What is good daily med that only treats anxiety and depression?

Hi Mr. Macabre,

I am so sorry for what you are going through. You wrote:

"He knows how much pain I'm in though on a daily basis..."

Now I'm not a Dr, but my knee surgeon said that once I reached the point you're at, it's time to do the replacement. I'd find another surgeon. I look for surgeons in their mid 30s to late 40s, with a good med school/residency/fellowship pedigree, great references, and with thousands of surgeries under their belt. These surgeons are young, talented, and ambitious at this point in their careers.

As for losing 30 lbs, that should be a suggestion, not something that needs to be done ahead of surgery imo. Rehab doesn't include any impact activities, in fact you won't be able to do impact activities with new knees. I understand you're a big guy, but big guys get bad knees too and should not have to live with pain.

I would not give up Mr. Macabre. Look for a new surgeon. And if you are bone-on-bone in your knees, that is, there is no cartilage left, you should get approved by insurance.

Again I am so sorry for what you are going through. It certainly sounds to me like you need replacements. Find a new doc and get approved for the replacements.

All the best to you sir. And please let me know if you find someone who can do the surgery. And I'd fight insurance as well. Bone-on-bone with arthritis is a condition that can only be relieved long-term by a TKR, as far as I know. And it sounds like the same is true for your hip(s). I had horrible pain in my groin from my arthritic hip and only a replacement fixed it.

(Also, your history of arthroscopic procedures should tell a surgeon and insurance that it's time for a total replacement, knees and hips. I had both knees scoped twice each before my TKRs. Enough.)

Joe

Thank you for your response, I really appreciate it. I've had a total of 5 surgeries on both knees, once on the right back in 2011, and 4 in total on the left. My GP knows my medical history better than any one else, and I know he sympathizes for me and thinks I need the procedures. My current orthopedist was my doctor from 2016 to early 2018. I've gone back to see him after the surgeon who did the partial retired, so he's my "new" old doctor. He did the last scope on my left knee, and removed half a dozen bone chips from my right elbow for me.
After the last arthroscopic procedure on my knee, I had to go back to see him to have my knee drained of excess fluid every 4 or 5 weeks until he basically gave up and referred me to the doctor who did the partial. No one in his office could figure out where all the fluid was coming from, and why it built up so fast. My left knee is full of excess fluid as well, but because of the partial appliance in there, they don't want to drain it for fear of an infection, so I'm in pain in that knee as well, again.
I guess I can try asking my GP for a referral to another orthopedist, it would be my 6th surgeon since 2010. I'll have to discuss it with my wife and see what she thinks, but the thought of those medical bills coming back is scary. We're having a hard time keeping our heads above water as it is, my SSDI benefit have given us a big decrease in our income. I've given some serious thought to just swearing off of medical specialists like orthopedists and neurosurgeons and just putting up with pain for the rest of my life. I'm not going to bankrupt my wife and myself, or my family with medical bills because I'm in pain, it's not fair to them.

I’m 78 and cannot take Paxil anymore. Im working with a great psychiatrist and we are doing a slow taper to Prozac. I am hoping Prozac will work. It’s Been 5 weeks and we are going very slow. I am journaling my progress. They tell me to be patient. Has any one switched from Paxil to Prozac successfully?
Mary Jean

Hi Mary Jean,

I have been taking Paxil since 2002 and it still works fine (40 mg/day). I tried a slow taper off of it a few years back, and once I got to 20 mg/day, I started feeling worse. I'm back on 40 mg/day.

I'm curious - why can't you take Paxil anymore?

Your psychiatrist is a great choice to guide you through this. If your Paxil dose gets very low, your psychiatrist can have a pharmacy titrate the drug into even smaller doses. You can check on that.

Depression is no fun, and I wish you the best in finding something that works for you.

Joe

Oh wow Mr. Macabre, I am so sorry for what you are going through.

Having your knees drained multiple times seems to indicate a chronic problem. It also sounds like you've got it in both knees. I had one knee drained before replacement.

I'd talk with your orthopedist about getting a recommendation to replace your knees, total replacements.

As for insurance, I don't know your situation other than what you describe. Your on Social Security. You would need to subscribe to part B and then have either a Medicare Advantage plan or Medicare Supplemental plan. Advantage is much less expensive and operates like an HMO. That's what I have and my surgery bills have been very low and I'm able to work with one of the top hospital systems in my state.

You could also see if you qualify for Medicaid.

Again, I'm sorry for what you're going through. I hope my suggestions help, and I hope you can find a better place.

All the best to you and your family.

Joe

I was having side affects , extremely exhausted and signs I was on too much for my age. They call it the ssri syndrome. My hands were shaking and I was having horrible tightening of muscles in my legs. I have felt for a long time that the drug was not working for me. With the help of a psychiatrist I am SLOWLY tapering to Prozac . I considered lowering the Paxil to 35 mg but my genetic testing showed Prozac was a good choice for me. it’s scary but I’m going to be patient. I’m now on 30 mg of Paxil and 10 mg Prozac. I have been dealing with some nausea in the withdrawal of Paxil and the addition of Prozac. I feel I’m on the right track. It’s been about 6 weeks and I believe 3 very small tapers. I am also on Clonazapam to help with the withdrawal symptoms when I have them. I would never consider going off Paxil without a plan for another drug to replace it. My son also tapered from Paxil to Prozac and is doing well.
It’s scary but I hope I can be patient enough to get through this. So far I’m encouraged by what I’m feeling. I do have a journey ahead of me. I’m hopeful!
GOODLUCK

Hi Mary Jean, and thanks for answering.

I also get leg cramps (hamstrings and calves) occasionally during the night. I had an MRI done and the cramps were due to tight lower back muscles (this put pressure on my sciatic nerve, causing the occasional and painful cramps). I'm much better now that I stretch my lower back.

And yeah, if you feel Paxil, or any drug, has stopped working for you, it's time for a change (and of course always under a Dr's supervision). And hey, if your son did it, you can do it! Good for both of you, and thanks again for sharing your story.

Joe

We have our medical insurance through my wife's employer of almost 30 years. She'll be 62 next month, so she still has a few years before she can retire. I was forced to walk away from my job in '15 and go on permanent disability. It's been a huge decrease in our income for going on 10 years, and it seems like we are falling further behind every year. Hence my thoughts on throwing in the towel and staying away from those "specialists".