dd
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John221us
En-Route
Yes, call Dr. Chien. There is probably no benefit to posting on a public forum. Depending on the type of flying you are looking to do, your options may bay.
lbfjrmd
Line Up and Wait
Rx and taking of both of those meds invalidates your medical. You will need to seek a new medical. best route is to cease taking klonopin (not approved in any circumstance) ... continue lexapro is you think it helps.
Rushie
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Yes listen to these two doctors, lbfjrmd and Dr. Chien. They'll help you with the certification although if you continue the lexapro there will be hoops to jump.
Aside from that just a personal perspective. I went through some extremely stressful times (involving my kid getting cancer and some other stuff) and I too was put on a benzo (not klonopin but they are all very similar) and an SSRI antidepressant for a temporary hump. I guess they really did help me get through that but it's not like I have a control to compare. Maybe some wine would have done the same thing. But anyway ultimately I concluded that past six months they will end up doing more harm than good (for most people). I'm not talking about the unipolar depression SSRI treatment path folks I am talking about otherwise supposedly normal people who hit a very rough spot. They all mess with your neurotransmitters which with long term use will turn you from a normal person into something different.
So I agree with the doc above the minute you regain some kind of equilibrium, taper off that klonopin and don't look back. Personally I would do the same with the lexapro too but that's just me, I have a real dislike for SSRIs. They can have some nasty side effects that I really think people are not sufficiently warned about. But they are preferable to suicidally severe depression. I think they are kind of like ADHD drugs, over prescribed inappropriately but that's not to say it was inappropriate in your case, glad you saw a psychiatrist and not a GP for that.
But good luck with the medical, I would do nothing at all with the FAA or your regular AME without first consulting Dr. Bruce Chien. (Don't know if lbfjrmd also does difficult medicals too?)
Aside from that just a personal perspective. I went through some extremely stressful times (involving my kid getting cancer and some other stuff) and I too was put on a benzo (not klonopin but they are all very similar) and an SSRI antidepressant for a temporary hump. I guess they really did help me get through that but it's not like I have a control to compare. Maybe some wine would have done the same thing. But anyway ultimately I concluded that past six months they will end up doing more harm than good (for most people). I'm not talking about the unipolar depression SSRI treatment path folks I am talking about otherwise supposedly normal people who hit a very rough spot. They all mess with your neurotransmitters which with long term use will turn you from a normal person into something different.
So I agree with the doc above the minute you regain some kind of equilibrium, taper off that klonopin and don't look back. Personally I would do the same with the lexapro too but that's just me, I have a real dislike for SSRIs. They can have some nasty side effects that I really think people are not sufficiently warned about. But they are preferable to suicidally severe depression. I think they are kind of like ADHD drugs, over prescribed inappropriately but that's not to say it was inappropriate in your case, glad you saw a psychiatrist and not a GP for that.
But good luck with the medical, I would do nothing at all with the FAA or your regular AME without first consulting Dr. Bruce Chien. (Don't know if lbfjrmd also does difficult medicals too?)
BigBadLou
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But isn't that what BasicMed is for? To bypass the FAA's requirement for healthy pilots so that even those who can't pass the 3rd class medical exam can still be in the cockpit with nothing but a simple doctor signature?
Or did I misunderstand BasicMed?
Rushie
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This is a very good point. OP if you have not already done so you might want to review the BasicMed restrictions with respect to what type of flying you do and consider going that route.
BigBadLou
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That was meant as tongue-in-cheek but I'll take credit for the very good point.
Rushie
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That was meant as tongue-in-cheek but I'll take credit for the very good point.
I can be sarcasm challenged sometimes.
Yeah now that I re read what you wrote after coffee this morning instead of tired from a long flight yesterday, your subtle yet humorous subtext is clear.
BigBadLou
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Subtle? Subtle?!?I can be sarcasm challenged sometimes.
Yeah now that I re read what you wrote after coffee this morning instead of tired from a long flight yesterday, your subtle yet humorous subtext is clear.
Dang, I need to turn up the pressure.
tlglenn
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bbchien
Touchdown! Greaser!
So to give a reasonable answe we need to know:
How long were you on the meds?
Had you ever had an episode before?
Were you on klonopin regularly or spot
Did you have a psychiatrist evaluation(an expert)?
FAA really limits the authority of a family doc to short exposures In folks with but a single difficulty in their whole lives....
How long were you on the meds?
Had you ever had an episode before?
Were you on klonopin regularly or spot
Did you have a psychiatrist evaluation(an expert)?
FAA really limits the authority of a family doc to short exposures In folks with but a single difficulty in their whole lives....
Rushie
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Oh Wow!!!! I also was on prednisone a couple of times, once was very high doses for about a month, the stuff makes you psycho. Good grief. It sounds like you are perfectly normal but got tangled up with mind altering drugs due to your UC. Of course I'm not a psychiatrist and have not even recently stayed in a holiday inn express so I'm not claiming to know you but if it were ME in your shoes .... you only got these last Monday??
Okay in that case drop the Lexapro right now. It doesn't even really kick in until you've been on it several weeks. What's been helping you is the benzo (Klonopin) and it does an extremely good job eliminating anxiety. If you are suffering this severe anxiety after such a traumatic series of events you might indeed need to treat it but the trick is to get the maximum benefit of the benzo without becoming physically dependent or developing a tolerance and the way to do that is to not take it daily. Keep it to the lowest dose possible (try half what the doc told you, it might work!) and take it no more than two or three days consecutively, then take a day off of it. If you need it again cycle this a few times - a very few.
These types of drugs cause reactive anxiety very quickly which means your anxiety can become worse than it was before because your brain "recalibrates" to being on the drug. So what you really need to do is allow your brain to naturally heal from the trauma and the benefit of this drug is to give you a kick start - get your brain off the hamster wheel it's stuck on. Viewed this way they can be very useful which the FAA understands and is why they limit to short term use.
But you do not want to take it daily for 59 days then stop cold turkey. You could be thrown into withdrawal as that long could get you a bit "hooked". That would be the last thing you need!
My advice is to view this drug as only one item in an arsenal to treat your anxiety. You need to bring other tools into play. If you don't exercise take up something even just long walks. Look at your diet and make sure you aren't having blood sugar swings from too many carbs or allowing yourself to go too long without eating. Get plenty of "good" fats, they satiate and relax the mind.
Also remember that acute panic attacks are self limiting. It's their very nature to make you feel like it's an emergency and you must do something now (like reach for a pill) but in reality they will pass on thier own in a few minutes. I guess recognizing this would come under "cognitive behavioral therapy" so hopefully someone is giving you that too.
The idea is to kick you off the amplifying feedback loop that is the nature of worsening anxiety. Break the cycle. Use the Klonopin only to put a stick into the spinning wheel then quickly withdraw it and use these other tools like braking the rim with your hand as it starts to slow. Klonopin can tamp down the worst of it when nothing else helps but should not be viewed as a complete and single treatment. Time and distance and your improving (hopefully) life will see it recede.
There are some herbal supplements very good for anxiety but like any psychoactive substance use these with caution, however in general they are milder and safer and much less addictive than prescription drugs and they have the benefit of being a nonissue for the FAA. If you have trouble sleeping due to anxious thoughts especially on the days you aren't taking Klonopin try Valerian root. Be very generous with doseage (increase until effective). There are many others too much to go into here. Alternative medicine is a huge subject but if you are intelligent and selective and do your homework it can be extremely helpful.
What happened to you is the combination of several traumas and I've been there, that happened to me. A single trauma like a death or illness or job loss is one thing but when you suffer multiple major hits in quick succession it's like being body slammed again and again without sufficient time to recover in between. You can't regain your equilibrium before the next one happens. While mentally healthy people can absorb one shock reasonably well, when coincidence (in my case) or cascading results (like from your UC) bring several within a short span of time, even mentally healthy people can need up to several years before they start feeling like themselves again - and even then there will always be scars.
I can't answer your certification questions, just point you to these good doctors here; listen to them and they'll get you through it. I can just tell you that it looks from here you are having a "normal" reaction to very extreme circumstances. There is a new normal in your future and it will come.
Okay in that case drop the Lexapro right now. It doesn't even really kick in until you've been on it several weeks. What's been helping you is the benzo (Klonopin) and it does an extremely good job eliminating anxiety. If you are suffering this severe anxiety after such a traumatic series of events you might indeed need to treat it but the trick is to get the maximum benefit of the benzo without becoming physically dependent or developing a tolerance and the way to do that is to not take it daily. Keep it to the lowest dose possible (try half what the doc told you, it might work!) and take it no more than two or three days consecutively, then take a day off of it. If you need it again cycle this a few times - a very few.
These types of drugs cause reactive anxiety very quickly which means your anxiety can become worse than it was before because your brain "recalibrates" to being on the drug. So what you really need to do is allow your brain to naturally heal from the trauma and the benefit of this drug is to give you a kick start - get your brain off the hamster wheel it's stuck on. Viewed this way they can be very useful which the FAA understands and is why they limit to short term use.
But you do not want to take it daily for 59 days then stop cold turkey. You could be thrown into withdrawal as that long could get you a bit "hooked". That would be the last thing you need!
My advice is to view this drug as only one item in an arsenal to treat your anxiety. You need to bring other tools into play. If you don't exercise take up something even just long walks. Look at your diet and make sure you aren't having blood sugar swings from too many carbs or allowing yourself to go too long without eating. Get plenty of "good" fats, they satiate and relax the mind.
Also remember that acute panic attacks are self limiting. It's their very nature to make you feel like it's an emergency and you must do something now (like reach for a pill) but in reality they will pass on thier own in a few minutes. I guess recognizing this would come under "cognitive behavioral therapy" so hopefully someone is giving you that too.
The idea is to kick you off the amplifying feedback loop that is the nature of worsening anxiety. Break the cycle. Use the Klonopin only to put a stick into the spinning wheel then quickly withdraw it and use these other tools like braking the rim with your hand as it starts to slow. Klonopin can tamp down the worst of it when nothing else helps but should not be viewed as a complete and single treatment. Time and distance and your improving (hopefully) life will see it recede.
There are some herbal supplements very good for anxiety but like any psychoactive substance use these with caution, however in general they are milder and safer and much less addictive than prescription drugs and they have the benefit of being a nonissue for the FAA. If you have trouble sleeping due to anxious thoughts especially on the days you aren't taking Klonopin try Valerian root. Be very generous with doseage (increase until effective). There are many others too much to go into here. Alternative medicine is a huge subject but if you are intelligent and selective and do your homework it can be extremely helpful.
What happened to you is the combination of several traumas and I've been there, that happened to me. A single trauma like a death or illness or job loss is one thing but when you suffer multiple major hits in quick succession it's like being body slammed again and again without sufficient time to recover in between. You can't regain your equilibrium before the next one happens. While mentally healthy people can absorb one shock reasonably well, when coincidence (in my case) or cascading results (like from your UC) bring several within a short span of time, even mentally healthy people can need up to several years before they start feeling like themselves again - and even then there will always be scars.
I can't answer your certification questions, just point you to these good doctors here; listen to them and they'll get you through it. I can just tell you that it looks from here you are having a "normal" reaction to very extreme circumstances. There is a new normal in your future and it will come.
bbchien
Touchdown! Greaser!
Since this is a work in progress I'd say-
"You are in no shape to fly right now so self grounding is the rule of the day"
Try to get off of all the meds in no more than 3-6 months- but if you need the meds to stay healthy- that's just how it is.
Recertification on ONE med with less than six month's exposure is not difficult.
With TWO meds, or longer than six months, it's a bigger deal.
At after two years, it's a ton of work but can be done.
If you get to four months and no end is in sight....get a psychiatry consult, FAA will want to see it anyway, eventually.
Health first, FAA after.
"You are in no shape to fly right now so self grounding is the rule of the day"
Try to get off of all the meds in no more than 3-6 months- but if you need the meds to stay healthy- that's just how it is.
Recertification on ONE med with less than six month's exposure is not difficult.
With TWO meds, or longer than six months, it's a bigger deal.
At after two years, it's a ton of work but can be done.
If you get to four months and no end is in sight....get a psychiatry consult, FAA will want to see it anyway, eventually.
Health first, FAA after.
