The Gates of Hell

Back in the early 70s, in the pre-Glastnost days when the then Soviet Union was a major mystery and, to many, public enemy number one, I had a very progressive history teacher who felt a field trip would make for far better learning than the opinions du jour.  So we went, a 747 full of wide-eyed teens and cautious chaperones.  It was the experience of a lifetime that began and ended with a stopover in HEL.

HEL in this case was Helsinki.  At the time, the SU was planning their annual May Day celebration which meant a roll out of military equipment and might at the airports - something we were not allowed to witness.  So we had to land in Helsinki and travel by land, under the cloak of darkness to our destination.  It was a great journey into the unknown and one I will never forget.  When I returned home, I joked that I'd been to hell and back and had the luggage tag to prove it.  Little did I know...

Six weeks ago I decided I'd had enough of the incessant weight gain and dragging feeling brought on by Venlafaxine (Effexor).  I'd been on the stuff for a full year and quite frankly I was feeling a bit freaked out by the potential long-tern side effects.  I wanted off and I wanted off NOW.  So I mentioned it to my neurologist who set me up to wean off.  Rather than follow his instructions which would have meant tapering from 75 mg per day to 37.5 (the smallest prescription available), I leaned heavy on my chemistry background and decided I could titrate down to zero and thus avoid the heinous withdrawal effects I'd read about.  So much for theory...

Round about 18 mg/day, the headaches became insistent.  A swooshing sound filled my head whenever I turned, nodded, tilted, moved.  It was light so I felt it okay to continue to wean.  At 10 mg/day - my head began to pound.  Imagine a medicine ball, one of those small ones with the sandbag inside.  Whenever I would turn my head it as as if my brain were the sandbag smacking into the side of the ball, my skull.  Oy.  As evening approached, my ability to drive and orient became seriously impaired.  I barely made it the 10 miles from my friends' home to mine.  Okay, I thought, I'll tough it out. That night I went to bed without taking the next lowest dose.

The next morning I could barely get out of bed.  Vertigo had set in along with the swooshing and the banging.  I felt nauseous and completely disoriented.  The couch became my very fast friend.  If I lay very very still...  A trip to the bank was sheer hell.  I got lost and couldn't seem to orient or decide - home or run another errand.  I chose home.

Monday, I was on the phone to my neurologist.  He suggested I go back on the drug.  I was reluctant but what could I do.  I started at half a dose with the intention of weaning again.  I stopped at 22 mg/day.  The headache - pressure behind my right eye and throbbing in my right temple - became constant.  I felt it safer to simply stay at this dose to see if I would adjust.  Gratefully, I had an appointment scheduled with the neurologist for the following week.