Sunday, September 20, 2009

Nortriptyline Machine

I'm off that stuff. Let's see how the machine runs sans Nortriptyline.

I waited and kept taking the med, hoping the NP would return my call, then went off it on my own, and finally got a hold of her by calling again and being transferred through a hospital in-house line. Turns out she had been on vacation and it took 3 days for her to catch up on her desk full of work and her meetings, but, "I got your message and it's on my list of call-backs." But, "yes," she said, "some patients experience the opposite of what the medication is supposed to do, and get more wakeful instead of drowsy." So there's a lesson or two: if the med is too weird, don't wait for the docs to call you back. Trust yourself, go off that weird med. And if the docs don't call back, keep calling them. Squeak, wheel; squeak!

I had hoped I was just going through an adjustment period and the sleep thing would even out. I was enjoying increased energy and decreased pain, but as night after night went by with 4 or 5 hours of sleep, I was less and less able to do anything productive with the energy. By day I knocked about doing scattered chores, wishing I could focus clearly on the more urgent needs piled in my paperwork inbox, and particularly on the search for housing. By night I tossed and turned, practiced every relaxation technique I could, and still lay awake with my wheels uselessly spinning. Spin, wheels; spin.

So I went off the Nortriptyline on my own initiative, after having taken it for one week. The NP wrote an Rx for Gabapentin which according to the Mayo "is sometimes helpful in reducing fibromyalgia symptoms," but its original purpose was to control seizures. Those seizure meds can be weird-and-a-half, so I'll do my research before I take it. I hope I can get enough clarity to read up on it soon. Engage, gears; engage.

After going off Nortriptyline I continued to have fragmented sleep for a few more nights, though this could have to do with my PMS, a really bad endometriosis flare-up, perhaps a touch of flu, Fibro/ME flare-up... who knows? I spent several days hitting 8's and 9's on the pain scale. Release the pressure in a steam whistle cadenza, up that scale: Do, re, mi, fa, so, la, ti, ouch.

Day 5 off Nortriptyline, and last night I got back to sleep enough times to patch together a fairly restful night. After a week with no sleep and no brains, and four days of extra pain, do I have some brain capacity available for tough tasks? I look at my in-box overflow. I think about my name on the NP's list of calls to return, and hope those other names on the list got their calls returned. I know how it is to return to work after a vacation or illness and have a pile of work waiting. And I know how it is to have only a couple of hours a day, at best, to catch up on things. Not only that. I know how it is for the sickdays to recur, recur over the course of two years, and the pile to keep piling. Always the overflowing in-box, and never caught up. All I can do, is a very little. Remember the advice of Dr. Hain. Do less, think less, eat less, poop less. Nortriptyline jacked up the pace without alleviating the inflammation. Rev up the engine without replacing the worn out gaskets and where you going to be? Side of the road.

If I'm able to pull back into traffic now, it will be in the slow lane. Pain Doc told me when he prescribed Nortriptyline, "The idea is, it will make you drowsy at night and give you more energy in the day. More energy in the day, you get more active, that gets you tired out, and you sleep at night." I'm sure it works that way for some people, but for me it was wasted fuel. No more Nortriptyline for this machine.

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