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	<title>Comments for The Blonde Pharmacist</title>
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	<pubDate>Sat, 19 Jul 2008 07:30:00 +0000</pubDate>
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		<title>Comment on Brain shivers&#8230; brain zaps&#8230; brain shocks&#8230; by Bob T</title>
		<link>http://theblondepharmacist.wordpress.com/2007/11/17/brain-shivers-brain-zaps-brain-shocks/#comment-1249</link>
		<dc:creator>Bob T</dc:creator>
		<pubDate>Sun, 01 Jun 2008 14:21:32 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/2007/11/17/brain-shivers-brain-zaps-brain-shocks/#comment-1249</guid>
		<description>I had been on zyloft, celexa, for many years, then tried lexapro for my Mj. depression. My doc &#38; I were trying to find a drug that was helpful. None were.
Then he told me about a New drug: Effexor &#38; how it is showing good result for a person with both depression &#38; anxiety. Shall we try it?  I said, "ok."

My history is my body is extremely sensitive to meds--they either don't work or they work with taking a very small (even pediatric) dose.

The Effexor was causing me all kinds of problems. But I was staying with it, to try to work my way through them.  I found myself in the ER twice, before they concluded my pain &#38; problems could be from the Effexor. I had taken it for four weeks.  They said I should come off it.

We did as told in the package insert (USA) &#38; I was off in a week. Prior to that, I was having mem. lose, couldn't stand, sweating, shakes--in fact we counted 52 things going wrong at the same time.  It certainly was time to come off.  

My doc told me I should have called him right away--but since I had had similar experiences with just about every med I ever took, I stayed with it too long &#38; the side-effects became severe.  The doc said, if ANY drug causes problems at the 2 wk mark, it's time to try something else.

So off I went. And here come the brain zaps as well as tinnitus and my BP in those 4 weeks went from 124/72 to 170/150 (It has not stabilized, even today.)

This was about 7 years ago--when Efx. 1st came out.

When I told my doc about the shocks, I could see on his face he didn't believe me. I believe he really thought I was a "nut" case. I even thought so myself--these things can't be happening. 

My brain zaps were coming fast and hard.

Finally, thinking I was crazy, I called Whythe (sic) labs. They put me through to a nice lady who recorded post marketing symptoms.

I told her about the brain zaps and she told me I was not going crazy. These were legitimate discontinuation effect for some people, especially, those who have come off the med too quickly (although my doc follow the published info on how to do it).

She told me of private instructions they had for people who were having trouble with withdrawal. Go Slow. If the symptoms return go back up if you can, then try a slightly lower dose--because of the other problems it caused me I needed to get off as quickly as possible. But she said the 1 wk thingy in the publication was wrong. It's more like a couple of months to get off.  If having problems, do not cut the dose in half, but empty the capsule and try 3/4 of the dose, and on down like that. If 3/4 was too large, go to 7/8s. And gradually come off it.

It was nice of her to reassure me I wasn't loosing my mind. And to tell me the "inside" info the company had on how to come off--too bad they didn't tell these things to the docs back then.

The literature made no mention of the electrical-like disturbances, and severe withdrawal that could happen (as it does today.)  I think I read on the web site if a person has been on Effexor for 1 week, they must be withdrawn slowly and watched carefully.   --that really helps now!

My brain zaps were making a mess. They happened especially when I moved my eyes, side-to-side. Up and down was okay.  When I closed me eyes, they seemed to go away. In a few days though, at their peak, closing me eyes didn't help either.

I think the peak for them came about 3 wks out from stopping the drug. 

They and the other symptoms gradually got better.  For encouragement, I marked the calender every day &#38; put a star on days when I felt a bit better.  It took 10 months--that's months, not weeks, for things to settle down.

Now, I have permanent tinnitus,shakes, BP uncontrollable, and instead of brain zaps, the occasional Sound of -- zap, zap, zap when I move my eyes. But no more shocks. Just the sound.

Has anyone experienced the sound, without the shocks?

Now for the bad news:

So, 10 months to get down to a few zaps a day. Especially in the morning, when light gets to my eyes.
I hate it but can tolerate it. But the docs still think I'm crazy, even when I tell them it's a published withdrawal effect.  Oh, the lady told me they didn't not know who long they would take to go away, or if they would go away at all.

--I suffered a nerve injury to my wrist. Have been taking pain meds for 10 yrs to cope with that.  We've had to try many different meds, because of my sensitivity or lack of response.

My pain doc &#38; I finally found a combination of meds that were least harmful to me and still helped the nerve pain--major drug is fentanyl.

On with my story:

My doc left that clinic. I've been shuffled from doc to doc for pain management. 

A new doc asked me if I had even tried Cymbalta, it's for nerve pain. I said, no, I wasn't famailiar with it but would try it. (can you see what's coming?).

I took 1, only 1 capsule of the smallest does and guess what--all the discontinuation effects from Effexor are back :(

Can't walk, can't see, hurt, my tinnintus has doubled, I shake so much I cant hold food on a fork/in a spoon, and the brain zap noise (not shocks though) have gone from being a few times a week to nearly constant.

I've been off the 1 Cymbalta for 3 weeks and the symptoms have not abated.  Am I in for another 10 months of this?

Had that doc told me (as he was supposed to) that Cymbalta is a SSNRI, sister to Effexor, I would have never tried it. What really peeves me is I went through with him, face-to-face my problems with meds and what Effexor had done--even the brain zaps (I think this doc thought I was making it up).

I asked him agiain, what is Cymbalta for?  He said, nerve-pain. Not once did he mention it as an SSNRI. 

Now, I recall that my psychatrist &#38; I were looking for a substitute for Effexor. He told me he didn't know of any SSRI or SSNRI that he would consider safe for me to take. The only thing left was Wellbutrine and he was skeptical about it.. But we tried and it's not without problems, but it did get me up &#38; out of bed. But he told me again, if he hadn't seen with his own eyes, what happened to me with Effexor, he wouldn't have believed it. And he knew that his colleages would just put me on something else.  But, he told me, don't let anyone every give me another SSRI or especially anything like Effexor.

So, here I am, back to where I was 7-8 yrs ago. The symptoms, with the exception of the permanent damage had mostly disappeared, but now are back.  The worse being the double loudness and my version of the brain zaps but no shocks--just the sound (which really throws me out of balance &#38; pretty much are incapacitating--just from the sounds of the zaps.

To make this long, long story short. We've tried Effexor &#38; know what it can do. Please NEVER (shout) try another SSNRI, such as Cymbalta, without knowing you risk bringing back all the old horrors. And if you do try it, be followed, very closely.  In my case, it took only 1 capsule to screw me up again--so following closely wouldn't have done any good. It's a Russian roulette that I don't thnk you want to play.

Please comment on having the brain zaps, but now, only the sound  --

Oh, one other discontinuation effect I had, was with my teeth. While I was going through getting off the Effexor, my teeth were fine. One day, I was too ill to brush them. The next day, I noticed the enamle had begun to come off.  The enamle had sloughed off the front of 22 teeth---scary, huh.</description>
		<content:encoded><![CDATA[<p>I had been on zyloft, celexa, for many years, then tried lexapro for my Mj. depression. My doc &amp; I were trying to find a drug that was helpful. None were.<br />
Then he told me about a New drug: Effexor &amp; how it is showing good result for a person with both depression &amp; anxiety. Shall we try it?  I said, &#8220;ok.&#8221;</p>
<p>My history is my body is extremely sensitive to meds&#8211;they either don&#8217;t work or they work with taking a very small (even pediatric) dose.</p>
<p>The Effexor was causing me all kinds of problems. But I was staying with it, to try to work my way through them.  I found myself in the ER twice, before they concluded my pain &amp; problems could be from the Effexor. I had taken it for four weeks.  They said I should come off it.</p>
<p>We did as told in the package insert (USA) &amp; I was off in a week. Prior to that, I was having mem. lose, couldn&#8217;t stand, sweating, shakes&#8211;in fact we counted 52 things going wrong at the same time.  It certainly was time to come off.  </p>
<p>My doc told me I should have called him right away&#8211;but since I had had similar experiences with just about every med I ever took, I stayed with it too long &amp; the side-effects became severe.  The doc said, if ANY drug causes problems at the 2 wk mark, it&#8217;s time to try something else.</p>
<p>So off I went. And here come the brain zaps as well as tinnitus and my BP in those 4 weeks went from 124/72 to 170/150 (It has not stabilized, even today.)</p>
<p>This was about 7 years ago&#8211;when Efx. 1st came out.</p>
<p>When I told my doc about the shocks, I could see on his face he didn&#8217;t believe me. I believe he really thought I was a &#8220;nut&#8221; case. I even thought so myself&#8211;these things can&#8217;t be happening. </p>
<p>My brain zaps were coming fast and hard.</p>
<p>Finally, thinking I was crazy, I called Whythe (sic) labs. They put me through to a nice lady who recorded post marketing symptoms.</p>
<p>I told her about the brain zaps and she told me I was not going crazy. These were legitimate discontinuation effect for some people, especially, those who have come off the med too quickly (although my doc follow the published info on how to do it).</p>
<p>She told me of private instructions they had for people who were having trouble with withdrawal. Go Slow. If the symptoms return go back up if you can, then try a slightly lower dose&#8211;because of the other problems it caused me I needed to get off as quickly as possible. But she said the 1 wk thingy in the publication was wrong. It&#8217;s more like a couple of months to get off.  If having problems, do not cut the dose in half, but empty the capsule and try 3/4 of the dose, and on down like that. If 3/4 was too large, go to 7/8s. And gradually come off it.</p>
<p>It was nice of her to reassure me I wasn&#8217;t loosing my mind. And to tell me the &#8220;inside&#8221; info the company had on how to come off&#8211;too bad they didn&#8217;t tell these things to the docs back then.</p>
<p>The literature made no mention of the electrical-like disturbances, and severe withdrawal that could happen (as it does today.)  I think I read on the web site if a person has been on Effexor for 1 week, they must be withdrawn slowly and watched carefully.   &#8211;that really helps now!</p>
<p>My brain zaps were making a mess. They happened especially when I moved my eyes, side-to-side. Up and down was okay.  When I closed me eyes, they seemed to go away. In a few days though, at their peak, closing me eyes didn&#8217;t help either.</p>
<p>I think the peak for them came about 3 wks out from stopping the drug. </p>
<p>They and the other symptoms gradually got better.  For encouragement, I marked the calender every day &amp; put a star on days when I felt a bit better.  It took 10 months&#8211;that&#8217;s months, not weeks, for things to settle down.</p>
<p>Now, I have permanent tinnitus,shakes, BP uncontrollable, and instead of brain zaps, the occasional Sound of &#8212; zap, zap, zap when I move my eyes. But no more shocks. Just the sound.</p>
<p>Has anyone experienced the sound, without the shocks?</p>
<p>Now for the bad news:</p>
<p>So, 10 months to get down to a few zaps a day. Especially in the morning, when light gets to my eyes.<br />
I hate it but can tolerate it. But the docs still think I&#8217;m crazy, even when I tell them it&#8217;s a published withdrawal effect.  Oh, the lady told me they didn&#8217;t not know who long they would take to go away, or if they would go away at all.</p>
<p>&#8211;I suffered a nerve injury to my wrist. Have been taking pain meds for 10 yrs to cope with that.  We&#8217;ve had to try many different meds, because of my sensitivity or lack of response.</p>
<p>My pain doc &amp; I finally found a combination of meds that were least harmful to me and still helped the nerve pain&#8211;major drug is fentanyl.</p>
<p>On with my story:</p>
<p>My doc left that clinic. I&#8217;ve been shuffled from doc to doc for pain management. </p>
<p>A new doc asked me if I had even tried Cymbalta, it&#8217;s for nerve pain. I said, no, I wasn&#8217;t famailiar with it but would try it. (can you see what&#8217;s coming?).</p>
<p>I took 1, only 1 capsule of the smallest does and guess what&#8211;all the discontinuation effects from Effexor are back <img src='http://s.wordpress.com/wp-includes/images/smilies/icon_sad.gif' alt=':(' class='wp-smiley' /> </p>
<p>Can&#8217;t walk, can&#8217;t see, hurt, my tinnintus has doubled, I shake so much I cant hold food on a fork/in a spoon, and the brain zap noise (not shocks though) have gone from being a few times a week to nearly constant.</p>
<p>I&#8217;ve been off the 1 Cymbalta for 3 weeks and the symptoms have not abated.  Am I in for another 10 months of this?</p>
<p>Had that doc told me (as he was supposed to) that Cymbalta is a SSNRI, sister to Effexor, I would have never tried it. What really peeves me is I went through with him, face-to-face my problems with meds and what Effexor had done&#8211;even the brain zaps (I think this doc thought I was making it up).</p>
<p>I asked him agiain, what is Cymbalta for?  He said, nerve-pain. Not once did he mention it as an SSNRI. </p>
<p>Now, I recall that my psychatrist &amp; I were looking for a substitute for Effexor. He told me he didn&#8217;t know of any SSRI or SSNRI that he would consider safe for me to take. The only thing left was Wellbutrine and he was skeptical about it.. But we tried and it&#8217;s not without problems, but it did get me up &amp; out of bed. But he told me again, if he hadn&#8217;t seen with his own eyes, what happened to me with Effexor, he wouldn&#8217;t have believed it. And he knew that his colleages would just put me on something else.  But, he told me, don&#8217;t let anyone every give me another SSRI or especially anything like Effexor.</p>
<p>So, here I am, back to where I was 7-8 yrs ago. The symptoms, with the exception of the permanent damage had mostly disappeared, but now are back.  The worse being the double loudness and my version of the brain zaps but no shocks&#8211;just the sound (which really throws me out of balance &amp; pretty much are incapacitating&#8211;just from the sounds of the zaps.</p>
<p>To make this long, long story short. We&#8217;ve tried Effexor &amp; know what it can do. Please NEVER (shout) try another SSNRI, such as Cymbalta, without knowing you risk bringing back all the old horrors. And if you do try it, be followed, very closely.  In my case, it took only 1 capsule to screw me up again&#8211;so following closely wouldn&#8217;t have done any good. It&#8217;s a Russian roulette that I don&#8217;t thnk you want to play.</p>
<p>Please comment on having the brain zaps, but now, only the sound  &#8211;</p>
<p>Oh, one other discontinuation effect I had, was with my teeth. While I was going through getting off the Effexor, my teeth were fine. One day, I was too ill to brush them. The next day, I noticed the enamle had begun to come off.  The enamle had sloughed off the front of 22 teeth&#8212;scary, huh.</p>
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		<title>Comment on Aluminum Toxicity by B</title>
		<link>http://theblondepharmacist.wordpress.com/2008/05/23/aluminum-toxicity/#comment-1248</link>
		<dc:creator>B</dc:creator>
		<pubDate>Sat, 31 May 2008 18:56:33 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/?p=112#comment-1248</guid>
		<description>Sorry to disappoint you :)  It's funny though when I ask people who are a little more qualified than me (or you if you are one too ;)) about the issue, their response is, "No one knows..."  It's how I feel as well.. no evidence to support it or no evidence to deny.

And then there's the whole issue of now that I have my own child and things to consider... makes everything a little more important than scouring through the research (and who has the time with a newborn?)...  

However I will say for the record, my son's 2 month vaccines are coming up...  he's getting them all... the only one I'm not doing is Hepatitis B b/c I don't see the point this early.. the rest I'm ok with...</description>
		<content:encoded><![CDATA[<p>Sorry to disappoint you <img src='http://s.wordpress.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' />  It&#8217;s funny though when I ask people who are a little more qualified than me (or you if you are one too ;)) about the issue, their response is, &#8220;No one knows&#8230;&#8221;  It&#8217;s how I feel as well.. no evidence to support it or no evidence to deny.</p>
<p>And then there&#8217;s the whole issue of now that I have my own child and things to consider&#8230; makes everything a little more important than scouring through the research (and who has the time with a newborn?)&#8230;  </p>
<p>However I will say for the record, my son&#8217;s 2 month vaccines are coming up&#8230;  he&#8217;s getting them all&#8230; the only one I&#8217;m not doing is Hepatitis B b/c I don&#8217;t see the point this early.. the rest I&#8217;m ok with&#8230;</p>
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		<title>Comment on Aluminum Toxicity by Nick</title>
		<link>http://theblondepharmacist.wordpress.com/2008/05/23/aluminum-toxicity/#comment-1247</link>
		<dc:creator>Nick</dc:creator>
		<pubDate>Sat, 31 May 2008 17:42:08 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/?p=112#comment-1247</guid>
		<description>No well done epidemiological study has ever found a link between mercury in vaccines and autism.   For that matter, no study has found a link between vaccines in general and autsim.  I would have thought that as a pharmacist you would be able to see the glaring flaws in the studies used to support these contentions.  Considering that our profession (yes, I am one too) is supposed to be the most evidence based of all the health care professions your inability to see through the layers of crap proposed by the anti-vaccinationists is dissapointing.</description>
		<content:encoded><![CDATA[<p>No well done epidemiological study has ever found a link between mercury in vaccines and autism.   For that matter, no study has found a link between vaccines in general and autsim.  I would have thought that as a pharmacist you would be able to see the glaring flaws in the studies used to support these contentions.  Considering that our profession (yes, I am one too) is supposed to be the most evidence based of all the health care professions your inability to see through the layers of crap proposed by the anti-vaccinationists is dissapointing.</p>
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		<title>Comment on Aluminum Toxicity by Tracie B.</title>
		<link>http://theblondepharmacist.wordpress.com/2008/05/23/aluminum-toxicity/#comment-1239</link>
		<dc:creator>Tracie B.</dc:creator>
		<pubDate>Fri, 23 May 2008 03:15:13 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/?p=112#comment-1239</guid>
		<description>Arrrrgh!  Like we parents don't have enough to worry about!  First thimerosol, now aluminum?  I have a 1 yr old that I have been vaccinating (mostly) on schedule, but I do worry every time.  I think I'd worry more if I did not vaccinate, though.  Good information, thanks for the post..I wonder why we haven't heard about this before?

Hope you and your little one are doing well:)</description>
		<content:encoded><![CDATA[<p>Arrrrgh!  Like we parents don&#8217;t have enough to worry about!  First thimerosol, now aluminum?  I have a 1 yr old that I have been vaccinating (mostly) on schedule, but I do worry every time.  I think I&#8217;d worry more if I did not vaccinate, though.  Good information, thanks for the post..I wonder why we haven&#8217;t heard about this before?</p>
<p>Hope you and your little one are doing well <img src='http://s.wordpress.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /></p>
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		<title>Comment on To answer a question&#8230; by bethers21</title>
		<link>http://theblondepharmacist.wordpress.com/2007/10/06/to-answer-a-question/#comment-1238</link>
		<dc:creator>bethers21</dc:creator>
		<pubDate>Thu, 22 May 2008 19:40:29 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/2007/10/06/to-answer-a-question/#comment-1238</guid>
		<description>Yeah, I'm in GA, too.  I've been scouring everywhere for a work from home job.  Remote order entry, DUR, anything.</description>
		<content:encoded><![CDATA[<p>Yeah, I&#8217;m in GA, too.  I&#8217;ve been scouring everywhere for a work from home job.  Remote order entry, DUR, anything.</p>
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		<title>Comment on Working from home continues&#8230; by bethers21</title>
		<link>http://theblondepharmacist.wordpress.com/2007/12/29/working-from-home-continues/#comment-1237</link>
		<dc:creator>bethers21</dc:creator>
		<pubDate>Thu, 22 May 2008 19:30:10 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/2007/12/29/working-from-home-continues/#comment-1237</guid>
		<description>Yes, very interested in working from home!!  I am very interested in any suggestions.  I've googled about every way I can think of and applied to all sorts of medical writer, PBM, industry type positions I can find with no luck yet.  I'm desparate to spend more time with my LO.</description>
		<content:encoded><![CDATA[<p>Yes, very interested in working from home!!  I am very interested in any suggestions.  I&#8217;ve googled about every way I can think of and applied to all sorts of medical writer, PBM, industry type positions I can find with no luck yet.  I&#8217;m desparate to spend more time with my LO.</p>
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		<title>Comment on Vaccines revisited&#8230; by lipstick</title>
		<link>http://theblondepharmacist.wordpress.com/2008/05/01/vaccines-revisited/#comment-1236</link>
		<dc:creator>lipstick</dc:creator>
		<pubDate>Tue, 20 May 2008 02:30:52 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/?p=111#comment-1236</guid>
		<description>hi blonde pharmacist!  I hope you are enjoying your maternity leave and are getting a nap every now and again.  I know what you mean about the whole vaccine thing.  We have kept the schedule mostly, but I am sometimes worried despite myself.</description>
		<content:encoded><![CDATA[<p>hi blonde pharmacist!  I hope you are enjoying your maternity leave and are getting a nap every now and again.  I know what you mean about the whole vaccine thing.  We have kept the schedule mostly, but I am sometimes worried despite myself.</p>
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		<title>Comment on About Me by RphChick</title>
		<link>http://theblondepharmacist.wordpress.com/about-me/#comment-1235</link>
		<dc:creator>RphChick</dc:creator>
		<pubDate>Sat, 17 May 2008 02:30:01 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/about-me/#comment-1235</guid>
		<description>Love your site.</description>
		<content:encoded><![CDATA[<p>Love your site.</p>
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		<title>Comment on Magic Mouthwash - the vague term for a concoction of ANYTHING by PAY FOR WHAT YOU GET</title>
		<link>http://theblondepharmacist.wordpress.com/2007/06/25/magic-mouthwash-the-vague-term-for-a-concoction-of-anything/#comment-1234</link>
		<dc:creator>PAY FOR WHAT YOU GET</dc:creator>
		<pubDate>Fri, 16 May 2008 19:46:04 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/2007/06/25/magic-mouthwash-the-vague-term-for-a-concoction-of-anything/#comment-1234</guid>
		<description>All this confusion , all this lack of knowledge at the Physician level. Consider the expertise of the Pharmacist who straightens it out and makes it happen for the patient.  and you object to a compounding fee?  Should we do it out of charity?</description>
		<content:encoded><![CDATA[<p>All this confusion , all this lack of knowledge at the Physician level. Consider the expertise of the Pharmacist who straightens it out and makes it happen for the patient.  and you object to a compounding fee?  Should we do it out of charity?</p>
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		<title>Comment on Vaccines revisited&#8230; by rxlynn</title>
		<link>http://theblondepharmacist.wordpress.com/2008/05/01/vaccines-revisited/#comment-1232</link>
		<dc:creator>rxlynn</dc:creator>
		<pubDate>Fri, 09 May 2008 21:00:19 +0000</pubDate>
		<guid isPermaLink="false">http://theblondepharmacist.wordpress.com/?p=111#comment-1232</guid>
		<description>Unless you plan to homeschool or apply for exemption, your new little one will have to have vaccines before entering school.  Much of what you read on the Internet on this subject will be extreme (one way or the other).  I would suggest talking with your pediatrician, and (while you might want to wait some) I would not suggest waiting to start until your child is 3 or 4, as it will be MUCH harder to get a toddler to cooperate with all the needles.  As bad as you feel about all the sticking, your child won't remember it if you get the shots done in infancy.</description>
		<content:encoded><![CDATA[<p>Unless you plan to homeschool or apply for exemption, your new little one will have to have vaccines before entering school.  Much of what you read on the Internet on this subject will be extreme (one way or the other).  I would suggest talking with your pediatrician, and (while you might want to wait some) I would not suggest waiting to start until your child is 3 or 4, as it will be MUCH harder to get a toddler to cooperate with all the needles.  As bad as you feel about all the sticking, your child won&#8217;t remember it if you get the shots done in infancy.</p>
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