new therapist

[mymorgy]

Dr.Moussavian is going to get me a new therapist...maybe a young male...
I explained to him that my current one reminds me of my parents with her lack of empathy and i don't want to work it out. I did tell him that she didn't seem to know that these drugs can cause weight gain and diabetes. His eyes looked a little shocked when i told him that when i complained about weight she said to go to a doctor and he would give me a pill.
He also put me back on welbutrin. I had a bad experience with it years ago but he says that changes.
bobby
I told him he was a treasure and wished him a happpy birthday. he seemed pleased that i remembered.

[waves]

Dear Bobby,

I'm so so so glad you talked to Dr. Moussavian and he is coming through for you and getting you a new therapist. :):):) I hope he has/had a GREAT birthday too... lol! That man's a gem! (And good job remembering).

Good luck with the Wellbutrin also. I had two very different experiences with Wellbutrin... I hope it works out well for you this time. I know it can be a wonderdrug - for me it was the first time i took it. Oh, and, btw, it might have an effect on weight: tends to reduce appetite with possible weight loss! :D

let us know when you will have your first therapy appointment with... the new person to be.

:heartthrob: love :heartthrob:

~ waves ~

[Mari]

Dear Bobby,

Thank goodness Dr. M stepped in and helped.
Maybe the next therapist can actually be helpful -- beyond the hoops that you need to jump through simply to see Dr. M.
Good luck with the Wellbutrin.

M.

[Isis]

Thats great Bobby. A very Happy Birthday to him certainly. :)
:hug:

[bizi]

Dear Bobby,
I think it is fantastic that you spoke up about your therapist. Good for you and am so glad that he is willing to help you get a new one.
I am hoping that you do not experience any problems with the welbutrin this time...will you know soon if it is going to work out for you.... side effects etc or will it take awhile?
keeping my fingers crossed for you.
Were you able to talk to robert?
bizi

[Mari]

Dear Bobby,
I wonder how you are doing? :)

Do you have a new therapist?
Is the Wellbutrin helping you?

I hope that you are ok.

M.

[mymorgy]

thanks for asking. ..a lying down disaster. i have sort of become antisocial. I forgot the song about worms about going into the garden and picking them up and eating them. My parents loved me but they treated me so harshly most of my life and i learned very well to treat myself harshly. Add that to bipolar and you have quite a mix. I have been dwelling a lot on death on a lot.
I got sick last week. what a joke. I had to miss Dr. M.'s appointment. I finally got excited over something ,qi dong ,and hoped that would bring me out of this long time depression and possibly help my energy. Now I have to miss this class. I probably have to see a heart doctor and a lung doctor because of shortness of breath when i walk a little bit...really depressing. I have been getting easily irritated at people who are basically so very kind to me...how can I be like this? I have had trouble reading the forum and responding. I wanted to write to you and say have you the combination of magnenium calcium and five m. of melatonin a half an hour before bed time? I couldn't get myself to do it.
I don't know if I did the right thing but dr.m. told my therapist EVERYTHING i told him ......i couldn't believe it....even about having the doctor giving me a pill to lose weight...she didn't remember that but said she must have meant an appetite suppressant because if there was a pill she would take it too.
She apologized and said she would try harder and that she was very sorry.
She said was not empathic I shouldimmediately tell that she wasn't being empathic. I causually told her I was a reject.
We will see
Bobby

[bizi]

oH BOBBY,
this does not sound good.
I am sorry that you are so unwell.
Do look into your physical medical problems they effect everything that is going on with you.
I was shocked that he told her everything that you said.
bizi

[mymorgy]

I am so scared of doctors Bizi. I am so scared of pain and I always think the worse. Once I experienced being badly burned I became irrational.
bobby
ps yes I was so shocked they he told her everything. He is really in my corner. I couldn't believe it. He is so intelligent. I started the session with what did dr. Moussavian tell you. I wonder if my eyes opened wide. I certainly didn't expect what she said.

[bizi]

I am glad that he is in your corner,
we are rooting for you too,
post when ever you are able...we miss you when you are quiet.
(((((HUGS)))))
bizi

[Mari]

t I have had trouble reading the forum and responding. I wanted to write to you and say have you the combination of magnenium calcium and five m. of melatonin a half an hour before bed time? I couldn't get myself to do it.



Dear Bobby,
Regarding the Magnesium and Calcium:
It might have been Waves that was helping you work out the Calcium / Magnesium dose. I will look for her post.


This is what I take:
I take 1 and a half teaspoons of Magnesium called "Natural Calm"

http://www.amazon.com/Natural-Calm-Superior-Magnesium-Powder/dp/B0001WNF0O
http://i372.photobucket.com/albums/oo166/carrotbl/31GW2S14ERL_SL500_AA280_.jpg

The package says that one serving is 3 teaspoons and 615 mg Magnesium Citrate. I take half that amount so I am getting about 300 mgs.
I also take 4000 IU vit D each day.

I don't take any calcium except for my occasional multi vit that I remember to take. A few years a go I started taking lots of calcium but it caused tremendous anxiety after a few days. My pdoc told me that the extra calcium was interfering with the Verapamil (mood stabilizer for me) which is a calcium blocker. I took lots of calcium during those three days (150 mgs or so). I have since not tried to recalculate the right dose for my mood. I started taking magnesium years ago because the Verapamil causes constipation. Taking too much Magnesium can cause gi symptoms. So I have worked my dose to be 1.5 teaspoons.


M.

[Mari]

Dear Bobby,

Here is the other thread:

the overall intake (food and supplements) of Ca:Mg should be 2:1, respectively.


http://neurotalk.psychcentral.com/showthread.php?t=111347&highlight=calcium
http://neurotalk.psychcentral.com/showthread.php?
t=111347&highlight=calcium&page=3
I think we were working out

1. metaforin
2. B 12
3. Calcium
4. Magnesium
5. Vitamin D


=-=-=-=-
Maybe it it not possible to figure out all 5 of these variables by ourselves.


I'm careful about foods (juice, . . . ) that have added calcium. I stay away from them -- this is what pdoc said. He did not say no calcium at all for me. He just said to be aware of what I was getting in food.
=-=-=-=-=-=-=-=


http://lpi.oregonstate.edu/infocenter/minerals/calcium/index.html

Most experts recommend obtaining as much calcium as possible from foods because calcium in foods is accompanied by other important nutrients that assist the body in utilizing calcium.
However, calcium supplements may be necessary for those who have difficulty consuming enough calcium from foods. No multivitamin/multimineral tablet contains 100% of the recommended daily value (DV) for calcium because it is too bulky, and the resulting pill would be too large to swallow.

The "Supplement Facts" label, now required on all supplements marketed in the U.S., lists the calcium content of the supplement as elemental calcium.
Calcium preparations used as supplements include calcium carbonate, calcium lactate, calcium gluconate, calcium citrate, and calcium citrate malate.
To determine which calcium preparation is in your supplement, you may have to look at the ingredient list.
Calcium carbonate is generally the most economical calcium supplement. To maximize absorption, take no more than 500 mg of elemental calcium at one time. Most calcium supplements should be taken with meals, although calcium citrate and calcium citrate malate can be taken anytime (50).


I'm sorry that I can't figure this out for you.

Here is an abstract -- maybe you have seen it:
http://care.diabetesjournals.org/content/23/9/1227.abstract

Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

I take lots of Vit B12. -- so much so that it came out around 2000 or something on my lab work.
I take

[mymorgy]

Dear Bobby,

Here is the other thread:




http://neurotalk.psychcentral.com/showthread.php?t=111347&highlight=calcium
http://neurotalk.psychcentral.com/showthread.php?
t=111347&highlight=calcium&page=3
I think we were working out

1. metaforin
2. B 12
3. Calcium
4. Magnesium
5. Vitamin D


=-=-=-=-
Maybe it it not possible to figure out all 5 of these variables by ourselves.


I'm careful about foods (juice, . . . ) that have added calcium. I stay away from them -- this is what pdoc said. He did not say no calcium at all for me. He just said to be aware of what I was getting in food.
=-=-=-=-=-=-=-=


http://lpi.oregonstate.edu/infocenter/minerals/calcium/index.html

Most experts recommend obtaining as much calcium as possible from foods because calcium in foods is accompanied by other important nutrients that assist the body in utilizing calcium.
However, calcium supplements may be necessary for those who have difficulty consuming enough calcium from foods. No multivitamin/multimineral tablet contains 100% of the recommended daily value (DV) for calcium because it is too bulky, and the resulting pill would be too large to swallow.

The "Supplement Facts" label, now required on all supplements marketed in the U.S., lists the calcium content of the supplement as elemental calcium.
Calcium preparations used as supplements include calcium carbonate, calcium lactate, calcium gluconate, calcium citrate, and calcium citrate malate.
To determine which calcium preparation is in your supplement, you may have to look at the ingredient list.
Calcium carbonate is generally the most economical calcium supplement. To maximize absorption, take no more than 500 mg of elemental calcium at one time. Most calcium supplements should be taken with meals, although calcium citrate and calcium citrate malate can be taken anytime (50).


I'm sorry that I can't figure this out for you.

Here is an abstract -- maybe you have seen it:
http://care.diabetesjournals.org/content/23/9/1227.abstract

Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

I take lots of Vit B12. -- so much so that it came out around 2000 or something on my lab work.
I take

I am onfused....it says "Serial serum vitamin B12 determinations revealed a similar decline in vitamin B12 and holoTCII. Oral calcium supplementation reversed the metformin-induced serum holoTCII depression. CONCLUSIONS: Patients receiving metformin have diminished B12 absorption and low serum total vitamin B12 and TCII-B12 levels because of a calcium-dependent ileal membrane antagonism, an effect reversed with supplemental calcium. "...that doesn't mean b12 does it?
thank you looking up all that...it is so confusing. I wonder if Metforin is contributing to pernicious anemia in older people with diabetes II on it.

[mymorgy]

Dear Bobby,
Regarding the Magnesium and Calcium:
It might have been Waves that was helping you work out the Calcium / Magnesium dose. I will look for her post.


This is what I take:
I take 1 and a half teaspoons of Magnesium called "Natural Calm"

http://www.amazon.com/Natural-Calm-Superior-Magnesium-Powder/dp/B0001WNF0O
http://i372.photobucket.com/albums/oo166/carrotbl/31GW2S14ERL_SL500_AA280_.jpg

The package says that one serving is 3 teaspoons and 615 mg Magnesium Citrate. I take half that amount so I am getting about 300 mgs.
I also take 4000 IU vit D each day.

I don't take any calcium except for my occasional multi vit that I remember to take. A few years a go I started taking lots of calcium but it caused tremendous anxiety after a few days. My pdoc told me that the extra calcium was interfering with the Verapamil (mood stabilizer for me) which is a calcium blocker. I took lots of calcium during those three days (150 mgs or so). I have since not tried to recalculate the right dose for my mood. I started taking magnesium years ago because the Verapamil causes constipation. Taking too much Magnesium can cause gi symptoms. So I have worked my dose to be 1.5 teaspoons.


M.

so that means you can't take the combo calcium magnesium and melatonin 5 miligrams for sleep, I am confused now how much calcium and maglnesium i take...sometimes I take a lot. vitamin d I take eight thousand-i hardly ever leave the house.
now I have screwed on afrin...i just read the instructiions....said becare if you have diabetes and high blood pressure and don't take for more than three days in a row and twice a day,,,,,\
haven't looked at my qi dong dvd yet
bobby

[bizi]

I was taking slow magnesium because it is recommended to be absorbed better in that form.
I didn't find that it helped me to sleep....
klonipin helps me to sleep...that and beer.
bizi

[Mari]

Dear Bobby,

I'm sorry that you were sick last week.

That's great about Dr. M. calling the Therapist. He went to bat for you!
She's a weird bird but you do have Dr. M on your team.


=-=-=-=-=-
The Qigong video looks interesting. I just looked up Qigong on Amazon. Sometimes when I buy a new video I just watch it first without doing the moves. After I watch it I am more comfortable doing the moves / sequences / and so on.

=-=-=-=-=-

I have had trouble reading the forum and responding
The same with me. I can kind of read. I think sometimes writing is easier than reading -- not sure. Sometimes if I am up to it I return to the forum later and give it another try --depending.

=-=-=-=-=-

Here is wikipedia on the dose of Melatonin with a reference:
http://en.wikipedia.org/wiki/Melatonin
Dosage
Studies from Massachusetts Institute of Technology have said that melatonin pills sold as supplements contain three to ten times the amount needed to produce the desirable physiologic nocturnal blood melatonin level for a more rapid sleep onset.

Dosages are designed to raise melatonin levels for several hours to enhance quality of sleep, but some studies suggest that smaller doses (for example 0.3 mg as opposed to 3 mg) are just as effective.[79]

Large doses of melatonin can even be counterproductive: Lewy et al.[80] provide support to the "idea that too much melatonin may spill over onto the wrong zone of the melatonin phase-response curve" (PRC). In one of their subjects, 0.5 mg of melatonin was effective while 20 mg was not.


Lots of footnotes in the Wikipedia article

Dosing info from the The Endocrine Society:
http://jcem.endojournals.org/cgi/content/abstract/86/10/4727

=-=-=-=-=-
I am onfused....it says "Serial serum vitamin B12 determinations revealed a similar decline in vitamin B12 and holoTCII. Oral calcium supplementation reversed the metformin-induced serum holoTCII depression.
CONCLUSIONS: Patients receiving metformin have diminished B12 absorption and low serum total vitamin B12 and TCII-B12 levels because of a calcium-dependent ileal membrane antagonism, an effect reversed with supplemental calcium. "...that doesn't mean b12 does it?
thank you looking up all that...it is so confusing. I wonder if Metforin is contributing to pernicious anemia in older people with diabetes II on it.

I found an explanation:
Increased Intake of Calcium Reverses Vitamin B12 Malabsorption Induced by Metformin

B12 absorption is calcium dependent:
http://care.diabetesjournals.org/content/23/9/1227.full.pdf -- see the conclusion on page 1229.

I found the above link on a patient forum:
http://www.diabetesdaily.com/forum/complications/1286-metformin-neuropathy-symptoms

Am I getting closer to what you were looking for with Mateformin / Caclium / B12?



Mari

[mymorgy]

am I further sabotaging myself with the melatonin by taking the high dose...eeks..
lately i have had little energy which makes it harder to read and respond to the posts.
Dr.M. and my therapist are four doors away in the same office so it was face to face I assume....If must have been rougher
what a researcher you are. i printed out the article and will give it to my doctor. thank you.
I will also give her this.Vitamin B12 Deficiency is Common in Subjects with Type 2 Diabetes Mellitus Not Taking Metformin and is Nutritional in Nature.
Jawa AA, Akram J, Sultan M, Humayoun A, Raza R.

Jinnah - Allama Iqbal Institute of Diabetes and Endocrinology, Allama Iqbal Medical College/Jinnah Hospital, Lahore, 54550, Pakistan.

OBJECTIVES: The primary objective of our study was to estimate the frequency of undiagnosed Vitamin B12 deficiency amongst subjects with type 2 diabetes who were not taking Metformin for at least the past 5 years. The secondary objective was to ascertain if Vitamin B12 deficiency amongst the type 2 diabetes subjects was due to nutritional deficiency or malabsorption. METHODS: Vitamin B12 levels were measured in 44 subjects with diabetes (40-70 years). 21/44 (48%) had low vitamin B12 levels (<200 microgram/dL). 10/21 subjects agreed to enter an intervention phase comprising oral mecobalamin 1500 microgram/day for 3 months. Those subjects who failed to normalize Vitamin B12 levels after oral supplementation alone would be presumed to have Vitamin B12 deficiency due to malabsorption. RESULTS: Almost one-half of type 2 diabetes subjects not taking Metformin had biochemically proven vitamin B12 deficiency. 10/10 subjects had normalized their Vitamin B12 levels after 3 months of oral supplementation. CONCLUSION: We conclude that Vitamin B12 deficiency is common amongst type 2 diabetes subjects and is nutritional in nature. In addition to intensive glycemic control, Vitamin B12 supplementation should also be considered for treatment of diabetic neuropathy. In almost 50% of low vitamin B12 subjects the deficiency was correctable with oral supplementation alone. This indeed is an important finding, as taking oral Vitamin B12 supplementation is easy, convenient and readily accepted by patients. This is a novel finding and stresses the need for aggressive and early diagnosis and treatment to avoid complications of Vitamin B12 deficiency.


sleep would be great
bobby
Vitamin B12 deficiency: a challenging diagnosis and treatment]
[Article in French]

Rufenacht P, Mach-Pascual S, Iten A.

Service de médecine interne générale, HUG, 1211 Genève 14. pierre.rufenacht@hcuge.ch

Vitamin B12 deficiency is usually evoked in presence of compatible hematologic or clinical (usually neurologic) signs. However, many cases of deficiency are little or not symptomatic. Pernicious anemia, caused by a deficiency in intrinsic factor, is a rare cause of vitamin B12 deficiency. The most frequent causes are gastric disorders, pancreatic insufficiency, or chronic drug treatment (proton pump inhibitors or metformin) that interfere with the digestion of vitamin B12 digestion, or disorders of the ileum mucosa reducing the absorption of vitamin B12. Oral treatment of vitamin B12 deficiency is possible whatever the etiology, but it has only been