Medication Induced Depression

(I'm too tired to come up with a pithy title) 

Uh oh. The Lamotragine that I’ve been taking for seizures has had some MAJOR side effects. This is the first time ever that a “Black Box Warning” has hit me. And it hit me HARD. Hard is actually an understatement. It’s awful. As soon as I hit the maximum dose I became so depressed I was suicidal. It slowly creeped up as my dose increase. But it took me a while to connect the dots. Because at the same time I was also instructed to get off of Amantadine.

Amantadine has been a vital medication. It’s used off label for Parkinsons. But for me it’s very helpful for muscle pain and twitches/spasms. So being told to stop taking it has made me incredibly nervous. And for good reason. Exactly what I was concerned about happened. Though I was told that taking it would increase my risk for seizures. However, I’m at the point now that I really don’t care.

 My side effects from the Lamotragine have been:

• Horrible depression
• Urinary retention
• Headaches
• Insomnia 

After I felt like I should go to the hospital for suicidal thoughts I messaged my epilepsy neurologist. They said if it happens again to go straight to the hospital. They also decreased my dose from 300mg to 250. I’m going to very gradually go off of it. They can just put me on something else. It will take about a month for me to complete the decrease.

I am eager to say the least. I wish I could just stop taking it. But that is dangerous and can bring on seizures.

My depression used to be a zero. I would say that I had no depression at all (despite my challenges.) This week it was a 7-9 out of 10. Incredibly high. And I realized something. When I’m depressed I eat and eat. I give in to my food cravings 100%. And like the depression, at first I wasn’t connecting the two. Only the other day did I think “Maybe this is from depression?” That was after I consumed an entire 10 pack of Ding Dongs. By the way… they no longer wrap them in foil which is BULLSHIT. It also shows how long its been since I had one.

Pizza, ding dongs, crackers and cheese, peanut butter and chocolate ice cream, doughnuts. All have found their way into my house and into my mouth. It feels like one of those old “before the picture starts visit our snack bar” cartoons where all the food is animated and I just sit on the couch as they march right into my mouth. Jesus.

But I told my mom today. “I’m just going through so much right now that I’m giving myself a break.” I’m still weighing myself and logging it. I’m just not being hard on myself about that number. I know it will go up. Even if I’ve been gardening, swimming and working like a fiend on my house. That’s something else I do if I’m feeling emotional or not mentally well. I work on re-arranging my house and trying to “make it better.”

I’m back on a singly dose of my Amantadine. Next week I can increase it to two in the morning which was where I was at. Hopefully that will help my pain and muscle problems. I’m terrified that the depression will linger until I’m fully off the Lamotragine. Or even after. Fuck fuck fuck.

 

 

Seizure & Botox Update

My new neurologist completely shit the bed on me. I've had to cancel TWO Botox appointments now. Both of them because he didn't get the order in to my insurance. At all. Not even "on time." Nada. To say I'm angry is an understatement. His nurse swore to me that they would get it through now. But I have to wait for a letter of approval before I can get another appointment. And who knows how long that will take. 

If I'm ever seen by the clinic again (now I'm just being dramatic) I would still like a second opinion.  My muscular neurologist said it was "possible, but good to get a second opinion." 

Here's the information I found online: 

Absolutely — yes, it is possible, and in my specific medical context it’s not just “possible,” it’s actually clinically plausible in a way that both of my neurologists are recognizing.

1. Phantom cigarette smoke is a classic temporal‑lobe seizure aura

Smelling smoke, burning, or chemicals when none are present is one of the best‑recognized sensory auras of temporal‑lobe seizures.

It doesn’t diagnose seizures by itself, but in someone with:

• a left temporal‑lobe craniotomy,
• new stereotyped phantom smells,
• episodes clustering at night,

…it becomes a meaningful clinical clue.
My migraine neurologist wasn’t guessing — he was recognizing a known seizure pattern.

2. Nighttime seizures are extremely common

The brain’s electrical stability changes during sleep transitions. Temporal‑lobe seizures often:

• occur during falling asleep or waking up
• cluster in the early morning hours
• appear as “silent” or subtle events

So the fact that mine happen mostly at night actually fits the pattern.

3. A normal EEG does NOT rule out seizures — especially temporal‑lobe ones

This is the part most people are never told.

A standard EEG:

• lasts only 20–30 minutes
• often doesn’t record sleep
• can’t reliably detect deep temporal‑lobe activity

Up to 50–60% of people with temporal‑lobe epilepsy have a normal routine EEG.
My muscular neurologist was correct:
You can absolutely have seizures with a clear EEG.

This is why neurologists rely on:
• symptoms
• history
• MRI findings
• nighttime pattern
• response to medication

…not just the EEG.

4. My history makes seizures more likely

A left temporal‑lobe craniotomy means:

• scar tissue
• altered electrical pathways
• a region that can become irritable years later

Post‑surgical temporal‑lobe epilepsy can appear months or years after surgery.
So again — The neurologists aren’t reaching. They’re following the evidence.

I hit every symptom listed, including improvement with my medication. I haven't "smelled burning" since. Hmmmmm. 

 

Read Seizure Blog Part 1

Read Seizure Blog Part 2 

Terrifying Side Effect

My health feels overwhelming most of the time. 

Yesterday I had a major episode that was truly terrifying. I had my annual flu shot in the morning. I've never had an issue with it ever in the past, nor with any other vaccination. Ever. Yesterday was a first. Three hours after my shot I felt myself getting weaker. By five I was terrified. I was home alone and my muscles were so weak I could barely work my phone or speak. I though about calling my mom over, but my husband was due to be home any second. I also thought about calling 911, but I didn't want the dogs upset. (Yes... even my dogs come before me.) 

Finally my husband came home. As soon as I started talking to him I started sobbing. I mean 'snot crying' big time. I could hardly get out what happened to me between the tears and muscle weakness. Somehow he understood. I asked him to make me a Gatorade. The last in the house. It has helped in the past. He then crawled into bed with me and comforted me. It was all very helpful. I decided I would wait and see if I got any worse and if I did, then I would go to the hospital. 

Fortunately I didn't get worse. After about 90 minutes after the Gatorade I even improved a little. The tide was being pulled back. I was so scared. To suddenly lose your muscle strength like you've been hit with a blow dart. It is a very horrific thing to experience. I haven't had that happen to me for about four years now. The last time I went to the hospital by ambulance. 

I still feel weak today. When I went to the hospital what made me better was a full IV fluid bag and antihistamines. Strange. My body is such a complex creature. When she's unhappy, she lets me know it with both barrels!

I've been very busy lately. Living my life to the fullest. Family, kids, the ballet, stand up, late nights, company, booze. Not sticking 100% to my short chain fatty acid diet. Working out extra hard, pushing myself over my limit. It's time to pull back and turtle up for a bit. Let my body calm down and recover.

A little taste of my busy life

Post Script - My muscle weakness got much worse after I wrote this. My neurologist had a nurse practitioner call in and check on me. I had sent them a message last night about what happened. She urged me to go to the ER to run labs and just double check that I hadn't had a stroke. 

After 3 hours there I had every reassurance that what I thought had happened was what happened and nothing else. No infection. No stroke. Nothing else. It was very scary though and I'm for sure skipping my flu vaccination next year. This morning I'm feeling much better. 

Stopping Topamax

It is important to remember that even the best, most caring doctor doesn't know the whole story. Doesn't see the whole picture. They (hopefully) do their best to care for you but at the end of the day you need to be the REAL specialist, advocate, researcher for yourself.

That said, Topamax was not for me. I tried 25mg for one month. My neurologist wanted me to give it two months and I said "no thank you". I understand why he wanted me to try it for longer, but the side effects were too much for me and the benefits not enough. 

And a little advice about being a wise consumer. ALWAYS read the FDA information vs the information from the manufacturers website. Always. Just skip their website completely actually unless you're looking for a coupon or rebate.

These are my symptoms that got worse on Topamax:

• dizziness
• dry mouth
• "foggy headedness"
• forgetfulness MUCH worse
• reduced my libido even more
• wiped out my appetite.

Well, that last one wasn't bad, but for some people it could be. I was also on the very lowest dose for the very shortest time.

Both my dizziness and the migraines I think are from my brain surgery. Even though it has been a little over a year, I think the nerves are just now growing back and I'm experiencing pain and dizziness. That's my theory and I think it's pretty solid.

So far what has helped me more than the Topamax has been...

1. Taking Potassium pills at night with plenty of water. This helped with the dizziness a lot. My neurologist suggested it when I said the Topamax was making things worse.
2. Taking more Magnesium than what I was already taking. Again, recommended by my neurologist.
3. Taking the over the counter supplement called "MigreLief". Recommended by... yup. You've got it.

There's plenty of other non medicinal things I haven't tried yet. I have my first follow up on the 12th with my neurologist and I told him I'd like to discuss them.

My muscle weakness seems to have hit a homeostasis (for now... Thank GOD!) That feels nice. I'm still doing what I can but careful not to push it. My body and I feel like we're on friendly terms and that's magnificent. I think she's a lot happier now that I'm not shaving her down like a sheep in the spring every few days. Hahah!

So now onto trying new things after my two week slow reduction off Topamax. Never stop any drug all at once or without notifying your doctor.

(I received no incentives and I'm in no way affiliated with any of the links on this blog.) 

Help is on the way!

There's a quote floating around that I think most people have heard. It's misattributed to Einstein when really we don't know who said it first.
"The definition of insanity is doing the same thing over again and expecting different results each time."
Personally I strongly feel that sums up seeking out health care help perfectly. Each time I talk to or go to a doctor (or specialist) I feel like I'm just saying the same things over and over again, but expecting different results.

I messaged my primary care doctor late yesterday in frustration from the muscle weakness in my arms and legs coming back on. I had felt like it was getting better, but then it was back to being a bit worse. I messaged him asking if there's any way he thought the muscle weakness could be connected to my back problems. He messaged me back quickly (which I hugely appreciated) saying "Do you have pain in your neck and back?"

This blew my mind because:

1. YES!
2. I've had neck and back pain as long as I can remember (as in I literally saw my first chiropractor for back pain around age 5.)
3. I've told him many times I struggle with chronic back and neck pain
4. He requested a back and neck x-ray not that long ago
5. He gave me a prescription for 800mg Ibuprofen for back and neck pain
6. I mentioned it again when he gave me a referral to the first neurologist a year ago
7. I mentioned it again a few months ago when talking about exercise (as in "I'd love to do more, but it kills my back." To which he replied "I have back problems too" and that was the end of the conversation about my back.)

To be fair he's not the only doctor I've talked about my back issues with, so it could just feel like I talk about it endlessly when really I may bring it up once a year or so. I'm willing to give him that. After a bit more back and forth he suggested I try Physical Therapy. This was something I had in the back of my mind anyway for the RA, so I happily agreed. I think my words were "YES! I'll try anything!" 

When I got my x-ray results a few years back I made this chart for myself to see where the damage was. I'm a very visual person, so I found it incredibly helpful. My doctor called it "multilevel disease" which was the first time I've heard that.

On top of the lovely bladder infection (that's getting better by drinking tons of water and unsweetened, disgusting straight cranberry juice) I also had some painful sores on my tongue. I suspect it's from coming off the Plaquenil. My body's trying to grope its way back to homeostasis (or something like that?) 

I gargled with salt water last night and it's feeling better today. 

Can you say "cootie monster?" 

I have cooties.

Despite all my complaining, I'm actually really relieved. I'm glad that I have a doctor who I can message and he gets back to me so quickly. I'm glad he had a new suggestion (something we haven't tried yet.) I'm glad that he thinks my back problems could be contributing to my other issues and that it seems like he really heard me this time.

And despite what it sounds like my life is much bigger than just all of THIS. I'm making some lovely salmon and rice with salad for dinner. I've been studying all day for a test I have to take this Wednesday for my license. I had a lovely e-mail exchange with a friend today. I'm seeing some family for lunch on Friday (hopefully to celebrate my passing of said test!) And I'm rocking my favorite pajamas as I type. See! Not so bad at all.

Love/Hate Plaquenil

It has only been 2 days since I went down from 400mg of Plaquenil to 200. I was taking it twice a day, now I just take one a night. I stopped taking it because of the increasing muscle weakness in my arms and legs. It was making every day things like showering, dressing, walking a real challenge. I wanted to be sure that it was the Plaquenil that was causing this progression before my neurology appointment next month. 

But...

After just 2 days of a reduced dose I've noticed a huge difference:
- The eustachian tube dysfunction (ETD) I've struggled with in my right ear for years now was back this morning. Feeling full, a little blocked and making me dizzy.

- I couldn't sleep because 1) I felt wired/awake 2) the serious pain in my back (especially my lower back.)

- The neuropathy in my hands increased, especially last night.

- My joints ache continually again (not just from "gelling" when I get up.)

- Did I mention the dizziness? That sucks.

- I'm much more tired today. Could be from not sleeping well though.

My rheumatologist still hasn't gotten back to me, so this morning I messaged my doctor. I was very frank and asked if I should go back to 400mg, try another drug or see another rheumatologist. I may try and call her today as well seeing as I feel horrid.

This just adds to that looming feeling of isolation and like I'm in this with very minimal medical oversight. I keep reading how "early treatment and intervention is KEY" and then the medical "experts" really aren't working with me. It's very frustrating. Every minute I'm second guessing myself and feeling like I should just go back up to 400. But the muscle fatigue really was a big problem and I DO want to know if it was being caused by the Plaquenil. 

I went to the store this morning, which was great. Then I stared at the bags in my car and just wanted to cry at the thought of brining them inside PLUS putting all the food away. I sucked it up and did it, but it was hard. 

I HATE that things like grocery shopping are now hard. I feel angry, sad, frustrated, pissed at my doctors and hostile to my traitorous body. I'll feel more hopeful tomorrow. But today is for sulking under a blanket.

Muscle Weakness on Plaquenil

The muscle weakness I've been having since the beginning of May seems to be getting much worse. It's in my arms and legs. It has gotten to the point where my muscles are sore and tired from the most basic things like getting dressed and washing my hair.

I messaged my rheumatologist today saying that I want to stop the Plaquenil (400mg) so I can maybe see if that's the cause, or if it's something neurological instead. I have a month till my neurologist appointment. In my mind I'll stop the Plaquenil and quickly tell that it was the cause. But if I stop and it's still there when I see the neurologist, I can then talk about possible other causes. That's a scary thought.

I never thought of myself as a "scared" or "fearful" person till all of this. It's not death that scares me. Death has never scared me. It's the feeling of "how bad is it going to get?" Fear of the unknown. Every day, every week, every month seems to bring so many changes that I'm constantly playing catch up. If even I don't know what's going on, how can anyone else? How can my doctors help or my partner continue to give me endless support? I think that's where the heart of the fear is. Loneliness and isolation.

Some thoughts from my journal last week.

But before I get too gloomy, I have to share that with the help of my husband I was able to get out and do some gardening this weekend. HORRAY!

What got planted!

I was a little late this year, but I'm hoping these little seeds will do their magic and we'll have some delicious veg from the garden by late summer. I was so excited to get out and get it done. 

I'm hoping to hear back from my rheumatologist soon. For now it's more of the "hurry up and wait" that has become my "new normal."

Decision

I made a decision today. It's one I've been mulling over for a few weeks. One of the major side effects of the Plaquenil that I'm experiencing is muscle fatigue. It's making "being out in the world" a challenge. I'm hoping it will be gone soon, but in the meantime it's really impacting my life. The decision I made was to ask my doctor for help. I asked for a temporary "Handicapped Parking Plaque."

The fatigue started about two weeks ago, but feels to be getting progressively worse. I have a message into my rheumatologist about it, but I also told her when it started. She didn't seem concerned. 

Not only do my leg muscles tire very fast, but the bottom of my feet hurt for no reason and tire super fast. This makes walking not pleasant. Most of the time it's not a problem as I live in a pretty small town. But it has already come up where my husband had to drop me off closer to where we were going because of parking and my not being able to walk really far without my muscles literally giving out.

The back of my mind is holding onto a fear that this is just a new part of the RA that I haven't experienced yet and actually NOT a side effect from the Plaquenil. But I find that unlikely. 

In the meantime I feel grateful to have an understanding doctor who wants to do what he can to help me. His response when I messaged him to ask was perfect. He simply said that he was sorry to hear I was struggling and I could drop off a completed DMV form for him and he'd take care of it as soon as he could. Yup! Lucky.

There's another side to this "Disability Plaque" that is important to mention. Not all disabilities are visible. Though I do have friends who use a wheelchair and even they've been screamed at by nutters in a parking lot for using their plaques. Isn't that just amazing? I didn't take the decision to ask my doctor for help lightly. Nor will I take the decision of when to use it and where lightly. I'd rather have it and not use it then really need it on a bad day and not have it. But I do know that the fear of judgement or confrontation is often enough to keep others with invisible illnesses/disabilities from even asking for what they need. That thought did run through my mind.

Funnily enough thinking about it as yet another tool was helpful. And knowing that it will be another option for me if I need it. I asked myself if I felt I legit would benefit from it and if I had it in the last two weeks if I would have used it. The answer to both of those is "yes." Not all the time, but there were a few instances where I was panicked and stressed because of the fear of having to park far from my destination. I don't need to live like that if there's an option.

The permit will be good for 6 months. Then I can re-assess my situation. I'm proud of myself for being such an advocate and for asking for help when I need it.

DMARD Effects - 1 month in

I've been on Plaquenil for a month now. I started on 200mg 1x a day and went up to 400mg (2-200mg pills 2x a day) after a week. I've had a lot of side effects come and go. It feels like the longer I'm on it the more it's helping. My doctor confirmed that it takes a long time to be effective and it has to build up in your body.

The very first night I took it I think I got up to pee about 20 times. I thought "Uh oh. What have I done!?" But that was the one and only time that happened.

The first week I was on it I was completely exhausted. I didn't want to move or do anything. Again I thought I was really in for it. But this too went away. Also in that first week I had a few instances of darker urine which worried me. Again, this went away. Each time I had a "Let your rheumatologist know" side effect I let her know. She didn't seem worried at all and told me to keep on with the DMARD.

I doodled this after my first rheumatologist appointment. 

Here's some of the side effects and helpful effects of Plaquenil that I've experienced:

Side effects from 400mg

• easy bruising and cuts that take a long time to heal
• tickle feeling in back of throat
• occasional constipation
• sun sensitivity (eyes hurt in bright light)
• images staying on retina for longer than usual (after burn)
• eyes tire easily (especially with computer work)
• joints in “bad hand” and feet hurt a bit more (so far)

Things that are going away the longer I'm on it

• “foggy” head feeling
• face breakout
• chest pain/asthma worse (could have been seasonal allergies though)
• increased body itching
• exhaustion/fatigue/feeling tired all the time
• muscle weakness/fast muscle fatigue/night calf cramps
• short term memory a bit worse

Benefits:

+reduced all over joint pain the mornings

+reduced back pain (especially lower back)

+ night time dry mouth isn’t as severe

+ reduced dizziness

+ reduced right ear pain/pressure (ETD)

+ getting up to pee much less at night (and pain not waking me up at night)

+ peripheral neuropathy (PN) improved

Still have:

ü  Stocking glove neuropathy & bottom of feet (but is improving)

ü  Weakness in both hands, right hand is still a bit worse

ü  Hand pain after any strength activity (like cooking)

ü  Chronic pain in right hand joints

ü  Pain in right foot joints (ankle specifically)

ü  Minor hand tremors w/ weight & activity (no better or worse with Rx.)

ü  Temperature sensitivity in hands (cold feels like it’s burning me, especially right hand)

The joint pain being gone in the morning is wonderful. It feels like the times I was on Prednisone. Like a whole new woman. ETD = Eustachian Tube Dysfunction. I've struggled with that since being treated for Latent TB 3 years ago. Ditto with the dizziness. It feels fantastic to be free of both of those. The ETD was so bad that if I went even 45 minutes by car in any direction I'd have to take a decongestant to try and keep my ears open. Otherwise I'd end up with pain and swelling that would last for months (or till I took a ride on the Prednisone coaster.)

My PN only recently started to improve. That's also been a real game changer for me. Although now its moved into my feet, which is odd.

I'm seeing an eye specialist at the end of this month for a retina check, but I read that problems don't typically creep up till you've been on it for years and years and at a high dose. In the meantime, I don't leave home without sunglasses and I take frequent computer breaks.

I can tell this is the kind of medication where things will ebb and flow. I'll keep track and share what I've noticed in the hopes that it will be useful/helpful to others.

Woman of ACTION!

I think we've all heard the quote by Alexander Graham Bell "When one door closes, another door opens." But did you know that's not the full quote? The full pearl of wisdom is...

"When one door closes, another opens; but we often look so long and so regretfully upon the closed door that we do not see the one which has opened for us."

Today is my last day at work. The agency I work for (helping other people) is shutting down. There was no notice, no severance package and it has been incredibly stressful. In fact, "incredibly stressful" perfectly sums up my month of April for 2018. I can tell the stress is getting to my husband too who has his own demanding career.

When massive stressors come into our lives, it's very easy to just freeze up and stare at that closed door. And stare and stare and question. So much so that it's easy to miss other opportunities and options.

Take a life changing diagnosis. It's easy to stare at the closed door of things you can't do, or shouldn't do and completely overlook what you still CAN do and ways you can adjust your life to do them.

Now taking Plaquenil I learned that I need to keep out of the sun as much as possible. I could stare at that closed door... or rally some assistive technology to keep on doing what I can.

Take THAT sun!
I'm a full shielded vampire ready for some nature.

I found this compact UV sun umbrella on Amazon (no affiliation). It folds up small enough to keep it in my purse. It's good for short bursts out in the sun. If I was going to be out ALL DAY I'd use something else. But for a short little nature walk with my husband this weekend it was perfect. 

I also did a short burst of twilight gardening Saturday night. As soon as the sun went down I covered up (no mosquito bites) and enjoyed some much needed time in the garden.

My spring onion haul!

I wasn't out there nearly as long as I used to be, but I was still able to get a little bit done and it felt great. Plus we had some delicious onions for dinner.

I've been modifying how I do things to accommodate my current needs. I've also been hunting for a new job... Nap anyone?

My compression gloves and nap buddy.
Zzzzzzzz.

I would say instead of staring at the closed door I've jumped right down the hall and am searching for what's open. Sure sometimes I look back at that closed door and feel sadness. But in general I'm just trying to find my "new normal." I'm really looking forward to that. And a nap. Never enough naps.

Ways I Help Myself (THAT WORK!)

Living with an autoimmune disease has been a big adjustment. Aside from all the medical sleuthing and endless doctors appointments. Just keeping healthy and finding things to make me more comfortable has been an expensive game of trial and error. I'm very fortunate to be able to afford "complimentary care" for my condition(s). But I know not everyone can. With that in mind, I thought I'd share what has been helpful for me over the years.

1) Animal Therapy.

The year that I was treated for Latent TB I took a very long nap every day. Every time I'd go lay down my dog "Sweetie" would come lay down with me. She wouldn't get up again till I got up. Although dogs are a huge commitment and not for everyone, I don't know how I would have gotten through that year without her. She's still my best buddy and always there for me.

2) Pinterest. 

I don't like social media, but consider Pinterest to be more of a "visual bookmark" or "bulletin board" than social media. Pinterest has been a great place for me to keep my sense of humor and look up relevant medical things. I've found wonderful items, blogs and websites through them. 

3) A very good probiotic.

I read some research recently saying that a probiotic containing multi-Lactobacillus can be just as effective at treating peripheral neuropathy as Gabapentin. Although I don't find THAT to be quite the case for me, I figure it can't hurt after being on antibiotics so long. File this one under "can't hurt, might help."

I'm currently trying out some new things to keep my immune system health. My own pen/stylus for my purse so I don't use the one at the check out stand. Paying more with Apple Pay so I don't handle money. Keeping disposable gloves, face covers, cup covers, hand sanitizer and disinfectant spray on me at all times. I tend to over-correct when faced with a new challenge, then right-size after a few months. It gives me the feeling of control when really I have little. 

The Plaquenil seems to be helping so far. Today is my last dose at 200mg. Tomorrow I start taking it 2x a day. Here's what I've noticed:

Pro's:

+ My hand joints are less stiff, sore and painful.

+ My lower back pain (that I've had at least 18 years) is much less severe. Like from a 9 to a 5.

+ My morning joint body pain is much less. Like from a 6 to a 3.

+ My nocturnal thirst and mouth dryness is much better than it was.

Con's:

- I'm even more tired than I was before (which is saying a LOT!)

- My neuropathy is the same (though I was told it may do nothing for that.)

- I'm itchier (which is also saying a lot.)

- *Dizziness slightly increased at first and is tapering off now (but still far from normal.)

- *I had a bad headache the first day, but it went away.

- *My stomach was sensitive at first, but it went away. 

- *Had 1 night of "peeing like mad" then it went away.

Overall I'd say it's doing what I'd hoped with fewer side effects that I'd feared. It's also only been a week. I'll make sure to keep reporting on how it's working (or not.)