I’m still in tough shape today and having to dictate this post to Dad, as I can no longer function well enough to use my computer.
Nonetheless, since yesterday I think we’ve pretty well figured out what has gone wrong + perhaps also what to do about it.
Before I go any further, both my Dad and I would like to acknowledge the invaluable advice we’ve received from Dr. Susan Solman in Miami. Susan is a treasured family friend and also an experienced PhD pharmacologist who follows my blog + who wrote last night to highlight a number of issues we hadn’t fully considered.
We are indebted to Susan for her professional counsel + even more appreciative of her caring enough to contact us urgently.
Susan’s most important two points are:
Firstly, clinical observation always trumps lab results. Or, as she put it …
“Practitioner will always treat the patient, not the lab data!”
From a detailed report on all of my symptoms, it is plain to Susan (as well as from the clinical literature) that I am suffering from what is known as Lithium Toxicity, which has potentially fatal consequences. Here’s a link if you’re interested in more details.
In other words, I’ve poisoned myself.
Secondly, Susan advises that our strategy (explained in yesterday’s blog) of reducing my intake of Lithium Carbonate until my lab data fall to the low end of the recommended dosing range is both flawed + seriously dangerous.
The reason for this warning is rooted in pharmacokinetics, a field in which Susan has many years of working experience.
The bottom line turns out to be counterintuitive — that is, I could reduce my intake of Lithium Carbonate right away, but my blood serum Lithium levels could continue to rise for some time.
So … since I’m already deep into toxic territory, this would be needlessly tempting fate. In other words … playing with fire … not clever!
Consequently, we decided to eliminate Lithium completely as of today and wait until I no longer manifest symptoms of toxicity before considering whether to get back on track with the protocol.
Since Lithium has a half life of about 24 hours, I probably won’t see improvement in symptoms until tomorrow at the earliest.
Meanwhile, we’ll continue to get frequent lab reports from the supportive Kunming Medical School team.
Today’s (Monday) lab results came in at 0.95 mEq/L … so almost identical to last Thursday’s 0.97 result. And Wednesday is my next scheduled blood test.
Perhaps the ideal outcome would be that I end up symptom-free at a serum Lithium level of about 0.6 mEq/L that is the bottom end of the range thought to be therapeutically effective to alleviate SCI-associated neuropathic pain … which is why I’m going to all this trouble in the first place!
Anyway, we’ll see … much still to play for.