19 replies to this topic

[pinballwizard]

I am seeing the neurologist Friday. He is expensive. So, what should I ask him? What should I tell him? How should I tell it? Do you want me to ask him something for you? Sorry for the long post, but it flows well. Throw me a bone here. Your post does not have to be long, but you got a couple days to tell me!

Here is what I want to tell him.

I have problems with memory (short and long), attention. And I have some minor problems with sleeping, stress and wakefulness.

I have been using a number of alternative drugs, and other items since I have been waiting for the appointment.

I would like to get a prescription of Aricept as a preventative measure to Alzheimer’s and for any other benefits. I would also like to discuss modafanil for getting up early in the morning, for wakefulness and for attention problems (ADD).

I also want to pursue neurological health by knowing more about me.

I would like to run the whole gambit of tests to eliminate any number of things. I am going to run some on my own actually. Cortisol, DHEA levels, AA/EPA ratio, allergies, mineral analysis, and possibly others. I am still researching it. However, remote, I would like to test it.

If you want to run an MRI or anything, I am more than willing to burn the cash as my budget is limitless.

(I heard his expertise is running tests to see what kind of problem I have.)



____________________________________________________________

Here are the questions I am answering from his questionnaire:

Age: 30
Height: 6'2"
Weight: 215

Handedness: Left

Q. What symptoms or problems are you having that prompted this consultation?
Memory, Attention. Minor problems: sleeping perhaps stress and energy levels and some wakefulness.

Q. When did your problems start:
Memory... when I was in early twenties, predominantly gotten worse. I think it is
Attention ... Apparently I had this problem with this problem all my life. ADD diagnosis for sure in the 7th grade. Treated with 25mgs 1x daily for a couple years. (That isn’t much)
Sleeping... I have always had problems with sleeping.
Stress…After getting out of college. But I was always a stress case in college.
Energy levels...
wakefulness...as a result of getting up at 4:00-5:00 AM.

Q. Are they staying the same, getting better, worsening or fluctuating?
Memory...for the most part getting worse, slowly. Nootropics has helped with long-term recall. Not much
Attention…for the most part getting better with nootropics/smart drug regimen
Sleeping…Same.
Stress…Same, it is worse when I am trading and better when I am working out.
Energy levels…Worse when I am not getting up at the same time everyday. Better when I workout as soon as wake up. My mental energy has gotten better with nootropics/smart drugs but it fluctuates.
wakefulness…Same.

Q. What has improved the symptoms?
Memory...Nootropics/Smart drugs. I have seen little significant that has helped short-term memory.
Attention span…Nootropics regimen
Sleeping…Getting away from the computer at night, 3 hours before I go to bed. Yoga. Cardiovascular exercise in the afternoon. Not eating late.
Stress…None yet, except the same things that help insomnia help stress to some degree.
Energy levels…routine, habits, schedules.
wakefulness…Coffee, nicotine, ginseng, typical energy drinks.

Q. What has made them worse?
Memory...cigarettes, alcohol, stress.
Attention…cigarettes, alcohol, stress.
Sleeping…cigarettes, stress.
Stress…cigarettes, and caffeine in the afternoon.
Energy levels…continued use of melotonin, Seasonal darkness.
wakefulness…continued use of melotonin, Seasonal darkness.

Q. What treatments have you tried so far?
(Doc, Please see my list of medications/drugs/alternative medicines for a more thorough ANSWER)
Memory...Piracetam, Aniracetam, Oxiracetam, Hydergine.
Attention…Piracetam, Aniracetam, Oxiracetam, nicotine gum
Sleeping…currently experimenting Kava Kava, Valerian but with little such luck
Stress…currently trying Phosphatidyl Serine, perhaps DHEA later.
Energy levels…deprenyl
wakefulness…deprenyl

Q. What diagnostic testing (such as X-rays or laboratory analysis) has been performed?
None.

Q. Is there any other information that you feel may help you?
Yes, I have waited for this appointment since mid-September, and since then, I have read several books on the brain, and health in general. Also, I have met a number of people online who are either people with similar problems, supplement manufactures, doctors, many of which have personally used the same stuff I have and have had good results after about 9 months. For the most part, they believe that these nootropics/smart drugs can be to some extent beneficial and perhaps very beneficial when combined and dosed properly for ones own neurochemistry. I have certainly read a lot and much of it has been actual abstracts, journals, and analysis that followed. I don't think I pose any risk, if I take the nootropics that have been used by Americans since the early 1990s or the -cetams that have been used by many Europeans a lot earlier than that.

Q. Do you have any current or previous medical conditions?
Rheumatoid Arthritis (which has gone totally inactive. Which means my body does not attack me. It only did for 6 months according to blood tests. Also, with exercise and glucosomine the pain is negligible. As a result I decided never to take pain killers and simply exercise and use glucosomine...It is simple more effective then a prescription.) FYI: I basically found that out on searching to solve my problem on my own. He offered me Vioxx. [thumb]

Q. What operations have you had in the past? (Followed by a whole list of conditions…I will spare you the details)
Ostiochondroma (a benign joint tumor) on my knee. It was removed by surgery in 1991. This is inconsequential, IMHO.

Q. Do your family members have any neurological conditions or other hereditary conditions. (followed by a whole list of conditions…I will spare you the details)
No

Q. Personal History
Single, no children

Q. What has been your main occupation or job?
Professional trader/Student, entrepreneur

Q. What is your current work status? (followed by a whole list…I will spare you the details)
I have not been working in the last 3 months. I have been waiting for my office to open and I took a vacation.

Q. Personal Habits?
Nicorette gum, but not cigarettes. about 6 cigarettes worth daily. If fluctuates between 0-10 Number of years smoked: 5 summed up. It helps me focus.

Q. Please list all medications including over-the-counter, alternative, herbal agents including the dosage, and how many times a day that you take them.
1. Deprenyl 1 mg AM every other day because I am 30 years old.
2. Piracetam 800-1600mg AM & 800mgs PM
3. Aniracetam 420 mg AM & PM
4. Oxiracetam 500 mg AM & PM
5. Phosphatidyl Serine 200-300 PM to counteract high cortisol in the evening.
6. Hydergine 4.5 mgs AM
7. Alpha Lipoic Acid in the form K+RALA 200 AM & PM as anti-oxidant
8. Picamilon 100 AM & 100 PM
9. Centrophenoxine 125 mg AM
10. Alpha-GPC 1500 AM 750PM
11. Pyritinol 200 mg AM & PM
12. Vinpocetine 10% 100 mg AM & PM
13. Creatine Monohydrate 1.5 teaspoons AM & PM (15 grams total) (The results are absolutely fantastic for weightlifting) I Cycle of for 2 weeks every couple months.
14. Fish oil 8-13 grams, where are EPA 216 mgs and DHA 144mgs respectively. That totals out to be 1.7-2.8 grams of EPA and DHA 1.1-1.8 DHA. (I am in a much better mood, happier and I don't eat as much garbage and I am losing weight, insulin is probably very stable.)

I also take a potent multi-vitamin and get the full RDA, drink protein shakes which sometimes consist of omega-3 and omega-6, and omega-9, green tea extract and wheat grass.

Occaisionally I will take Cognita brand pill that has over the counter neurological stuff in small amounts like:
Ginko 150mgs 1-3x daily, and choline and huperzine A 100mcgs, licorice root (100mgs) and other vitamins in small amounts

Do you have these current problems (to test for organ system problems)(Guys again, I will spare the details of the listed problems?
unintended weight gain (it goes up and down 20 lbs here and there)

_____________________________________________________________________





Additional Info outside the questionare

With regards to memory and Attention
Short attention span – All my life I have been plagued by a short attention span. It is better with the the regimen of alternative medicines I am taking.
Distractibility -- Also, I have found that it has to be quiet for me to work and I get easily distracted. It has gotten better with the regimen.
Multi-tasking – I am finding that it is harder and harder to do more than one thing at once or to remember more than one thing at once or to have a conversation while doing something. With the regimen it has gotten somewhat better.
Recalling long-term memories. I used to have encyclopedic knoweledg of many things. But I find myself forgetting these things. Eg. I did recognize my cousin the other day, but then called her by another name on accident even though I just had a conversation with other family members that I was forgetting names. This is better with the regimen, but it takes a long time.
Short-term memory—I have had situations where I could not find keys that I set down 30 seconds ago. This is still bad.
Semantic memory – I am not remembering the names of actors and actresses in Hollywood. This has gotten worse over the last couple years.
Episodic memory – It has always been bad.
Recent memories-- I having problems here, but I cannot think of an example. I often find it very slow to recall what I did yesterday. These are memories about things that have happened a few weeks or months ago. Recalling the name of your hotel on holiday after coming home is an example of a recent memory.
Prospective memory-- This memory has gotten a little worse. I find that I have forgotten doctor’s appointments. Memories that relate to doing things in the future, such as remembering to cancel the papers before going on holiday, or sending a card in time for a friend's birthday are called prospective memories.
Procedural memory --This refers to recalling the way to do a certain job or task. For example knowing how to ride a bike or tie a shoelace. No problems here, but my days seem more akward as I find myself having to concentrate on everything I do.

[pinballwizard]

My diagnosis, from the beginning and remains to be, that lack or sleep and too much stress contributed to my cognitive decline. Tests should be taken to make sure. Stress and sleep should be managed better somehow. Smart drugs should administered to heal the damage.

[nootropi]

First, you should DEFINATELY NOT tell your doctor what medications you are taking, especially the nootropics. That is just inviting disaster because in all likelyhood, the doctor will have absolutely no idea what these drugs are or why you are taking them. In all likelyhood, he will demand that either you stop taking these drugs immediately because he does not understand them at all.

Next, what is a neurologist? Do you mean a psychiatrist?

My advise to anybody who knows how to search medline and is able to understand the terminolgy used in medicine to form a basic understanding of the pharmacological solutions for your deficiencies. After you have determined what drugs have the effects that you seek, while eliminating anything from the list that may have have an adverse side effect profile; then seek a psychiatrist; and before you go into his (or her) office, express to this individual what medications you want based on your research; and be sure to bring in printouts of the studies that you are citing (of course: be sure to make them double blind, placebo controlled).

In all likelyhood you will have a greater understanding of these medications that he or she does; often psychiatrists are specialized to one or two sets of disorders; and I can pretty much guarantee that you will not find a doctor in the US who specializes in memory enhancement or antiaging unless you happen to get really really (and I mean really) lucky. So before you set foot into the respective doctor's office, speak with him or her on the phone and get at least a verbal agreement that he or she is willing to seriously consider writing you prescriptions for the medications that you want. Otherwise you are far more likely to walk out with a huge bill, a prescription(s) for a medicine that may or may not be effective; and is probably only being prescribed to you simply because it was heavily marketed to that M.D.

In regards to your other questions; it would be a better idea for us to speak on the phone; I should be available this evening. PM me with your phone number and a good time and I will probably be able to call you then; as I am out of school temporarily, so I have abundant free time.

[scottl]

How did you wind up with an apt with a neurologist? They deal with strokes or multiple sclerosis or nerve injuries. Cancel the apt.

More later.

[geigertube]

My diagnosis]too much stress[/u] contributed to my cognitive decline.  Tests should be taken to make sure.  Stress and sleep should be managed better somehow.  Smart drugs should administered to heal the damage.

This is just me, but I'd taper off/end the coffee and nicotine. Both interfere with your ability to sleep well, and contribute to stress. I drink very little coffee now and it has helped my stress and ability to concentrate a lot. They both helped short term, but it was a robbing Peter to pay Paul sort of thing, you know? If you are still on your vacation, this would be a great time to kick them, because you can more easily afford the drop in energy you are going to have until your body readjusts.

Steven

[Mind]

Caffeine can definitely wreck your sleep pattern. But....if you really need it....try switching to green tea, it is more healthy for you, and (by word of mouth) I have heard it does not give you "jitters" as much.

I also concur with others that a typical neurologist will have no clue....absolutely no clue what the effects of your stack (nootropes) are having on you. However, I am curious....if you do go, please let us know if your neurologist had any clue.

[pinballwizard]

Caffeine can definitely wreck your sleep pattern. But....if you really need it....try switching to green tea, it is more healthy for you, and (by word of mouth) I have heard it does not give you "jitters" as much.

I also concur with others that a typical neurologist will have no clue....absolutely no clue what the effects of your stack (nootropes) are having on you. However, I am curious....if you do go, please let us know if your neurologist had any clue.

____________________________________

I drink usually black tea with ginseng or a small half-caf mocha. Both are like 90mgs of caffeine. Green tea is like 20mgs. A medium starbucks mocha has 250 mgs of cafeine. So I am getting there.

I will let you know what my neurologist thinks. I am not expecting dancing, music, and lots of foreplay.

I think you might be surprised, however. Worst comes to worse, I can get what I want from my primary care physician or online doctor(?).

[pinballwizard]

How did you wind up with an apt with a neurologist?  They deal with strokes or multiple sclerosis or nerve injuries.  Cancel the apt.

More later.

My primary care physician and my rheumatologist both recommended the same guy when I repeated my problems with memory. He is the pre-eminent guy in the city. Apparently he is good diagonistics and testing. Yeah, I am not gonna be his typical patient. I am going anyway though.

~PW

[pinballwizard]

IN REGARDS TO NOOTROPI'S POST TO ME

First, you should DEFINATELY NOT tell your doctor what medications you are taking, especially the nootropics.
I am open to advice, but at this point I am telling him.

Next, what is a neurologist? Do you mean a psychiatrist?
No he is a neurologist. And they normally deal with head injuries, strokes and more serious stuff.

That is just inviting disaster because in all likelyhood... Yeah, but I want more opinions.

...because he does not understand them at all. I think he will understand all the items, he just won't understand why a young person is taking them. But I will let you know.

My advise to anybody who knows how to search medline and is able to understand the terminolgy used in medicine to form a basic understanding of the pharmacological solutions for your deficiencies. After you have determined what drugs have the effects that you seek, while eliminating anything from the list that may have have an adverse side effect profile; then seek a psychiatrist; and before you go into his (or her) office, express to this individual what medications you want based on your research; and be sure to bring in printouts of the studies that you are citing (of course: be sure to make them double blind, placebo controlled).


That is very sound good advice. Thank you. I promise I will be so armed with info, that I will put up a strong fight. And that I will search Psychaitrists and pose questions before seeing them.

In all likelyhood you will have a greater understanding of these medications that he or she does;
I doubt it. But I will let you know when I'm wrong or right. He just won't understand why I am taking them.

I can pretty much guarantee that you will not find a doctor in the US who specializes in memory enhancement or antiaging unless you happen to get really really (and I mean really) lucky.

I agree. I did some searches online for these types of doctors. Here is a list I came up with. http://www.ceri.com/referral.htm None of those doctors in my area got back to me. Some of the numbers were too old. But this neurologist did. The secretary said they deal with people like me with memory issues all the time.

So before you set foot into the respective doctor's office, speak with him or her on the phone and get at least a verbal agreement that he or she is willing to seriously consider writing you prescriptions for the medications that you want. Otherwise you are far more likely to walk out with a huge bill, a prescription(s) for a medicine that may or may not be effective; and is probably only being prescribed to you simply because it was heavily marketed to that M.D.

Sound advice, Nootropi

In regards to your other questions; it would be a better idea for us to speak on the phone; I should be available this evening. PM me with your phone number and a good time and I will probably be able to call you then; as I am out of school temporarily, so I have abundant free time.

Check your PM. I need journals to be armed. I will try the SF central library tomorrow.

Thanks again Pinballwizard,

PinballWizard

[scottl]

Please see PM.

[pinballwizard]

Here is where I am at:

1. My doctor is getting the dreaded phone call ultimatum. I am going to tell him my problems and symptoms briefly and that I want medications for them (Modafanil, Aricept, or for whatever is best). If he says under my circumstances he would he probably not write me up for Aricept or Modafanil, then I won't come in. My primary care provider had the pen out for Aricept. And then said, lets go to the Neurologist. They are in the same building. I might just walk up there and ask my primary care guy. I probably won't give him my nootropic list.

2. I am going to try to contact other doctors and professionals specializing in peak cognitive performance & health for normal individuals. Make appointments. If anyone has any contact info, let me know.

I will eventually see some good professionals. Perhaps psychiatrists first, but doctors who specialize in what I am looking for eventually.

This is good sound advice guys. It seems reasonable and scientific. Basically, see the right doctor for the job.

and is probably only being prescribed to you simply because it was heavily marketed to that M.D.

I don't necessarily agree with this. I think it more has to do with lawsuits than anything else. Then also you have the hippocratic oath and overworked doctors for common treatments and now I am going to throw a wrench into the system. Lastly, you have a lot of patients that find themselves wanting to put their head into the jaws of lion and doctors find themselves babysitting.

"All professions are conspiracies against the laity" --George Bernard-Shaw
But, I think medicine has the finest group of people out there.

[pinballwizard]

Modafinil works quite well in maintaining alertness over a long period of time, whether this is what you're looking for, I'm not sure. Aricept might have some moderate effects on concentration and memory, I don't know what makes it unique among AChEi drugs. Huperzine A should suffice, although nootropi was able to get a prescription for Aricept and I believe he favours it over Huperzine A.

I think nootropi also knows more about rolipram than I, but that may help in the formation of long term memories. I doubt it's available for prescription yet, but keep an eye out of it. Perhaps we can source it before it's even available through prescription.

Are there any other Memory or Attention enhancing prescription items out there that are excellent? Guys?

How could you get Rolipram before it is even out yet?

[pinballwizard]

I canceled today. The guy handles Multiple Sclerosis and elderly stuff.

Thanks guys for stearing me in the right direction.

Where am I going to go from here?
*do more research on my own.
*contact professionals in this higher performance of normal individuals (no disease).
*and get a regimen from them

[4jacques]

Modafinil works quite well in maintaining alertness over a long period of time, whether this is what you're looking for, I'm not sure. Aricept might have some moderate effects on concentration and memory, I don't know what makes it unique among AChEi drugs. Huperzine A should suffice, although nootropi was able to get a prescription for Aricept and I believe he favours it over Huperzine A.

I think nootropi also knows more about rolipram than I, but that may help in the formation of long term memories. I doubt it's available for prescription yet, but keep an eye out of it. Perhaps we can source it before it's even available through prescription.

Are there any other Memory or Attention enhancing prescription items out there that are excellent? Guys?

How could you get Rolipram before it is even out yet?

Good day.
Do you excercise pinballwizard and have enough sleep?

[pinballwizard]

"Good day.
Do you excercise pinballwizard and have enough sleep?"

Sleep no, exercise yes... For what it is worth, I dropped the modafanil and added 10 mgs of ritallin and 40 mgs of straterra. Straterra is mild compared to ritallin or modafanil, but it seems like modafanil is addictive and I found that I had problems speaking with it (interesting). I will take Modafanil for things like jet lag and emergencies at a half dose.

It probably is not common to take them both at the same time.

The ritallin that I am taking in is in the smallest dose possible, 10mgs. So far it seems very non-addictive and very very effective. I just need a small amount.

The negative effects of modafanil were seen after the second dose... I found that modafanil causes problems with speach and concentration days after use. It is not a clean drug for me. If you are trying it and getting a similar result, I recommend not keeping it up.

Ritalin seems so.

I think I am pretty much convinced my memory problems are due to cortisol which comes from responding to events stressfully. NOT SLEEP. I am going to send in my cortisol saliva samples on Monday.

I am starting a DHEA regimen now to combat cortisol levels. It is the cortisol that effects everything. I am a little worried that the DHEA pills are not time-released. I know that melotonin is better time released, so shouldn't the hormone DHEA be better time-released?

[ozone]

@pinballwizard
You're not taking Melatonin during the day are you? I sure hope not. Also you listed continued melatonin use as one of the effects for your problem. So... why are you still taking it?

[scottl]

Pinball...you saw the avant thread on cortisol and lean extreme by designer supplements right?