I just went off lithium and now I'm having all these weird heart and breathing problems. I was having problems being sick on lithium but they said my range was still therapeutic, to some people though even within range I've heard it can be toxic. I've had to go to the ER so many times, I don't even know what the financial situation is, it messed with my sodium and potassium levels and now I've been having those issues. They also misdiagnosed me with a UTI, gave me Cipro, it dehydrated me like nuts, and I got respiratory depression. I'm trying to balance everything but I don't know what I'm doing. Has anyone else had an issue like this? I've heard others say chest pain and low HR and I had those, now my blood pressure is really high and my HR gets really high and I have breathing problems, either too fast, or not working at all. And the doctors won't admit me to the hospital because their blood tests say I'm okay, I don't think there's something technically wrong with my heart or lungs I think that I messed up my electrolytes. They never even told me I might have to increase my salt intake to stay healthy. This is awful. If anyone has any advice my ears are open. Also as a note I was on depakote too, then they pulled that and that's when things as far as toxicity started happening. I really feely life is in danger I've been to the ER so many times and they said to meditate ? Now I haven't slept in 48 hours, it was six days before that. Out of desperation I voluntarily put myself in a mental hospital, but they started giving me drugs I'm actually allergic to and it was bad. before but I had a lot more in my system, I can't keep anything down either. I'm taking depakene now and Ativan and they gave me mirtazapine to sleep at night. I feel worried I'll stop breathing though and die. Ugh. And I have epilepsy so when I try to take my Gabapentin it dehydrates me too. I feel like I should take some though. I've been trying coconut water and I have potassium supplements. I have salt tabs as well. I can't seem to keep hydrated enough without pushing out these minerals, and I might be missing others that are important like magnesium.
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N&PD Moderators: Skorpio | thegreenhand
Lithium Nightmare, I don't know what I'm doing.
- Thread starter EliseBug
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PerpetualAnhedonic
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Hmm sounds like you have quite the complex pickle on your hands OP.....sorry you're having such difficulty.
Considering the complexity of your situation, it will certainly be difficult for me to be of much help over the net, but I can't in good conscience refuse to at least try so you're not alone in dealing with such a shit hand. Hopefully I (or any of our below Bluelighters) can be of any benefit to you.
What kind of remarks have the medical professionals made in regards to their conclusions in your visits?
First things first- may I please ask, what your medical records look like? By this, I mean every official diagnosis, medications, general health details, pertinent family history, etc etc...
-PA
Considering the complexity of your situation, it will certainly be difficult for me to be of much help over the net, but I can't in good conscience refuse to at least try so you're not alone in dealing with such a shit hand. Hopefully I (or any of our below Bluelighters) can be of any benefit to you.
What kind of remarks have the medical professionals made in regards to their conclusions in your visits?
First things first- may I please ask, what your medical records look like? By this, I mean every official diagnosis, medications, general health details, pertinent family history, etc etc...
-PA
Li toxicity will usually present with GI upset if acute or acute-on-chronic toxicity. Chronic toxicity can lead to all kinds of nasty things but respiratory issues and tachycardia aren't common symptoms and may be due to anxiety, same with the high B, you seem quite anxious to me. Li affects the re-absorbtion of Sodium and water which is why you need to possibly increase Na intake or at least keep it steady so as not to affect Li levels. It has a narrow therapeutic index as you mentioned. Make sure you are drinking a tonne of water if you are getting dehydrated. Your urine should be clear. The darker it gets the more dehydrated you are. Also pinch the skin on the back of your hand together and pull it up. It should snap back into place right way. If there's any "tenting" of the skin you are dehydrated. Dehydration and electrolyte imbalance can cause quite an upset, especially Sodium and Potassium since those are the two our heart rely on to depolarize/repolarize. If your lab work is saying that your electrolytes are fine then there could be another underlying condition being missed, or potentially a side-effect of the new meds.
The mirtazipine can cause a condition called "seratonin syndrome" which actually fits your symptoms as well as the listed side-effects of the drug. If you feel your heart racing or beating irregularly, are hyper reflexive or stiff, have dilated pupils, goosebumps, confusion, agitation, heavy sweating, stomache problems or any combination of those it could be seratonin syndrome and you should get off the mirtazipine or get the dosage lowered. Speak to a pharmacist at the drug store, they're actually full of useful info and typically know more about the meds than the docs do. I'd def look into it though. I'm a medic and have seen seratonin syndrome before and it's not something to take lightly so get yourself back to the doc and see if there's anything they can do for you. Hope that helps, take care.
The mirtazipine can cause a condition called "seratonin syndrome" which actually fits your symptoms as well as the listed side-effects of the drug. If you feel your heart racing or beating irregularly, are hyper reflexive or stiff, have dilated pupils, goosebumps, confusion, agitation, heavy sweating, stomache problems or any combination of those it could be seratonin syndrome and you should get off the mirtazipine or get the dosage lowered. Speak to a pharmacist at the drug store, they're actually full of useful info and typically know more about the meds than the docs do. I'd def look into it though. I'm a medic and have seen seratonin syndrome before and it's not something to take lightly so get yourself back to the doc and see if there's anything they can do for you. Hope that helps, take care.
Solipsis
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IIRC mirtazapine causing SS is controversial and it has potential to actually protect against it? I don't know about a lot of other effects reported and ins and outs of lithium but yes anxiety does seem to likely be a serious part of the problem, the polypharmacy is also very likely to produce a lot of off sensations which would really fuel anxiety about it. It's not for us to say where more physical and acutely toxic issues may be pressing nonetheless. Going on and off of medications like that especially a very complex combination doesn't allow your body to level off and get used to / compensate for part of the side effects.
I kinda want to steer off the anxiety and just talk about the symptoms. Yes I have anxiety but anyone would given the situation. The chest pains were really intense and I had a holter monitor. My heart was so slow they said I needed a pacemaker, but as the lithium lifted it go better and they opted out. And mostly I'm saying the repistatory depression is related to being dehydrated, and I think there something potassium and sodium balance in that, but mostly just being dehydrated. My case managed with bipolar after you go off a medications your other medications get weird, which has happened to me before. Last year I had a similar thing happen sbut for less of a length of time and not nearly as strong of drugs. I was ordered now to come off the mir and I have to stay off gabapentin too. I'm worried I'm reliant on the Imodium and I'm trying to do the diet but I have been feeling barely an appetite. And as far as my medical past I have bipolar, and ptsd, I have been using 4-8 immodium for probably over a year and that is scary too. I've been on so many different kinds of meds, I just can't take clonodine and lactmictal. I have epilepsy as well.
pofacedhoe
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why are you taking so much of a strongly constipating drug? why? loperamide in large amounts= wtf???
its no good saying " my heart rate was high and my blood pressure". give us the numbers please cos that statement is useless. people always make subjective comments about these things but for example...
a heart rate of 140 when you are doing nothing physical would be a real cause for concern, 103 would not be so much of a worry though it would still technically be high (tachycardic) for an innactive state and concerning
a BP of 160/95 would technically be high but cause slow long term damage as opposed to immediate life threatening decline (more like 190/110 upwards is pretty concerning)
they can test for electrolytes on a blood test easily. if you complained of heart problems its probably one of the main things they would do plus an ECG for sure.
all I can say is calm down. I am not saying what you described is not true just that you are pulling a few subjective statements out without any facts to back them up or clear details of what happened so as someone with bipolar these doctors are all "trust me i'm a doctor you are fine". which to someone with manic undertones is a huge paranoia trigger.
doctors often ignore crazy patients with legitimate syptoms because of the mental health diagnosis. yet you go to the ER regularly? why
when they "do a blood test" ask for a printout of the blood test and ask about potassium and sodium and have them give you the numbers for the normal ranges. I think you are clever enough to understand these things but that your a bit crazy for now and that the anxiety it causes and lack of sleep is making this 100 times worse in your head.
at the same time- just because you are a bit crazy doesn't make you wrong...
its no good saying " my heart rate was high and my blood pressure". give us the numbers please cos that statement is useless. people always make subjective comments about these things but for example...
a heart rate of 140 when you are doing nothing physical would be a real cause for concern, 103 would not be so much of a worry though it would still technically be high (tachycardic) for an innactive state and concerning
a BP of 160/95 would technically be high but cause slow long term damage as opposed to immediate life threatening decline (more like 190/110 upwards is pretty concerning)
they can test for electrolytes on a blood test easily. if you complained of heart problems its probably one of the main things they would do plus an ECG for sure.
all I can say is calm down. I am not saying what you described is not true just that you are pulling a few subjective statements out without any facts to back them up or clear details of what happened so as someone with bipolar these doctors are all "trust me i'm a doctor you are fine". which to someone with manic undertones is a huge paranoia trigger.
doctors often ignore crazy patients with legitimate syptoms because of the mental health diagnosis. yet you go to the ER regularly? why
when they "do a blood test" ask for a printout of the blood test and ask about potassium and sodium and have them give you the numbers for the normal ranges. I think you are clever enough to understand these things but that your a bit crazy for now and that the anxiety it causes and lack of sleep is making this 100 times worse in your head.
at the same time- just because you are a bit crazy doesn't make you wrong...
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Solipsis
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Although I would really verify first that your electrolytes are deficient or imbalanced like po suggested, the easy solution to avoid flushing them out of your system seems to drink isotonic drinks. Don't overdo it of course! And you might wanna get some powder to make your own isotonic drink because it's way cheaper. Also try to get the sugarfree version I guess.
You don't have to go to the ER, just get a referral from your doc to get some blood drawn and tested. Again though: first get some clarification because it would be really strange if they were considering a pacemaker if the problem was just an electrolyte imbalance which is not an uncommon adverse effect with lithium.
If the heart problems etc are partially a result of complex interactions of all the meds then I guess they would consider such temporary artificial ways to keep your vitals okay.
You can't really ignore the anxiety because of how much it can exacerbate symptoms, the point is that it can turn feeling fucked up and sick into like you're dying even though you aren't. Feeling fucked up from all the medication might not be serious, but it depends on why the docs are ignoring you. If they have actually done the tests showing that the serious signs are missing, then the urgency of your feelings is best explained by your anxiety and mental state. Either way: get them to actually share the medical info they use to answer that question of seriousness, the results of tests that address your symptoms and how they are explaining the test results.
With so many drugs in your system, trying to 'level out' and come off them likely involves really fucked up feelings you have to go through and can't go around. I get that you need more clarity about your medical state, so get it from them so that you can focus on the recovery.
Not only the lack of sleep, anxiety, drug side effects (and many other factors mentioned) but also attempts to remedy your situation based on guesses / self-diagnosing can just endlessly complicate the matter. Partially, I trust some symptoms are obvious and it's not all wrong to do something about it.
You can't really get actual medical info about your personal state from this forum, but from previous testing and extra tests you could do. Just get on the phone and see if you can get your GP or the hospital to release the relevant test info. Seems like constant ER visits are pointless if you ask for attention rather than information.
You don't have to go to the ER, just get a referral from your doc to get some blood drawn and tested. Again though: first get some clarification because it would be really strange if they were considering a pacemaker if the problem was just an electrolyte imbalance which is not an uncommon adverse effect with lithium.
If the heart problems etc are partially a result of complex interactions of all the meds then I guess they would consider such temporary artificial ways to keep your vitals okay.
You can't really ignore the anxiety because of how much it can exacerbate symptoms, the point is that it can turn feeling fucked up and sick into like you're dying even though you aren't. Feeling fucked up from all the medication might not be serious, but it depends on why the docs are ignoring you. If they have actually done the tests showing that the serious signs are missing, then the urgency of your feelings is best explained by your anxiety and mental state. Either way: get them to actually share the medical info they use to answer that question of seriousness, the results of tests that address your symptoms and how they are explaining the test results.
With so many drugs in your system, trying to 'level out' and come off them likely involves really fucked up feelings you have to go through and can't go around. I get that you need more clarity about your medical state, so get it from them so that you can focus on the recovery.
Not only the lack of sleep, anxiety, drug side effects (and many other factors mentioned) but also attempts to remedy your situation based on guesses / self-diagnosing can just endlessly complicate the matter. Partially, I trust some symptoms are obvious and it's not all wrong to do something about it.
You can't really get actual medical info about your personal state from this forum, but from previous testing and extra tests you could do. Just get on the phone and see if you can get your GP or the hospital to release the relevant test info. Seems like constant ER visits are pointless if you ask for attention rather than information.
Okay so to be specific, 143/110, not doing anything, HR usually from 110 to 130, not doing anything. I know the fear about taking the meds is there but I am also having back reactions to them which just causes a circle. I am aware, but my kidney doctor was telling me to go to the ER today because my HR was up, and my case manager was saying to stay home, I took gabapentin cause they told me to, and being wobbly was fine, but shortness of breath and gastric upset really got bad. And I was taking so much loperamide because the diahrea never stopped. It was on going for a over a year and I was told I could use it. Not saying it's right but I was taking directions. I do have anxiety but I've never ever experienced these symptoms, usually they are lighter. I do feel like I come across crazy but when you do everything they say and you still feel like you're dying, it's hard.
pofacedhoe
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people who stop loperamide get insane amounts of liquid shits. be careful and taper it when you do come off it. if you are not on the drug your took it to mask the shits from why still taking? taper maybe but over a long time
i would listen to your kidney doctor lithium patients make up a tiny proportion of renal failure but it does happen. it fucks kidneys a bit but high bp will do moreso as will diabetes.
your blood pressure is fine systolic not that high.
elevated heart rate at 130 when not excercising seems too high.
look you clearly aren't mega crazy but when you tell me you havent slept for multiple days that will make anyone a little crazy, if you get a label of a mental illness doctors will knee jerk and judge and not all of them have a great grasp of these things
i would listen to your kidney doctor lithium patients make up a tiny proportion of renal failure but it does happen. it fucks kidneys a bit but high bp will do moreso as will diabetes.
your blood pressure is fine systolic not that high.
elevated heart rate at 130 when not excercising seems too high.
look you clearly aren't mega crazy but when you tell me you havent slept for multiple days that will make anyone a little crazy, if you get a label of a mental illness doctors will knee jerk and judge and not all of them have a great grasp of these things
Yeah I hadn't slept because my heart rate at the time was 37 and i was having shortness of breath, like respiratory depression not rapid breathing or anything. The bipolar and anxiety did NOT help but neither did them telling me to take more meds that were flooring my blood pressure. I was discharged from a hospitals and had a syncope episode and hit my head on the concrete. They obvserved me over night and sent me home. I was at that point desparate so I went to a mental facility voluntarily, and they didn't even have a therapist for me to talk to, they thought I wanted to kill myself and that's it. I went home and finally slept some. Been into the ER a few times since then because of dehydration, they filled me with two IVs and I still didn't have to urinate. They never admit me for anything. I understand I'm not bleeding out on the table but it can be nerve wracking going back home having little idea what to do.
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