Help please

[[Li...]]

Good morning, I had to sleep on everything and  journal. I'm a bit  overwhelmed but not in a panic. lol The reason I was suggesting a 5% cut is because I don't know how long my nurse practitioner will prescribe this. I'm assuming this could take a year or more to taper.  That's understandable , but I don't know if she will keep prescribing it for over a year.  I will start at 2.5. But I was wondering if I could possibly go to 5% if I don't have crazy symptoms. My other question is, how often do I make a cut? Every 2 weeks? She does not know I'm reducing. The last time we spoke, she wanted me on the full dose. I don't really trust doctors, and 5 months from now She could tell me that she's cutting me by 50 percent because I've been on so long. I'm trying not to catastrophize , but you never know with the doctors. 

[[Li...]]

10 hours ago, [[P...] said:

You're finally feeling a little bit better so its time to change all that, sheesh, this is a nutty process! 

I like @[El...]'s caution, you've got this. 

@[Pa...]  Another IMPORTANT question. I have a bottle with a few 1mg tablets left from the July refill. Can I cut them in half to a 0.5 ( that's what I take now) and use them before the taper? I'm asking this, so I have extra of the 0.5. Throughout the month of September, my prescription refill is literally down to the wire. There was a problem the past 2 months with them filling them in time. I basically wanted to get rid of the old script in case of an issue of them filling them on time. I don't want to cut the 1mg in half to cause an issue, though? Same dose just a 1mg tablet

[[Pa...]]

@[Li...], I think conserving your available medication is smart, I don't see a problem with your plan. 

[[Li...]]

4 minutes ago, [[P...] said:

@[Li...], I think conserving your available medication is smart, I don't see a problem with your plan. 

@[Pa...] great! I didn't want any issues from the 1mg pill and cutting uneven? 

[[El...]]

@[Li...] Good morning!

Yes, you need to weigh ten pills, then divide by 10.  This will give you the average weight of 1 pill.  We need this to begin calculating your percent reductions.

It is entirely possible to speed up a taper.  I suggested a more modest first step to gauge how quickly you are able to handle your reductions.  Hopefully, your symptoms will be very minor/settle quickly and you can then attempt a larger percent reduction.  The key, really, to having a successful taper is to let your symptoms guide you.  Speed up if you feel well enough and able enough...slow down if symptoms become overwhelming.

Are your 1 mg pills scored?

[[Li...]]

9 minutes ago, [[E...] said:

@[Li...] Good morning!

Yes, you need to weigh ten pills, then divide by 10.  This will give you the average weight of 1 pill.  We need this to begin calculating your percent reductions.

It is entirely possible to speed up a taper.  I suggested a more modest first step to gauge how quickly you are able to handle your reductions.  Hopefully, your symptoms will be very minor/settle quickly and you can then attempt a larger percent reduction.  The key, really, to having a successful taper is to let your symptoms guide you.  Speed up if you feel well enough and able enough...slow down if symptoms become overwhelming.

Are your 1 mg pills scored?

@[El...] I have 0.5 mg that I've been taking in August.  I was just wondering if I can finish the 1mg (I had in July)  so I have extra pills incase of a future issue. I only have 2 left so 4 dose. Yes, they are scored 

[[El...]]

Good idea to finish the old pills.  I was just wondering if they were scored.  It is generally accepted that scored pills have evenly dispersed active ingredient.  But, no worries.  Finish those...then proceed with your taper with the 0.5 mg pills.

[[Li...]]

12 minutes ago, [[E...] said:

Good idea to finish the old pills.  I was just wondering if they were scored.  It is generally accepted that scored pills have evenly dispersed active ingredient.  But, no worries.  Finish those...then proceed with your taper with the 0.5 mg pills.

@[El...] I will keep you posted on measurements.  Thank you sooo much. 

[[Li...]]

0.606 Was 10 pills. Are those the ones I'll be cutting first and together I assume? @[El...]

[[El...]]

OK, here is how you would calculate your first reduction with your script containing 0.5 mg pills (10 pills weigh 0.606 grams).

Given that 10 pills weigh 0.606 grams, then 1 pill will have an average weight of 0.0606 grams. (0.606 ÷ 10 = 0.0606 grams)

Each dose must be reduced by 2.5%: 0.975 × 0.0606 = 0.059085 grams.

For purposes of your scale, you will need to round to 0.059 grams per dose.

So, for your first reduction, you will shave and weigh each dose to be 0.059 grams.

It is important to note the following. 1) If the pill originally weighs more than 0.0606 grams (for example, 0.062 grams or 0.063 grams), still shave the pill to 0.059 grams. 2) if the pill originally weighs less that 0.0606 grams (for example, 0.059 grams or 0.058 grams), do not shave the pill. Take the pill as is.         (*I know this may seem counterintuitive!  But pill manufacturers are allowed a small variation in amount of active ingredient as well as a variation in the amounts of fillers and binders. Using the average weight “accounts” for these variations.)

One more note: Since you are somewhat concerned about obtaining future scripts…If you inadvertantly shave too much, just save that pill for future reductions. If the pill “crumbles” during the shaving process…save these “crumbled” fragments. I have often made a dose from previous 2 or 3 pieces of  “crumbled” fragments.

If you are interested, your new dose in mg is 0.487 mg per dose or a ~2.6% reduction overall.

I hope this is clear! Please let me know if you have questions.

 

[[Li...]]

48 minutes ago, [[E...] said:

OK, here is how you would calculate your first reduction with your script containing 0.5 mg pills (10 pills weigh 0.606 grams).

Given that 10 pills weigh 0.606 grams, then 1 pill will have an average weight of 0.0606 grams. (0.606 ÷ 10 = 0.0606 grams)

Each dose must be reduced by 2.5%: 0.975 × 0.0606 = 0.059085 grams.

For purposes of your scale, you will need to round to 0.059 grams per dose.

So, for your first reduction, you will shave and weigh each dose to be 0.059 grams.

It is important to note the following. 1) If the pill originally weighs more than 0.0606 grams (for example, 0.062 grams or 0.063 grams), still shave the pill to 0.059 grams. 2) if the pill originally weighs less that 0.0606 grams (for example, 0.059 grams or 0.058 grams), do not shave the pill. Take the pill as is.         (*I know this may seem counterintuitive!  But pill manufacturers are allowed a small variation in amount of active ingredient as well as a variation in the amounts of fillers and binders. Using the average weight “accounts” for these variations.)

One more note: Since you are somewhat concerned about obtaining future scripts…If you inadvertantly shave too much, just save that pill for future reductions. If the pill “crumbles” during the shaving process…save these “crumbled” fragments. I have often made a dose from previous 2 or 3 pieces of  “crumbled” fragments.

If you are interested, your new dose in mg is 0.487 mg per dose or a ~2.6% reduction overall.

I hope this is clear! Please let me know if you have questions.

Thank you.  So I am saving everything I take off the pill? Even if it's particles? @[El...]

[[El...]]

@[Li...] I generally did not save the "dust" from shaving the pill.  But, you certainly can, if you feel it might be helpful down the road.

I found that occassionly the pills just broke into pieces while I was shaving them down to an appropriate weight. I would save those pieces that I could pick up with my tweezers.  Anything smaller, was just to difficult for me to handle with any accuracy.  But, just see how it goes.  You will soon get a sense of you what you can weigh and manipulate with accuracy.

Let me know how your first set of weighings proceeds.  (Make sure you calibrate your scale!)

[[Li...]]

18 minutes ago, [[E...] said:

@[Li...] I generally did not save the "dust" from shaving the pill.  But, you certainly can, if you feel it might be helpful down the road.

I found that occassionly the pills just broke into pieces while I was shaving them down to an appropriate weight. I would save those pieces that I could pick up with my tweezers.  Anything smaller, was just to difficult for me to handle with any accuracy.  But, just see how it goes.  You will soon get a sense of you what you can weigh and manipulate with accuracy.

Let me know how your first set of weighings proceeds.  (Make sure you calibrate your scale!)

@[El...] Sorry Ellie, one other question.  I'm taking 2.5. Off each 0.5. Dose? Not just 1.5. Sorry My Boyfriend will help with the math this week. I'm just making sure I'm shaving each dose at 2.5.  

[[El...]]

@[Li...] Please never apologize!  Questions are good thing!

Yes, that is correct.  You are reducing each 0.5 mg pill by 2.5%.  Each pill should weigh 0.059 grams.

[[Li...]]

5 minutes ago, [[E...] said:

@[Li...] Please never apologize!  Questions are good thing!

Yes, that is correct.  You are reducing each 0.5 mg pill by 2.5%.  Each pill should weigh 0.059 grams.

Thank you.  I will keep you posted this week.  How long do I hold, 10 days? And of course I know symptoms come in to play as well @[El...]

[[El...]]

@[Li...] It is certainly prudent to plan a week or 10 days to stabilize after this reduction.  But, as you say, you need to let your symptoms guide you.  That might mean after a week that you feel well enough and able enough to make another reduction.  But it also might mean that after 10 days, you find yourself not well enough or able enough to make another reduction.  Then you would need to hold your dose longer and consider whether you should make a smaller reduction once stabilized.  

Are you keeping a record of your symptoms?  As you go along in your taper, looking at your past responses to reductions is often helpful.

[[Li...]]

3 minutes ago, [[E...] said:

@[Li...] It is certainly prudent to plan a week or 10 days to stabilize after this reduction.  But, as you say, you need to let your symptoms guide you.  That might mean after a week that you feel well enough and able enough to make another reduction.  But it also might mean that after 10 days, you find yourself not well enough or able enough to make another reduction.  Then you would need to hold your dose longer and consider whether you should make a smaller reduction once stabilized.  

Are you keeping a record of your symptoms?  As you go along in your taper, looking at your past responses to reductions is often helpful.

Yes, I have. I write stuff down everyday.  I'll also be starting one for when I begin the Taper. I'll be finishing off the old script and I'll begin the Taper I believe Wednesday or Thursday @[El...]

[[Li...]]

@[El...] I forgot to ask. I'm not cutting the pills right now with a pill cutter correct? Im just using the file scrapping little pieces to start? 

[[Li...]]

53 minutes ago, [[L...] said:

@[El...] I forgot to ask. I'm not cutting the pills right now with a pill cutter correct? Im just using the file scrapping little pieces to start? 

@[El...] I  also was wondering what do I do if I don't get the exact precise cut. Shaving too much off by accident or to little. I don't know if it will be perfect 

[[El...]]

@[Li...] Good morning!

For your first reduction, you will not be cutting your pills.  So that is correct.  You will just shave off a very small amount of a whole pill.

It is very difficult to be exactly precise.  If you shave too much, just save that pill for a later date (further along in your taper).  You can only do as best you can do!  Please try not to stress about it!  But here are some tips that might improve your accuracy:

1. Place your scale away from drafts (heating or cooling vents, fans, open widows).

2. Place your scale away from sources of vibration (kitchen appliances, areas of heavy foot traffic, rickety table tops).

3.  Make sure your scale is level (you can use a carpenter's to check).

4.  Keep your scale away from electronic devices (computer, cell phone).

5.  Calibrate your scale before each weighing session.

6. Use the provided weigh boat so you do not contaminate the scale's weighing surface with pill "dust and fragments".

7. After calibrating, place 2 quarters on the scale's weighing surface.  Place your weigh boat on top of the 2 quarters.  Press "tare". Then proceed with weighing your pill.  This may give you a more accurate weight.

8.  Let your scale warm up for 20-30 minutes before use.

9.  Once you have your pill on the scale, allow the scale to "settle". This might take 20-30 seconds.

10. Change the batteries at regular intervals.

But, most of all, just try not to stress about this!  You can only do the best you can do.  So, weigh your pills, store them away...and then walk away.

 

[[Li...]]

24 minutes ago, [[E...] said:

@[Li...] Good morning!

For your first reduction, you will not be cutting your pills.  So that is correct.  You will just shave off a very small amount of a whole pill.

It is very difficult to be exactly precise.  If you shave too much, just save that pill for a later date (further along in your taper).  You can only do as best you can do!  Please try not to stress about it!  But here are some tips that might improve your accuracy:

1. Place your scale away from drafts (heating or cooling vents, fans, open widows).

2. Place your scale away from sources of vibration (kitchen appliances, areas of heavy foot traffic, rickety table tops).

3.  Make sure your scale is level (you can use a carpenter's to check).

4.  Keep your scale away from electronic devices (computer, cell phone).

5.  Calibrate your scale before each weighing session.

6. Use the provided weigh boat so you do not contaminate the scale's weighing surface with pill "dust and fragments".

7. After calibrating, place 2 quarters on the scale's weighing surface.  Place your weigh boat on top of the 2 quarters.  Press "tare". Then proceed with weighing your pill.  This may give you a more accurate weight.

8.  Let your scale warm up for 20-30 minutes before use.

9.  Once you have your pill on the scale, allow the scale to "settle". This might take 20-30 seconds.

10. Change the batteries at regular intervals.

But, most of all, just try not to stress about this!  You can only do the best you can do.  So, weigh your pills, store them away...and then walk away.

@[El...]. Thank you, Ellie, for everything. I will keep you posted. Any  tips on how to handle my ocd/ ruminations and about this process in general? I have definitely gotten better, but the scariest part is the fear and obsession about Benzos and the taper.  This symptom won't leave and lingers 24/7.  I believe it's causing major fatigue and more anxiety. 

[[El...]]

@[Li...] Your fear and obsession with this taper is perfectly normal.  It is normal to feel some fear given the difficulties you experienced reaching stability.  It is normal to obsess over something that is "unknown".  Once you begin, and proceed at a pace that is comfortable and "not alarming", much of this fear will dissipate.  It is just like all the other challenges you faced on your path to stability.  You were anxious when faced with certain obstacles, but you overcame it, and now you are ready to taper.  This is the same type of challenge.

You have come such a long way.  It will get easier. 

[[vo...]]

On 26/08/2024 at 19:22, [[L...] said:

@[Pa...] Did you have stomach cramps or feel like you had a uti as a symptom? 

Hi @[Li...]. I just did a search for uti and saw your post.  This is exactly what it feels like. Did you go to the doctor to be sure you didn't have a uti infection or did this symptom go away for you?

[[Li...]]

Anyone else's mood change constinately. I have a lot of anger then depression,  it's a shift all the time? Sometimes numb. 

[[Li...]]

1 hour ago, [[v...] said:

Hi @[Li...]. I just did a search for uti and saw your post.  This is exactly what it feels like. Did you go to the doctor to be sure you didn't have a uti infection or did this symptom go away for you?

They go away. Sometimes they come back at Night.