A (lucky?) walk-in
My mum tried to follow the psychogeriatric's advice. She managed to successful stop taking benzhoxol but still couldn't go without clonazepam. The dizziness worsened and so, upon Dr N's advice (she kindly responded to my text), we decided to consult GH's psychiatrist as a walk-in patient.
Turned out that there was no clinic day that morning and so my mum was attended quite quickly by the stand-by psychiatrist. We were a little worried that she would be asked to go through the outpatient clinic first because there was a sign stating the procedure for walk-in patient but the doctor, later on while we were parting ways, assured my mum that she could go straight to the clinic.
We briefed the doctor on the situation and also told her of the psychogeriatric's plan. After consulting a senior specialist, she suggested the following:
(1) Cut off the day time olanzapine for 2 to 3 days and observe whether mum's still ok. Incidentally, previously mum tried (without consulting anyone!) cutting the night time dose from 10mg to 5mg for 2 nights and apparently it did ease the dizziness a little.
(2) If ok, then cut clonazepam to 0.125mg (quarter tablet) once every 4th night. The first try is probably going to be a little stressful as the body is trying to adjust without the usual dosage (it's a sleeping tablet after all). It doesn't help that currently she napped a lot because of the dizziness and so that would make it difficult for her to fall asleep at night. If really cannot take it, then take the missing dose.
(3) If ok for 2 to 3 rounds, then repeat the cycle with quicker cut i.e. once every 3rd night for 2 to 3 rounds, alternate night for 2 to 3 rounds, every night etc.
Mum was given a much earlier appointment (about 2 months earlier) so that they can assess the effect of these changes.
In the meantime, the doctor advised mum to get her eyesight checked after she knew that it hadn't been checked in years. Much later, the optometrist confirmed some changes (relative to the spectacles she was wearing). Most seem minor to me (short-sightedness, astigmatism, axis line) but the significant increase was her long-sightedness.
Oh, also, upon query, the psychiatrist explained that the referral to ENT specialist was to rule out vertigo.
Let's hope mum can wean herself from clonazepam and that these changes to the medication, as well as the new pair of glasses, would at least ease the dizziness significantly.
Turned out that there was no clinic day that morning and so my mum was attended quite quickly by the stand-by psychiatrist. We were a little worried that she would be asked to go through the outpatient clinic first because there was a sign stating the procedure for walk-in patient but the doctor, later on while we were parting ways, assured my mum that she could go straight to the clinic.
We briefed the doctor on the situation and also told her of the psychogeriatric's plan. After consulting a senior specialist, she suggested the following:
(1) Cut off the day time olanzapine for 2 to 3 days and observe whether mum's still ok. Incidentally, previously mum tried (without consulting anyone!) cutting the night time dose from 10mg to 5mg for 2 nights and apparently it did ease the dizziness a little.
(2) If ok, then cut clonazepam to 0.125mg (quarter tablet) once every 4th night. The first try is probably going to be a little stressful as the body is trying to adjust without the usual dosage (it's a sleeping tablet after all). It doesn't help that currently she napped a lot because of the dizziness and so that would make it difficult for her to fall asleep at night. If really cannot take it, then take the missing dose.
(3) If ok for 2 to 3 rounds, then repeat the cycle with quicker cut i.e. once every 3rd night for 2 to 3 rounds, alternate night for 2 to 3 rounds, every night etc.
Mum was given a much earlier appointment (about 2 months earlier) so that they can assess the effect of these changes.
In the meantime, the doctor advised mum to get her eyesight checked after she knew that it hadn't been checked in years. Much later, the optometrist confirmed some changes (relative to the spectacles she was wearing). Most seem minor to me (short-sightedness, astigmatism, axis line) but the significant increase was her long-sightedness.
Oh, also, upon query, the psychiatrist explained that the referral to ENT specialist was to rule out vertigo.
Let's hope mum can wean herself from clonazepam and that these changes to the medication, as well as the new pair of glasses, would at least ease the dizziness significantly.
Comments
Unfortunately not :(