get me, asked me about side effects, gave me my samples, sent me on my way.

Nurse changed me from 10mg Lexapro a day to 15mg Lexapro. Which means I get to use a pill cutter every two days to cut a 10mg tablet into a 5mg tablet. She says she's taking me up only 5mg to hopefully prevent a recurrence of the nausea and sedation side effects while increasing results. We'll see how it goes.

Clinic Visit #1/ Day 8 (Lexapro)

Today was the first of my weekly clinic visits. I will be going in every week (apparently every Tuesday if my schedule stays the same), to fill out a questionnaire, answer a research tech's (aka "research lady") questions, answer questions for a nurse (not sure how consistent the nurse is going to be, so I shall put off giving them a code name for now), get my meds for the week and go.

Research Lady (hereafter known as RL) had the day off today, so I got to see Research Dude. "Dude" because he looked like a surfer dude and seemed more nervous about asking me the questions than I was about answering them. Or maybe he wasn't so much nervous as putting on a great display of what spending 4 years of undergrad and 2 of grad school (maybe more?) in a lab with other science nerds does to your social skills. But that is besides the point.

I found out today that I am a white 1inch 3-ring binder. There is a tab for each week of this part of the study. Behind each tab is where all my answers to the questions week to week will be recorded. Research dude said that if I get through this part of the study I get a bigger binder. Lord knows how big my binder will be if I make it to part 3 of the study.

But Research Dude (RD) assured me that they use recycled paper, so I guess I don't have to worry about the impact this study has on my carbon footprint just yet. ;-)

I got to find all this out because apparently I answer questions more quickly than RD expected, and had a bunch of time to kill before the Nurse was ready to see me. So we chatted akwardly for bit, he sent me out to the waiting room again, and then brought me back in to chat awkardly for another 5 minutes before the nurse finally came and got me.

Apparently the Lexapro isn't helping as much (or at all really) as they like to see in the first week, so Nurse asked me if I wanted to go from my 10mg to a higher dose. However, she recommended since I am experiencing nausea and exhaustaion (a side effect they call "sedation" lol...both of which should taper off the longer I take the drug) to wait a week and then raise the dose so as to prevent having further side effects. So that is what I am doing.

The worst part of the whole process is coming into the clinic and leaving. It's located in one part of a big medical complex, and the suite it is in is clearly marked "psyciatric services" right across from the reception desk for the "breast health" center. So the ladies who see breast cancer patients all day watch me walk into the "psychiatric services" suite, as do any business suited guys who happen to be walking down the hall from some other part of the building. So I enter the waiting room, which may or may not have a variety of people in various stages of distress in it. I tell the receptionist I'm here for a research appointment, whe validates my parking ticket, and I am sent back to a different, more tiny, waiting room. Last week I got to hear a girl have a half whispered breakdown while her mother tried to comfort her.

After the whole process is over I take the walk to the patient exit. All of the questions I have been asked replay in my mind, and I start thinking about why I am there, why I'm depressed, and what it has done to me. Part of me feels like I don't belong here, with the sobbing and the sedated, while another part of me knows all too well that I need this. It starts welling up, and I get to fight with it all the way home to regain some kind of "normal."

God, I hope that part gets better.

weight: 193
depression symptoms: feeling "blue", lack of motivation, trouble concentrating
possible medication side effects: nausea, sedation