Contents

   History

   Observations

1965 - In addition to working I was active as a canvasser in a local political campaign.  One night I felt a "slip" in the thigh muscle of my right leg.  I stopped campaigning for the duration.  For about two weeks after the "slip" in the muscle, the muscle had the "muscle buzzing sensation" feeling.  I was very tired during these two weeks.

I continued to work, but I did terrible work.  My concentration and attention to detail were severely hampered.  I was doing bookkeeping.  My boss had to redo the work I did during those two weeks.  The fatigue and "muscle buzzing sensation" ended after about two weeks.  During this two week period I was not aware of the poor quality of the work I was doing.  I became acutely aware of it when I watched my boss redo my work.

My purpose in providing this historical information is to show that the mental illness/fatigue issue was apparent long before I collapsed at the end of 1969.

12/68 - I experienced crunching chest pains.  The episode lasted a few moments.  I ignored it.  I thought I was too young to have a heart attack.  (Need an expert in denial? See me later.)

11/69 - I again experienced crunching chest pains.  They lasted a few moments.  I went to see my internist.  He asked if I could clime 3 flights of stairs.  I lived up 2 flights and thought I could climb 3 flights.  He told me to quit my job.  I could not.  (Don't ask, I don't know why).  Within a month I realized the job was over.  I began to take my personal belongings home.  A few weeks later I was let go.  It was just in time.  By then I was taking aspirin regularly for physical pain.  The pain and fatigue I experienced were serious.  I also had trouble with constipation and indigestion.

When I left my employment at the end of 1969, I was given the option of taking my health insurance with me.  I declined.  This was not a financial issue.  I didn't think I needed it.  This was denial and unloading stress.  I had all I could do to feed myself.

1/70 - Physical collapse and onset of obvious muscle and mental fatigue. The "muscle buzzing sensation" in muscles all over my body began at this time.  Occasionally I had instances of red lines on my body from bathing.  I do not recall any increased fatigue from bathing at this time.  I was unable to effectively deal with these health issues.

A few days after leaving the job I began to relax.  The "muscle buzzing sensation" in my muscles began and I started to feel the pain I had been suppressing.  When I bathed, I had a large black and blue blotches on the front inside of each of my thighs.  They were ovular in shape.  They ran from the inside of my thigh, about mid way between groin and knee, to the top of the thigh higher up.  These went away after about 2 months.

About the time the black and blue blotches went away the fatigue became less, and the level of pain diminished.  Neither the fatigue nor the pain went completely away.  The "muscle buzzing sensation" feeling in my muscles continued.  I was able to walk a mile or two a day.  I never measured it.  I could climb the two flights of stairs from the street to my apartment.  I did this daily.  I could not sit up for more than about 3-4 hours at a time without becoming seriously tired.  This was evidenced by increased muscular pain, lessening of mental acuity.  My basic energy level has been much higher and much lower during intervening years.

1975 - I saw an internist who gave me a diagnosis of Neuromuscular Asthenia. He recommended a psychiatrist and gave me a name.  I didn't think I needed a psychiatrist.  I had been in psychoanalysis for 3 1/2 years in the early 1960's.

1975 - Went on SSDI.

1975 - About six months after I received the diagnosis of Neuromuscular Asthenia, I went to see the referred psychiatrist.  About a month later I experienced a complete collapse.  I was not strong enough to handle the stairs of the front stoop to my building.

I called the psychiatrist.  He prescribed Parnate.  I gradually increased the dosage to 60 mg/day over a period of 2 1/2 years.  I was house bound for this time.  During this period I was living in a private room in a hotel.  It supplied housing and food services and regular contact with other people.

It took me about 2 1/2 years to get the Parnate dosage up to 60 mg., but at this level, exercise made me stronger.  I was able to increase my strength with walking exercise to the point that I was walking six or seven miles a day.  I could climb a steep hill without overtiring myself.  I still experienced the "muscle buzzing sensation."  I experienced distressing side effects from the medication.  I was very spacey and had little cognitive ability.

After my noon time dosage of Parnate, I usually needed to take a nap.  I still cold not sit up for more than 3 or 4 hours at a time without becoming overtired.  This would make going back to any sort of work difficult.

1982 - Dropped from SSDI.

1983 - I changed psychiatrists.  I was with this doctor until June 1998.

1983 - Changed meds from Parnate to Desyrel.  Began Interpersonal Psychotherapy.

I returned to full time work.  I worked graveyard shift as a security guard.  I was able to lay down during the middle of the night.  There were a handful of people working in the building and there were a few deliveries during these hours.  It was lonely enough work that everyone was glad to see each other.  I kept this job until 1988.

1989 - The Desyrel was loosing it's affect on me.  My psychiatrist wanted me to switch from Desyrel to Prozac.  I have a lot of physical distress and increased fatigue during the time it takes to adjust to a new level of antidepressants I had taken.  The Psychiatrist wanted to do it as quickly as possible.  I went into the hospital as a voluntary psychiatric inpatient.  I was an inpatient for 5 weeks.  I went from taking 450 mg/day of Desyrel to 20 mg/day of Prozac.  During the next six months I increased the Prozac dosage to 80 mg/day.  I was a day care patient for about 5 months after I was an inpatient.

1996 - Prozac was loosing it's affect on me.  I Began switching from a cocktail of Prozac, Serzone, Lithonate, BuSpar to Wellbutrin.>/p>

01/01/98 -  I was taking 400 mg/day of Wellbutrin and searching for something to add to it that would give me more boost.   Sometimes my fingers and hands and sometimes my arms were unsteady.  It was particularly noticeable with light precise activity like using a computer mouse.  Sometimes I was unsteady on my feet.  Not faint, just a little unsteady.  The frequency of this decreased with the increase of Serzone.  These symptoms were replaced by cognitive difficulty and some sexual dysfunction as I increased the Serzone from 100 mg per day to 600 mg per day during 1998.  My erection was not as stiff in October 1998 as it was in January 1998.

I've tried a number of different medications in conjunction with Wellbutrin. Serzone, Zoloft, Paxil, Effexor, Remeron, and Cylert.

In 2012 I was diagnosed with Fibromyalgia. I am on a cocktail of meds which includes 90 mg of Cymbalta per day.

In addition to the "muscle buzzing sensation."  When I am recovering from being over tired, I experience instances of twitching muscles.  I've observed them in the muscle on the outside of my shoulder (deltoid).  I've observed them on the inside of my left thigh just above the knee.  I seldom actually see them.  In fact I had to specifically look for them to observe them.  This does not happen very often.  I expect it happens many more times than I've observed.  It happens in places I can not see - i.e., my back, or it happens when I'm covered by clothing or bedding.

I also experience single muscular spasm events.  I have not observed them, but I do feel them.  The spasm usually happens at the end of a period of recovery from two much activity.  The spasm (correct word?) feels like the muscle suddenly relaxes.  The feeling is not one of pain.  It is a sudden feeling of relief when the spasm stops.

A different sort of spasm occurs if I push myself to the point that the "muscle buzzing sensation"  temporarily stops.  When recovering from this degree of over exertion, I experience singular instance spasms.  They are not rhythmically regular, they are frequent in terms of minutes.  It sometimes feels like a twang.

My vision is affected to a noticeable degree by some antidepressant medications.  My eye glasses prescription is more or less accurate depending on the medication and the amount of medication.  I didn't have this difficulty with the Serzone (1998).  I don't think it was an issue with the Wellbutrin.  I had to delay getting new glasses while I changed meds from Prozac to Wellbutrin because of the constant change in my vision.  Every change in the Prozac dosage resulted in changes in the near/far sighted balance.

I increased the dosage of Wellbutrin at the same time I reduced the dosage of Prozac.  My reason for pinning the eye glasses prescription change on the Prozac is that I remember it affected me when I originally started the Prozac.  As I gradually raised the dosage of Prozac in discrete increases, my vision was increasingly affected.

Sleeping.  For about five years I took Desyrel before I went to bed.  It put me quickly to sleep.  A very useful side affect at the time.  I was working graveyard shift and had to sleep during the day.

Prozac did not effect the length of my sleeping hours.  It made keeping sleep hours consistent very difficult.  It moved my circadian rhythm to 26-27 hours per day.  I know this is the normal range but normally your life style holds you to a 24 hour day anyway.

With the Prozac I had serious difficulty trying to keep a 24 hour day, even when I was working.  The addition of BuSpar didn't affect this one way or the other.  I don't think the addition of Lithium affected this either.  I don't remember how the Wellbutrin affected the length of my day.  Without difficulty, I can keep a normal 24 hour day with my current combination of medications.

Both Desyrel and Prozac declined in efficacy over a period of years.  I am concerned that this will occur with Wellbutrin.  I've been on and off four or five antidepressant supplements to the Wellbutrin/Cylert combination.  I really don't know if it is happening or not.

During a consultation with one psychiatrist in 1996, I asked if the lessening efficacy of the meds over time was because of increased illness or the body adjusting to the meds.  He said "we don't know."

Fatigue symptoms from activity have been responsive to antidepressants.  The best experiences I have had with antidepressants in terms of only antidepressant effect was when I was on 60 mg/day of Parnate and on 60 mg/day of Celexa.  At high levels of these drugs walking exercise made me stronger.  I went from being house bound to regularly walking about five to seven miles a day and often climbing a steep hill.  It took me the better part of a year to gain this strength on the Parnate; about six months on the Celexa, but I was starting from a higher level of activity when I started Celexa.

At this levels of these drugs I was also very spacey.  It was valuable level for me, but it was not a level of meds I could sustain indefinitely.  The other meds made me stable for a number of years, but I have not again been able to increase my strength by exercising (2013).

"Muscle buzzing sensation."  A psychiatrist whom I consulted 1996 asked if it "...feels like a small motor is running in the muscles."  This is a good description.  He said it can be a symptom of anxiety, but he had never seen it on this scale.  Neither BuSpar nor Librium has had a noticeable affect on it, although they have made me feel better.

Degree of muscular discomfort.  The muscular discomfort I experience is usually less than "ache" in my legs, arms, back, shoulders, chest, others areas.  Aching shows up if I am over tired first in my thighs and calves.  Sleep is sufficient to make the ache go away.

Current strength. I can walk about 1 mile per day.  If I exceed this the "muscle buzzing sensation" intensifies for a period that can last from hours to days depending on the amount of excess.  Then the "muscle buzzing sensation" stops for a period that is equal to the period of intensity.  I can count on this and plan around it. Both mental and physical fatigue are more pronounced during these periods.

Over doing it. If I over exercise, my body temperature goes low.  My respiration rate increases enough to be noticable.  I do not feel so cold as to cause shivering.  I am cold enough to be uncomfortable.  Normal blanket covering is not enough.  I require an extra blanket at these times.  The period ends with a swift change in temperature to being overheated for an hour or two and then back to normal.  One minute I am under an extra blanket.  The next minute I am tossing it off.  My slightly elevated respiration rate returns to normal and I experience a reduction in muscular discomfort and mental sluggishness.

Generally Speaking. My ability to concentrate is limited.  I tire easily.  I can do entertainment with my computer or office type work.  I built this web site.  I have not been able to do any serious programming or serious studying for many years.  In the early 1970's after I collapsed I was able to learn and play duplicate bridge at an intermediate level.  I was never able to count cards well enough to rise to the expert level.  My concentration has not been that good since.

My short term memory is very poor.  I just do not have the strength to pursue intellectual threads.  I must write everything down or in a few minutes it will probably be gone.  If I copy a paragraph in one section of a document that needs to be relocated, I frequently forget what the content was and where it should be placed.  If a wait for a minute or two, it comes back to me.

It "hurts" mentally to concentrate on work.  It doesn't hurt like a headache.  It is more a feeling of hurt than a physical sensation.  It is very difficult to get started on a project that is just "work".  For example the project to update these medical records.  Once started I can continue at it for a period of hours and from day to day.

Currently, April 2013, I can consentrate if I work hard at it but my memory is still bad.

Sense of Humor. Generally speaking, I would rather be in Philadelphia. :-)