61 lines
5.3 KiB
Markdown
61 lines
5.3 KiB
Markdown
---
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date: 2025-12-02
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created: 2025-12-02
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category:
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- "[[Daily Notes]]"
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---
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# today's activity
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![[Daily note today.base]]
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# to-dos
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- [x] Print reading for funeral [[2025-12-01 0953 Grandad's funeral message]]
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- [x] Check suit for funeral
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- [x] put reading in suit pocket
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- [x] cut hair
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- [ ] finish assignment
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- [ ] fish tank water change
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- [x] pickup Erin on way to get kids
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# future to-dos
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- [x] buy another andis clipper comb
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- [x] https://funeral-notices.co.uk/notice/beswick/5275905
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# [[daily-reflection]]
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## on [[ADHD Treatment]]
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### a brief summary of my titration so far
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A couple of weeks ago I switched from [[Methylphenidate]] (54mg Concerta XL) to [[lisdexamfetamine]] 30mg, and with it, I've seen a return in my [[me ADHD Symptoms]].
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I'd forgotten what it was like to honest. I'd been titrated on Medikinet XL (methylphenidate), from 10mg up to 40mg, and whilst the come up and crashes where very noticeable, there were other changes in me that were slow and subtle, it's only when I reflect do I see them. My motivation and ability to actually get things done, that I planned to do, being chief among them.
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But it was the early afternoon crashes that were too much. So my prescriber, [[Claire Budding]] moved me over to 54mg Concerta XL. Which, while didn't hit as hard in the morning, I felt it wasn't too bad at first, and my racing heart rate had almost disappeared. But I missed that quick hit in the morning that gave that get up and go, some mornings I felt as though it hadn't done anything, I felt the old 'irritable morning me' return a couple of times--that person who just wanted to scroll on my phone rather than engage with anyone. I noticed in other areas there was a regression as well. I was back to losing my phone around the house multiple times of day again, making tea in a travel mug only to leave it a home, and struggling to work on my course assignment.
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I discussed this with my psychiatrist, [[Dr Marie Cawley NSCHT Psychiatrist]], at my last medication review ([[Attachment.pdf20251202212742.pdf|summary here]]. She suggested two options for medication:
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1. Continue with 40mg Medikinet in the morning, add 10mg methylphenidate IR in the afternoon
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2. Switch to 30mg Elvanse (lisdexamfetamine)
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I elected to try the lisdexamfetamine, as I wanted to see the difference between the two different drugs, and if it didn't work out I could always switch back. And so I switched over to lisdexamfetamine and I would start the titration process again. When I queried what the increases would be at each review, Marie said that because I'd tolerated methylphenidate well she would increase by 20mg each time (usually 10mg) to speed up the process.
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I've been on Elvanse 30mg for 2-3 weeks now. At first I didn't think it was much different to Concerta XL, other than the much smoother release profile. But it's in the subtle everyday things that I noticed it lacking. I find myself getting distracted and consumed by things that aren't important, wasting time on things that catch my attention and become a hyperfocus for the day.
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I think I'm beginning to see how [[me ADHD]] effects me, and with that I think I'm beginning to tell the difference between side effect and therapeutic effect, That bump in my mood was a side effect, that ability to not waste the day engrossed in some small detail at the expense moving on, was the therapeutic effect.
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[[Erin Mary Hodgetts|Erin]] has previously said that she can really see the medications effect in that I'm 'present', but since moving off Medikinet I've regressed. I can't say that I noticed any difference in myself at first, but as time has gone on I've seen it more and more.
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I've really noticed it these past few days, where I've felt myself slipping even further into a funk. I missed an assignment deadline last Thursday and I'm struggling to fight that pressure to just waste the day letting my mind do what it wants to do. I can feel myself withdrawing into my thoughts, I'm distracted by them, I'm feeling the pressure from them increasing. I'm catching myself disappearing into my own thoughts more and more recently.
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### and onto today
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So this morning I decided to take a does and a half (45mg). It took a while, but I felt it was much better, I felt a return of my attention to the here and now. Effect wise, I'd say it's on a par with 54mg Concerta, so maybe not quite enough, but I get a much better idea when I get to try 50mg on a regular basis. That is if the new prescriber ([[laura adhd prescriber]]) lets me jump up 20mg like the Marie said, following my medication review in a week's time.
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## and other things today
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[[Jessica Louise Hodgetts|Jess]] and [[Isabella Jaime Hodgetts|Bella]] had a [[Werrington Primary School|school]] trip to the theatre today. I think they were very excited given the noise levels at breakfast time.
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[[Erin Mary Hodgetts|Erin]] helped on the school trip, she then stayed at school afterwards to sort out the aftermath from the [[Friends of Werrington 2025 Christmas Fair|school Christmas Fair]]. I picked her up from school before going down to my [[9 Shugborough Close|mum and dad's]] to collect the girls.
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It's my [[David Robert Beswick|Grandad's]] [[2025-12-01 0953 Grandad's funeral message|funeral]] tomorrow. My [[Margret Dianne Hodgetts|mum]], and especially my [[Robert Mark Hodgetts|dad]], seemed quieter than normal. Dad didn't say much at all, he was biting his nails at times.
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