Can You Hear Me Now?

Robot Brain

Tinnitus sucks. I’ve had ringing in my ears before but never like this. I’ve been looking for ways to alleviate it but only some things help. The problem is some of it is counterintuitive and some of it is catch-22. Yesterday I went for a long walk and it disappeared. When I got home it came back worse. I did a Google to ask why. The first thing I saw was anxiety can make it worse because it causes your body to release adrenaline and cortisol. That makes sense because it seems to have gotten worse around the time my anxiety was out of control. The catch here is worrying about the tinnitus causes anxiety. One of the ways to combat anxiety is with exercise. Another catch. Exercise releases adrenaline which makes the tinnitus worse until it wears off. I have been proving that to myself by taking long bike rides trying to help my anxiety. That helped both the anxiety and stopped the ringing until I got home and it came back worse than ever.

Another thing that helps is being outside because it helps calm you down and the sounds around you mask the symptoms. That is great but the catch there doesn’t really make sense. Going from a noisy environment into a quiet one makes it sound louder. That is what I figured out on my own. Another tip for anxiety is meditation which I do but lying down in a quiet space also makes it louder. This causes more anxiety! Help me! Two things I read I had already found out on my own. Listening to low volume ambient music or sounds helps a little. That is the reason I ordered noise cancelling earbuds. I hope they work! Also, distracting myself by concentrating on something else, like writing this now is good. But there is only so long I can sit here at the computer unless people want to read 10 of my blog posts a day. I didn’t think so.

I mostly found I have been driving myself crazy with the things that were helping me also making it worse. Ouch! Yesterday I went for a 3 hour bicycle ride and didn’t hear anything in my ears at all. But like they said, it’s a trade off. It is worth it to me because I get the exercise and less anxiety but I don’t know what I will do when winter comes. So much for staying in the moment! I did start to wonder why it went away when my daughter took me out driving around Sunday. Sometimes after it subsides a bit I am able to do a meditation which also helps. That is good because I can do it while staying inside. The biggest problem I am having is the anxiety the tinnitus is causing makes it worse. The more I think about it.. Ugh.

The website I found had a lot of good information but at the bottom they were trying to sell me aids. One was a white noise machine to put in the room with me. Another was an earpiece that emits white noise. That is what I am hoping for with the ear buds. Except with soft music. They were also trying to sell downloads of nature sounds and ambient music. I can get that for free on YouTube.

I am hoping it is anxiety related but that also makes me worry if it is permanent. What if? What if? What if? Oh man…

It’s the Plumber, I’ve Come to Fix the Sink

I woke up way too early this morning. I guess that is to be expected since I’ve been trying to sleep for the past 12 hours. I can do something like sleep but I am still aware of the 24/7 music I hear in my head and the ringing in my ears from tinnitus. It gets worse when I’m lying down. The other day I had two songs in my head at the same time. Beck and Guns ‘N’ Roses. “Milk and honey… You can make my money tonight”.

My bathroom sink backed up Sunday and it is causing me much distress. First, clear water was draining slowly and I thought it would be no problem. I have a small plunger made for sinks. I tried running more water and plunging but it would still take a few hours to empty. I tried again and suddenly a geyser of black sludge filled the sink. That is when I gave up. That didn’t look like anything I had ever put in there. I knew I would have to call the landlord Monday and that boosted my anxiety a ton. A normal tenant would have no problem with this situation. The company that owns the apartment buildings has sent out several notices threatening to charge us for the plumber. Which is bullshit since the building is 50 years old. Still, it’s enough to make me stress about it. They like kicking people out of here and find various reasons to threaten. I caught myself catastrophising and thought about it logically for a second. I will call, they will send a guy up, he will snake it and five minutes the problem would be solved. Right?

Monday I went through the process again and called. A few hours later the kid from maintenance knocked. First he asked if I had any gloves. Like, seriously? No. Then he tried my plunger and nothing happened. No shit, Sherlock. He looked under the sink and asked me if I had something to catch the water when he opened the release. Seriously? What kind of job did this kid come prepared to do? That didn’t work and finally he opened the large plastic container that held the snake machine. Finally! He tried that and found no obstruction in what I guess was about 4 feet into my system. He said, Looks like I will have to call the plumber. He packed up and left.

He said the plumber should be here today around 9am. This sounds like a lot of money the owners won’t want to pay. My anxiety was causing my imagination to run wild yesterday but I got it under control. I thought I would be ruminating all night. That wasn’t the case. I’m still worried about it now while I’m waiting for the plumber to show up in… 45 minutes? Or 4 hours? I don’t want this to eat up too much of my day. I’m still thinking they will show up with a longer snake, 2 minutes and they are out of here. But the kid said they would have to take it apart. I looked underneath and all the pvc pipe is glued. It’s not the type that comes unscrewed. This makes no sense. It’s like they never expected any plumbing issues to occur. I really don’t think he knows what he is talking about. Wouldn’t a real plumber be prepared for this?

I’m still thinking they will try to screw me and I have no extra money. Ever. The main reason I am worried has nothing to do with plumbing. It is their ridiculous parking rules where they have 100 reasons you will get towed away. Everyone gets two stickers but the cars must be registered to someone on the lease. Visitors are only allowed to park in a regular spot from 9am to 5pm. After that they must move down to the visitor spots. Which are about a half mile away from the furthest buildings. Good luck if it is raining. They are unnecessarily strict. There are many more available parking spots than the theoretical amount of cars and most people living here only have one car anyway.

It gets worse in the winter. They will tow you if you don’t move your car in the morning before they plow and again if you don’t move your car back to a clean spot after they plow. That makes sense but you are screwed if you have a visitor. When it snows nobody is allowed to park in the visitor spot and they also cannot park in an assigned space. No exceptions. So it snows at night, your visitor must leave the premises I guess. What the fuck? That is the only one that applies to me. Whenever there is snow expected they post the rules everywhere. It is 2 pages! Not large print and not double spaced! If you do this you will be towed, if you do that you will be towed… etc… etc…

I’m surprised I am not freaking out over this. Yes I wrote this page because it is on my mind but I am sitting here calmly waiting for a knock on the door. The black sludge did go down mostly overnight which is better than Sunday night when if did not move at all. I’m still thinking it is a 5 minute job. How can they blame me? Where would I get all that black bilge water to dump in there? The problem is obviously outside my unit. I’ve got better things to worry about.

Welcome to the World

Robot Brain

July 31, 2021, Saturday: When I woke up this morning I texted my daughter, “Good morning proletariat”. Then I thought, Maybe I should have looked up the spelling before I wrote it. I Googled and had it right, it also meant exactly what I thought. I got lucky because I used be so sure of these things. Now I doubt my memory but I am usually surprised. Unless I am having a huge brain cramp.

I was nervous all day about her first day at work for no good reason. She loved it. She made friends with the girl who trained her and they went to lunch together. I was surprised. She used to be slow at making new friends. I am still so happy!

I checked today’s weather yesterday and it is going to be another beautiful day. Again, I told myself I am going for a long ride no matter what happens. I didn’t really sleep and by 8am I was already making excuses to get out of it. Too chilly, little cloudy, wind is blowing the trees pretty hard. Fuck all that! I felt so good the last time I went, I have to do it. It is going to feel weird going for a ride on a Saturday and not be visiting my daughter. She is working again today.

Maybe I will ask her mom what is going on at her house today. I know most of the people who might be there on a weekend but I don’t want to invite myself over. We have known each other for 20 years and we are still friends. I get along with her husband. I have always gone there to see my daughter and I don’t want to put her in the position of having to say no.

Ha! While I was typing that my mom texted me and asked if I was going to see my daughter tomorrow on her day off. I was confused. I had it in my head she was working Sunday and had Monday and Tuesday off. Completely backwards. I don’t know why. I saved the pic of her schedule and I’ve looked at it several times. Another excuse to stay home today. I don’t know if I can make the ride two days in a row. Which is bullshit, I know I can and I don’t even know if she has plans tomorrow.

I definitely have tinnitus and it is getting worse. It used to be slightly annoying. Now it is front and center. I searched for a way to relieve it and found there was no cure. That scared me. I read people use noise cancelling headphones to help or low background music. I’ve been trying the low music and writing to take my mind off it. It was helping a lot but today it is loud. CBT is also supposed to help but I’m not sure how or where I could find a therapist who knows about it. I was afraid the magnesium was causing it and did a Google and found it is specifically used for relief. I thought it worked a couple of times but today I don’t know. It may not have had time to kick in yet. It is fairly loud and hard to ignore. I may have to invest in a pair of headphones.

I started worrying about how much they would cost while I’m sitting here with all the information in the world at my fingertips. I was surprised I could buy a highly rated set of noise cancelling wireless earbuds for $44 at Walmart. I was thinking they would be out of my $ range. They are on the way! No need to fret!

“Keep their heads ringin’!” Dr. Dre.

Space Exploration

My daughter starts her first job today! It’s at Goodwill. But, believe it or not, it was her first choice and she got hired two days after she got her license! She has been buying all her clothes at thrift stores for the past few years. Except her Doc Marten’s. She has started wearing dresses and skirts for the first time since she was 4 and started choosing her own clothes. That was a shocker. She would pitch a fit whenever her mom tried to make her wear them. But now she is into boys and has a serious boyfriend.

The Goodwill store is about a mile from me. Yesterday I told her I was going to come in and embarrass her. She said, “Please don’t.” I said, joking. I asked her if I was going to get the inside scoop on the good t-shirts now but she isn’t allowed to buy anything until it has been on the rack for a week. I like to go there once in a while because I can usually find an interesting shirt, never worn with the tags still on it. But still only 6 bucks. She is only scheduled 15 hours a week but it pays $11 per hour. I was surprised. I thought it would be minimum wage. $7.35 an hour which is ludicrous because it has only increased by 10 cents in 40 years. Here in America, the richest country in the world. That is a big Fuck You! to the common man. I said she will be excited to make her own bank. She has really taken to having her own car. She knows how to jump start the battery and check and fill the oil. She is afraid to do the coolant but she will have to learn since the warning light keeps coming on.

My anxiety is still under control. That is pretty cool. It was the first time in my life I really thought it could last forever. Now my biggest anxiety is the super anxiety returning. Now I am back to my little fears I can quash pretty quickly. I am having a newish disturbance. It started a few months ago as annoyance but now it is incredibly intrusive. I will hear short phrases or bits of the last song I heard repeating all day and night. I can’t fully fall asleep. I have had songs stuck in my head before but this is different. It takes over half of my brain. Strangely, I can quell it with deep breathing but I can’t concentrate on that and something else at the same time. Luckily a few days ago I discovered if I listen to one of the chillout or lo-fi hip hop stations streaming on YouTube while I’m writing one of these in the morning, I can usually hear it for the rest of the day. It’s not entirely unpleasant. The worst is when I’m watching television and they play a short clip of a familiar song, it just sticks. Yesterday sucked. There is a commercial for some product and all day I heard, “Build me up, Buttercup.” Over and over. I tried YouTube a few times but it didn’t work. I don’t know… It’s not really interfering with my life. I’m still taking care of myself and my responsibilities. I’m still focused on my daughter and glad I can share in her happiness.

Damn, I need a good title

Robot Brain

Thursday, July 29, 2021: Okay, I got a little excited yesterday. The Green Day concert is not today, it is next Thursday. Still time for you to buy tickets. I’m not going but a lot of people I know are.

Yesterday I did a great job managing my anxiety. I woke up in the morning and was surprised the weather forecast had changed from rain all day to “the best day of the summer!” Clear blue skies and temps in the 70’s. I don’t know what that is in Celsius but it means you are styling in shorts and a t-shirt! I set two rather lofty goals for myself and said, no matter what happens I am going to accomplish them. That may have been a mistake if I failed but I was feeling rather determined. The first was a walk to Walmart. I didn’t really need anything. It is a two mile round trip which is a reasonable walk for me. I chose to walk rather than ride my bike because I wanted it to take longer. I was actually holding myself back from leaving my apartment which was unusual since I’ve had to force myself to go outside and would only do it for necessary reasons lately. I found I had to keep slowing down my walking pace and reminding myself I am not in a hurry. Also I was still ruminating about everything that was going on in my head from my previously intense anxiety. I would find myself thinking about people I was pissed at and stop it and say, don’t let these people live rent free in my head. Instead I was able to think about people who have been good to me.

When I got home from Walmart I was feeling pretty confident about my next goal which was to go on my semi regular 25 mile bicycle ride. Again, I had to restrain myself and remembered I had only eaten an apple. I cooked and ate a bowl of lentils which takes about an hour and had a great orange. Yum! Despite my anxiety I had still been able to complete maybe three bicycle rides but they never reduced it. I found myself pedaling as if I was being chased by the devil. This time I told myself to keep a leisurely pace. I was able to do it for the most part. I kept myself in the correct gear to pedal just enough to feel like I was at a cruising speed. It was much more relaxing than usual and added an extra half hour to my excursion. Again, part of my goal was to stay outside as long as possible. Mission accomplished! When I arrived home every muscle in my body was sore but it felt really good and it was my first Advil free day for quite a while.

I knew exercise, fresh air and being out in nature (Three quarters of my ride is very close to the ocean) were good for anxiety but my previous three trips made me feel worse because they had little effect and I was starting to get afraid it would last forever. Twinges of low anxiety kept creeping in during my ride making think it would get worse when I got back home. I actually felt great for the rest of the day and today is starting out even better!

I accidentally discovered I did two more things to help anxiety. Sunlight helps your body create vitamin D which was the first I heard as anxiety relief. The second was the fish oil gels capsules I bought at Walmart intending to get Omega 3 fats into my body. Previously I had been eating chia seeds but I kept forgetting to buy them after running out. I didn’t realize Omega 3 fats help with depression and anxiety until I Googled the recommended daily dose. I feel like I did a great job. I set reasonable goals and accomplished them and had two serendipitous discoveries. Incredible! I feel like a new man.

Happy Days are Here Again

Robot Brain

Wed July 28 2021: I was quite proud of myself yesterday for making it through 2 weeks of the worst anxiety of my life. (that is saying a lot) I was happiest because I did it without drinking (since I’m a raging alcoholic) and only taking 1mg of clonazepam each day, although I am prescribed and and had available 3mg per day. I don’t know how I managed that. Every time I saw the bottle sitting there I really wanted instant relief. That would make the anxiety worse. (as if that was possible) I don’t know why I was so determined. Like I said I was feeling pretty good about kicking anxiety’s ass, until it came back unexpectedly later in the evening. That was scary because none of the techniques I used yesterday were working. My biggest fear was it would go on forever. It only lasted about an hour. Phew! I was getting pissed because it was interfering with the joy I felt sharing in my daughter’s happiness about getting her license and being out there doing her own thing. She is a very different person now.

Speaking of my daughter, she is doing great! She is the first of her friends to start driving and they were waiting in line for her to take her for a ride in her old school black on black BMW. It’s so old it only has a CD player for her music. No phone plug in and certainly not bluetooth. She likes it since she is into retro. She already has a pretty good collection of CD’s and wants to bring me to her favorite music store in Portsmouth. She has her eye on the next one. She has great taste in music. When I visit her the first thing she does is show me what she has added to her collection. I was surprise to see Jimi Hendrix “Are You Experienced” one of my favorites from when I was younger. The first week she was driving she and her boyfriend had a picnic in Prescott Park. I was surprised to hear that. It doesn’t sound like something she would be into. She made him peanut butter and fluff roll ups, his favorite and they had strawberries with sugar. When I left I told her how happy I was she is getting out there and doing her thing.

Tomorrow she is going with her parents, their friends and her boyfriend to see Green Day in Fenway Park! She is so excited. It is her first concert since the virus and she has never been to the ball field. She wanted to take her car but her mom won’t let her drive in Boston. I told her she is going to have the best time! I am so excited for her. Thinking about how awesome she is makes my throat tighten and my eyes start to tear up. It is a new feeling for me. I am so happy!

Take Me Out To The Ball Game

Robot Brain

One of the things I’ve been doing to deal with my anxiety lately has been live texting Red Sox games to my mom. Watching baseball with my family is one of my better memories from my childhood. Neither of us are really into it now but this year the Red Sox are doing great in first place. Most of the games are really exciting because they have the most come from behind wins than any other team this year. They usually do it in the late innings so it is even more fun. She says I am good at calling the play by play. Like I said she wasn’t into it at first but now I have her staying up past her bedtime. Last night was another good one. They were losing 4-3 for most of the game when they got a man on in the 8th inning. Verdugo was at the plate and he is clutch so I opened my eyes. He worked it to a 3-1 count. The pitcher couldn’t walk him with a man on in a one run game. He had to throw a strike. I watched Verdugo standing there and he knew it and I knew it. If that pitcher throws a strike he is hitting it outta there. Sure enough, right over the plate and BOOM! He hit a no-doubter! Red Sox win. My anxiety was still out of control but it was a good distraction.

Finally, last night I had enough. My mind had been going non stop all day every day for at least a week. I couldn’t think of any way to catch a break and it was getting worse. I didn’t think that was possible. I was all out of ideas. I said fuck this shit! I rolled on to my side, put my hand on my cat and pulled in a solid breath, down to my diaphragm and said, You are stressing yourself out for no reason and let out the air. My anxiety started to chatter with, it’s not going to work, what if? But? And all of the impossible possibilities. I shut that shit right down. I’m done reasoning with anxiety. I thought, Too complicated, have to simplify. I changed it to, Stressing for no reason, with each breath in and out. My anxiety tried to say, You can’t breathe like this forever. I said, Fuck you, I’ll breathe like this for the rest of my life if I have to. After about two minutes I couldn’t believe it started working. I kept going. I five minutes I couldn’t believe it. My anxiety was all but gone. I didn’t trust it, so I kept it up. Finally I tested it out. I could think straight. Now as soon as any doubt creeps in, I immediately start again and shut it down. I had to do it again this morning but it was a lot easier. I can’t believe I hadn’t tried that. I know it helps but I haven’t had to deal with such intense anxiety for a long time. I stopped practicing for a long time. I remember when I used to do it I could get my breathing down to 3 cycles a minute. I would do it even if I had no anxiety because it made me so relaxed.

Here is an example of how bad I was getting. One morning last week I was doing okay and I started talking to myself. You’ve been chugging gallons of water a day for years. In a few minutes you are going to start with the water and wonder why you suddenly drinking so much. It’s nothing new. Then you are going to worry why you started pissing so much. It’s nothing new. Sure enough 4 bottles later and I had to stop drinking it. Anxiety was out of control for the rest of the day! What am I supposed to do? Never drink water?

Today has been much better. I am relieved.


Robot Brain

A week ago I was the happiest I have ever been in my life seeing my daughter get her license. I was so happy for her I actually started crying. I’m not sure if that has ever happened before. She is like a different person. She is so much more confident. I don’t just mean driving. I mean everything. Her whole approach to life seems to have changed.

I’m still happy for her but something changed for me. My anxiety suddenly went almost completely out of control. It hadn’t been much of a problem for the couple of months while I was freaking out about the akathisia. I was completely stressed out but that is not the same kind of anxiety I take medication to help.

I’m not sure what is going on now. Maybe it is a bounce back. Medication isn’t very effective for me anymore. I do best when I can lie down and get my breathing under control and catch my mind when it starts tripping on things they teach about in CBT.

What I have the most trouble with is imaginary anxiety. My mind comes up with impossible scenarios and adds to them and I am certain that is what will happen. I’m been doing this since last week and driving myself crazy. The more I try to calm myself down and tell myself I am being ridiculous, the more worked up I get. My anxiety mind has a seemingly plausible argument for everything I say.

The weather hasn’t been the best this summer but Thursday was a perfect day and I forced myself to go for a bike ride. I went for 2 and a half hours and it was fantastic but my mind still wouldn’t quit. I was calmer when I got home though. Saturday was the exact same weather. Even though my daughter just got her license I told her I wanted to bike to her house and meet her. I knew I needed to burn off something before I got there. I was surprised she didn’t want to drive somewhere. The whole time my mind and my stomach were churning and I felt like I was trying my best just to act “normal.” I’m glad I went though.

Yesterday I couldn’t stop ruminating and keeping myself on the edge of panic. Finally about 9pm I tried a guided body scan meditation. I set my sights high and chose a 40 minute session. I really didn’t think I would last 5 minutes but I did the whole thing and didn’t want it to end. Anxiety was still high but settled down to a simmer. I liked it but I can’t just lie there listening 24/7. I was able to fall asleep for a few hours and I realized a mistake I had been making. Usually I would jump out of bed and it would be a new day. I forced myself to stay there and slept a couple more, woke up, rolled over, slept a couple more. My mind never stopped working but at least it was some rest.

My cat knows when I am in trouble. The whole night he stayed close enough to be touching. When I rolled over he would move to my front side and just lie there. I would keep one hand in contact with him and that is how I made it through the night. I didn’t add up the hours but it was much more sleep than I’ve had in a long time.

Once I had a therapist tell me to do the opposite of what I wanted. I didn’t know what the hell she meant but it makes sense now. I didn’t want to leave the house and go on bicycle tours but I felt better when I made myself do it. Today, the last thing I wanted to do was sit here at the computer and write this but it’s helping. Just the thought of getting on the internet has been triggering me. But again, I can’t type all day.

Let the Good Times Roll

Robot Brain

Monday, July 19, 2021: My daughter got her license Saturday! She is so happy and excited. We all are. We were texting each other the play by play all day. I was really hoping she would pass the first time because of the look on her face when she was describing how to parallel park. I knew she would ace the driving test but she wasn’t as confident about the written. She is taking me out to lunch in a couple hours! I can’t believe it. It seems like yesterday she was just a little peanut I could hold in one hand. Now she is driving around in her own car.

Akathisia Help

Magnesium! I don’t know the science behind it. I couldn’t find any studies related to magnesium and akathisia. In all my internet searches no medical professionals mentioned it. My psychiatrist never heard of it and pretty much said he gave up, go talk to a fucking therapist, asshole. It only popped up once on Google and it was just some random guy saying it works so I discounted it. Finally I got so desperate after a 48 hour stretch of intense akathesia pain and non stop walking, I was afraid to take one more dose of my anti-psychotic. I did one more search and typed, “magnesium” and “akathisia” into the bar and apparently millions of ordinary people know about it. But all they said was different variations of “it works.” I still didn’t believe it because nobody gave any details. Nothing on about how many milligrams, how many times a day to take it, how long it takes to start working. Nothing.

Again, so desperate, on the fourth of July at 9am in the pouring rain I rode my bike down to Walmart and bought some for less than 10 bucks and no prescription. I got home and took the 600 mg dose indicated on the label right away. I was still scared to take my medication because everyone said plain magnesium and all I could find was slow release magnesium chloride. Plus I still didn’t believe it could be so simple. Finally at midnight I took a dose and waited the 2 hours for my calves to tighten up telling me the pain and uncontrollable movement was going to start soon. Not a twinge. 3 hours, nothing. 4 hours, nothing. I fell asleep and woke up, still no symptoms of akathisia! Oh my god, it fucking works!

I took another dose of Latuda at midnight Tuesday and a couple hours later I got the feeling in my legs and thought, I knew it was too good to be true. But a couple of hours later the pain faded away. The shortest time since the akathisia became apparent a few months ago. Wednesday night, same thing. I was jubilant! I could handle this. I was so excited I ordered big bottle of 200, 500mg tablets of plain magnesium and another bottle of the same SlowMag, magnesium chloride just in case.

I’ve been all fucked up for the past month since the last time I talked to my doctor he told me, “Your medications are making you worse, it’s called a paradoxical reaction, it means your medications have the opposite…” I interjected immediately all pissed off and started, “What the fuck…” I wanted to tell him, no shit I figured that out last December, I just didn’t know it was a thing with a name and you all know about it and it only happens to me. He interrupted me immediately, asked if I wanted therapy, I said I don’t know and he said call the office and make an appointment for 2 weeks. I hung up and thought, what the fuck is going to change in 2 weeks? He didn’t make any changes and never mentioned the akathisia. I was just too stunned to notice.

I was like I need some time to think about this and made an appointment for a month. After that I was sleeping about 2 hours a night, waking up at 1am and it was a 5 hour long battle with myself to talk myself into taking the medication and finally I would take it and be so worked up I would need an anxiety med but he had me so messed up I was afraid to take that even though I knew it helped at least a little. It would be a half hour process of me wondering what med to I take for what symptoms when he just told me everything had opposite effect. Was I supposed to smoke some crack to calm down? By the time I took the med I had so much anxiety nothing was going to work. Then a day of akathisia, the next day no med because I couldn’t take the horror.

Every day I was thinking, why was I spending so much time and energy and effort and stress and anxiety trying to figure out a way to tolerate a med that caused the akathisia and he just told me is making me worse? He is going to call tomorrow and I am going to tell him about the magnesium and now I am able to take enough latuda to safely taper off and that is what I want to do. I have no idea what he will say but the protocol for akathisia is to get you off the med that causes it.

I don’t know if magnesium will work the same for everyone but it has been working better each day for the past ten days and I had to tell someone. It is safe, your body needs it anyway and the only side effect is I’m less thirsty and I have to be conscious to make sure I drink enough water during the day. Oh no, I might get slightly dehydrated! It is a million times better than anything my doctor tried. Phew!