Wednesday, May 18, 2011

An Update, and A Call For Prayers

First, let's talk about me. It's been almost two weeks since I posted about the Cymbalta incident, and I am still feeling the effects of that. Thankfully they are almost non-existent, but every once in a while, I notice.

I went through a very rough period after the Cymbalta incident. It seemed as if all of my medications had stopped working, and the pain was impossible to ignore, and I was not able to cope. I saw my PCP about it, and he went through his ideas for treatment with me. Most of them were medications I had previously tried that had no effect. Then he suggested raising my prednisone dose, which I told him the Mayo Rheumatologist did NOT want happening, so that was out. Finally he suggested that maybe my issues were from lack of sleep, as I hadn't slept well in months. He prescribed Valium to try and help me sleep (I can't do most actual sleep meds) and hoped that would help, otherwise we'd be back at square one.

The first couple of nights didn't work, I was taking the Valium, plus Unisom and Melatonin to try to get sleep. No dice. The third night I discont'd the Melatonin, and switched from Unisom SleepGels (diphenhydramine) to Unisom SleepTabs (doxylamine). That night I slept like a rock, had multiple dreams, and woke up the next day in complete awe of what a good night sleep could do. I hadn't felt that good in YEARS. I had energy, felt like doing things, and though I had some minor aches, they weren't even bad enough to warrant an ibuprofen. I have been feeling pretty good since, and I really hope it continues.

Now for the prayer request.
I've written about my friend Becca a few times, I met her last summer in pain rehab at the Mayo Clinic. She was diagnosed at 4 with Primary Sclerosing Colangitis. She's had two liver transplants, but is currently in need of a third. I went to visit her at the beginning of April. The first day and a half of my visit she was doing okay, and we enjoyed a wonderful warm day out. On my third day, her nausea was so overwhelming that I took her to the hospital. She was admitted, and has basically been in ever since. She was released for a day or so, only to transfer from one hospital to another that has a liver transplant clinic. She is not doing very well. Her nausea is such that she can barely eat, and they are considering putting in a feeding tube. Her quality of life right now is not so great, and I worry about her quite a bit. She is only 23 years old, and one of the most genuinely kind, caring people I have ever met. Even as sick as she is, she makes origami for other patients, and talks with them. So if you could spare a prayer, a thought, or even just some healing vibes and send them her way, that would be great.

Hope you are all well.

Thursday, May 5, 2011

Missing Meds: The effects doctors don't warn you about.

According to Wikipedia, "Duloxetine (sold under the brand names CymbaltaAriclaimXeristarYentreveis a serotonin-norepinephrine reuptake inhibitor manufactured and marketed by Eli Lilly. It is effective for major depressive disorder and has been shown to be as effective as venlafaxine for generalized anxiety disorder (GAD). Duloxetine alleviates pain associated with diabetic neuropathy and fibromyalgia."

True. Doctors have been pushing Cymbalta on people since it came on the market. I personally ended up on Cymbalta after the councilor I was seeing for some various family and depression issues, suggested I speak with my psychiatrist about changing medications, as he believed my Sertraline (brand name Zoloft) had become ineffective.

So I saw my psychiatrist. She agreed a med switch may make things a little easier, and suggested I go on Cymbalta. I agreed, as I had no reason to doubt her judgement. At that time she also told me she'd like to see me back in three months, but she would be switching clinics. I agreed to follow her to the new clinic.

Fast forward to Friday, April 29th. I was on my last pill of a 3 month supply. I had forgotten to make the appointment with my psychiatrist, and there were no refills on my medication. Drat. Since I'd never previously had any problem skipping a few days of meds, I decided to wait until Monday to call. Friday was also the day I went to the horse expo with my roommate, we walked three miles, and I horribly overdid things. That night I started feeling sick.

By Saturday, my sleep patterns were a bit messed up, and I was having some light dizziness and nausea. I attributed all of that to my time spent at expo. Sunday the dizziness and nausea were worse, and I could not sleep for the life of me. Every muscle felt tense and my brain felt hyperaware of the dizziness. By Monday night, I'd had enough. At 10:30pm my roommate and I took off for the emergency room. At this time I was still attributing things to my overdoing it at expo. They gave me zofran for the nausea, it did nothing. Tramadol for the pain, more nothing. They finally gave me a shot of domperidone, and that took care of the nausea. At this point, I was exhausted, but also felt like every nerve and muscle in my body was on full alert and wide awake. By the time we got home at 2am, I still couldn't sleep.

Tuesday I woke up and felt fine for the first 30 minutes of being awake, and then it all hit me at once. Dizziness, nausea, blurred vision, brain fog, hyperaware nerves, insomnia, tremors, confusion, "zaps", profuse sweating, feeling flushed, vertigo, irritability, aggression, anxiety, headache, lethargy, nightmares, extreme muscle tension. You name the symptom. I had it. I felt like I was dying. It was while looking through my pill bottles for something, ANYTHING that might work, that I came across my empty Cymbalta bottle. It was then that I put two and two together. I googled Cymbalta withdrawal. The things I read were horrific, and yet so familiar. I was never warned about any of it.

My problems did not stop there, however. I could not get my medication refilled until Wednesday, since they would have to call in to the clinic I went to. Wednesday my symptoms had increased yet again, and I was in a constant haze. My mom called me at 7:30pm saying they had my meds, and I drove the forty-five minutes home to get them. I took one at 8pm. I returned to my apartment by 9:30 and decided to have dinner. BAD IDEA. The nausea, which had been just barely tolerable, became impossible to ignore. By 11:30pm I felt so awful that I called my mother in tears, pleading for her to make it stop. After that call, I went back to my bed, across from my soundly sleeping roommate, and spent the next hour trying not to vomit.

Thankfully, at 12:30am, the medication seemed to have entered my system, and the nausea backed off enough for me to fall into a fitful sleep. I woke up at 6am and took all my medications, including a zofran. Now that the day is wearing on, and I have had 60mg of Cymbalta in my system, I am feeling much more human. Still slightly dizzy, a tiny bit nauseous, and I have a headache, but I will take that over everything I had yesterday.

So take this story as a warning, and ask your doctor if any new medications he or she prescribes to you have side effects and or cessation effects. I wish I had know, maybe I wouldn't have had to suffer.