I brought all these goodies back to China, with the Rx to counter any accusations that I may have inappropriate possession of these controlled medications.

Consumed the Effexor in 28 capsules over a month, made some enquiries locally about the availability, as I'd seen some advice about abrupt withdrawal.

Subject : Medications
From: "A doctor" (services@deleted.com)
Sent:Friday, 9 May 2008 10:34:15 AM
To: Jamieson@something.com

Dear Mr Jamieson,
 
Thank you for your email.
 
Effexor (by Wyeth) is available in 75 mg tabs, in boxes of 14. Each box costs 175rmb. Stocks are currently available.
Diazepam is not available. 
Consultation charge: 350 rmb upwards (excluding first time registration fee of 100rmb).
Please kindly call us at 0512- 6*** ****, if you need an appointment.
 
Yours sincerely,

Nice Doctor
**********************************************

.......visiting a General Practioner for FREE (vs 350 rmb upwards)  and medication at an unbelievably subsidised cost.

Effexor 150 mg cost me AUD $5.00 for 28, Full cost : $51.30.

Do the maths. 75 mg x 2 = 7 day supply = $30 AUD. 28 day supply = $120 AUD.

J declined this generous offer and stopped taking the Effexor when it was all gone.

Then it started. Vivid, violent disturbing nightmares. Mongrel morning headaches that lasted until mid-afternoon.

*****************************************************************
The event.

Yesterday was a good day, a trip downtown to Starbucks for a free "Language Exchange" session with 2 pleasant young Suzhou ladies who covered my "transport fees" very handsomely. Get home, have dinner, shower, chat with Mrs. J. then curl up with:

"Economic Growth, Challenges, Threats to Nation-States and local culture in the Newly Industrialised Economies of the 4 Asian 'small tigers' "

and

"Chinese Government perceptions of regional order and implications for Australia".

A fairly usual routine at Club Jamieson, lights out at a reasonable hour, everything's fine.

VERY F***ing Unusual.

Jamieson is woken up at 2.16 am by an agonising chest pain and a severe shortness of breath, severe pain when breathing - couldn't breathe comfortably in any position except sitting at the edge of the bed. Felt a carotid pulse several times - regular and normal rate. Mrs. J. was blissfully sleeping.

What is this ? Pre-cursor to a heart attack ? Angina ? Musculo-skeletal spasm ? Some type of anxiety attack  - what, in the middle of sleep ? - highly unlikely.

So, like an idiot I waited and hoped it would subside and I could get back to sleep.

Ignoring acute chest pain and panting in short, very painful breaths is probably a foolhardy thing to do for a 46 year old smoker with little exercise, a Chinese diet swimming in saturated fat and pork galore (Yuck).

Mrs J. wakes up to see what's wrong.  We hum and hah, procrastinate and it's getting worse. 

3.30 am and Big J has had enough, we get dressed, toddle out and get a cab to the Hong Kong Hospital Accident and Emergency Department.  I didn't fancy being in a local Hospital, thanks very much. Of course, it's the most expensive Hospital in Suzhou * - but we have more than sufficient financial reserves.

This is definitely NOT part of the plan.

Register, and get straight in to see a Doctor. Very quick medical history and it's off to a treatment room.

                    

J. gets the Nasal Oxygen Cannula, BP checked, a quick listen with the stethescope. Nursey wheels over the EKG and wires J. up, pops a tab under his tongue. Nitroglycerine ? New Nursey wheels up a trolley and takes 50 ml of Laowai blood.

Dr. White Coat wanders over, tears off the EKG printout, has a close look and assures J. that "it's absolutely fine". (Whew).

(Laowai = foreigner)

Jamieson is very happy to see Laowai-type brand names on gleaming VERY EXPENSIVE brand-new high-tech medical devices*. We've got General Electric, Raytheon, Hewlett-Packard connected to Mr. J. and some impressive Philips thingy over there in the corner.

And it's ALL for ME.

* Hence the high costs involved at this Hospital.

Nursey comes in again 10 minutes later. Mrs. J. interprets. "Roll over and bare an arse cheek, you're going to get an injection for the pain."

Oh, wonderful.

So, I'm laying there with a pulse and blood oxygen saturation sensor on the index finger, Expensive Orgasmatron beeping in synch with the ticker. Nice multi-coloured display on the monitor !

Nice snooze for 10 minutes at a time, frequently interrupted by Nursey pulling back the curtain to check on the Laowai.  Then, Laowai starts running a temperature, nothing serious. Dr. White Coat comes in and checks the chart. He is nonplussed.

He mumbles something about a severe anxiety attack.

Jamieson mumbles about withdrawal from Effexor.

All seems well. "You can go home if you like, or we can give you an IV to lower the fever".  J. selects the former. We get another taxi back to Casa Jamieson, scoff a few painkillers, crank up the air-con and blissfully sleep the whole day.
******************************************************I
I told him I had recently stopped taking Effexor, but I think that wasn't part of his training or clinical experience. After all, how many Chinese take anti-depression meds ?

Comments from others who have stopped Effexor - off the web.

" I TRIED TO WEAN MYSELF OFF LAST YEAR AT THIS TIME BUT BAM INTO A Panic disorder with agoraphobia ATTACK."

"Sample US Cost of Effexor: $100 for 30 75mg XR capsules. As of 11/10/2003. Full retail for the uninsured. Go ahead and gloat, citizens of civilized countries and all of you with full medical coverage."

"Some Effexor withdrawal symptoms:  sensations of shortness of breath or smothering; feeling of choking;  chest pain or discomfort; nausea or abdominal distress"

" A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed mood or the loss of interest or pleasure in nearly all activities, representing a change from previous functioning, and includes the presence of at least five of the following nine symptoms during the same two-week period: depressed mood, markedly diminished interest or pleasure in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation. "

"Generalized Anxiety Disorder (GAD)  (DSM-IV) is characterized by excessive anxiety and worry (apprehensive expectation) that is persistent for at least 6 months and which the person finds difficult to control. It must be associated with at least 3 of the following 6 symptoms: restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance."

" Effexor (venlafaxine hydrochloride) is also approved for GAD. Yet it frequently makes the anxiety that is part of bipolar much worse. I can't honestly give a good risk/reward analysis for Effexor (venlafaxine hydrochloride) and anxiety. Given the experiences I've read of everyone who has taken it for bipolar and depression, I'm surprised it was even approved for anxiety."

                                

"No one can stay upbeat and positive all the time; it's natural to have bad days. However, if you are having more bad days than good ones, talk with your doctor."


I did.  I confessed. I have made a huge 180 degree turnaround on the booze thing, saving heaps of money. Dropped the drugs - and wham.

I was mulling the idea of returning to Australia for Cardiac treatment when I was in the bedroom, in the 'unknown' stage. I had no fear of dying - or going to die any time soon. Coherent and lucid, able to make rational decisions. Just God-awful chest pain and agony when breathing.

36 hours later I'm right as rain, zero side effects, no pain at all - business as usual. Now I have to get back into the books and research reports again. Which one(s) today ?

"Chinas unprecedented growth and implications for the Asia-Pacific region" 

"A Shift in Focus. Australia and stability in East Asia"

Perhaps a quick leaf through "Beyond belief - Islamism, radicalisation and the counter-terrorism response".

A day in bed is nice, but there is a schedule to keep !

************************************

 So, now you know.

"I'm clean now Baby, I promise..."

I'm just glad it was Effexor, and NOT high grade uncut Afghan Heroin.

That's Jamieson's Luck.