CHAOSTOCOSMOS

Monday, 3 January 2011

2011, so far …

imageIt’s still early in the year, certainly, but already, days 2 & 3 have been notable deteriorations from day 1 and this does not really bode well, as starts go.

To begin with, I’d slept through the New Year celebrations, because basically, I couldn’t be arsed. I felt so crap anyway, as I still had a stomach ache – it still feels like someone kicked me in the lower abdomen - after a painful attack of IBS on the morning of the 31st.

Over the Christmas period, the *price* for enjoying turkey, trimmings, pastry & sweet things (really, a LOT less of them than most “normal” people will have had) was that I suffered alternate days of constipation and it’s attendant insupportable migraine-like headache and (after curing those) days with the exact opposite, along with the equally unbearable pains and spasms (like labour contractions) of IBS.

Of course, I took prescribed medication to solve the IBS attacks, so the next day I wouldn’t be able go again and would need constipation relief, pain relief pills ...

Rinse, repeat, repetitively.

And there are only so many hour-long, gut-wrenching bathroom visits one’s body can stand. It left me feeling weak and ill, just as if I’d had serious food poisoning.

(Is it any consolation to think that, without the diarrhea attacks I might have put on more than just the 4 lbs I did over the Christmas Break? No. It. Isn’t!)

Only as long as I stick to my boring meat free, dairy free, wheat free, gluten reduced, chemical free (and consequently often flavour free) diet, mostly, can I keep attacks down to a minimum. Sometimes as long as a month apart. Weekly is more usual.

How often did I get these attacks when I lived in Tenerife? Once or twice, that I can remember, in all 16 years and it certainly didn’t ever need medication.

I’d suffered with, been diagnosed with and treated for IBS, twice, when I’d lived in the UK before; in around 1980 and again in 1989. And it wasn’t the only problem that either disappeared completely, or was reduced to a bearable level out there.

How much of the increase in all of my symptoms is down to the climate in the UK not agreeing with me, the considerably higher levels of pollution; in the air, in a closed and carpeted house, in the food, or the numerous additional stresses I live under here, I really can’t say, but it’s VERY hard to deal with, because, all put together; the fibromyalgia pain from head to foot and in every muscle and joint, the chest pains, the (medical) fatigue, the constant ups and downs in the gastro-intestinal department, the ever-present nausea, the constant fog in my brain that makes me feel like I’m getting Alzheimer's, plus dizzy spells, shaking, orthostatic intolerance that has me swaying like a drunk every time I try to stand for more than 30 seconds or so and that mean I often cannot even sit up, leaves me with a quality of life that …

Well, it has no quality. It’s hardly even a life.

In the meantime, I’m currently trying Venlafaxine (after finding that fluoxetine (Prozac) makes me sweat like a pig and though I tolerated citalopram well, that didn’t really help the situation) as I’d read that Venlafaxine is also well-tolerated, that it’s prescribed to treat orthostatic intolerance and postural orthostatic tachycardia syndrome (that I suffer badly) and, can help reduce the severity of the symptoms of hot flushes in menopausal women (and, by golly, mine certainly need reducing!)

Apparently, Venlafaxine has a similar effect to amitriptyline, which is what is always first prescribed (off-label) for fibromyalgia (it’s reported, because it’s so cheap) in the UK, but which I suffered really bad side-effects and couldn’t get along with.

(It’s the serotonin implications that one needs these anti-depressant drugs with fibromyalgia, not simply because one is depressed, although I am, severely, which should hardly be a surprise with the sum total of what I have to deal with.)

In addition to that, after 2 years of begging, I finally got some medication for pain: Gabapentin. Though, if I were a superstitious person, I might conclude that fate does not really want me to have this, because of the lengths I’ve had to go to to get it:

Once the pain levels became unbearable in the UK, way back in September 2008, I went to the GP, who prescribed the amitriptyline and referred me to a rheumatologist, who confirmed my diagnosis of fibromyalgia and ME/CFS, but could offer no more in terms of treatment than to tell me to keep taking the amitriptyline.

Eventually, I got the prescription changed to fluoxetine (Prozac), but that does nothing for pain and I could see I was really getting nowhere, so I changed GP.

The new one wouldn’t prescribe anything for pain until a specialist recommended it and referred me to the pain management service. In August 2009, I was assessed at one facility, who thought a different facility were better equipped to help me, so I was referred there. I eventually got assessed again in early 2010 and an appointment in the middle of the year, only to find that they cannot prescribe at all.

After all that, in desperation basically, I asked the GP for another referral back to the rheumatologist to (hopefully) a) carry out an MRI scan on my constantly painful hip, b) to investigate the severe pain and loss of movement in my neck and c) to see if she would make this “magical” pain drug recommendation to my GP. She did all of those things and I’m currently waiting for a follow-up appointment to find out the results of the MRI that was done just before Xmas and an X-Ray on my neck.

So on December 15th, I went to the GP to see if she’d got those recommendations and finally got a prescription for the Gabapentin. Went to the chemist with it to find … they didn’t have any, so as I was going for the MRI the following day and wouldn’t have been able to go back again then as they asked (a mile walk there and a mile walk back), arranged for them to deliver the gabapentin when it was available.

By December 23rd, it still hadn’t arrived and I was losing all hope of it arriving before Christmas – I was, naively, hoping for it to relive some pain over the holidays so I could possibly enjoy them for a change – so I walked up to the chemist to chase it, only to discover that they STILL hadn’t had a supply in (snow was blamed) and yet again, was asked if I could come back the next day, Christmas Eve.

I’d specifically wanted to avoid having to go out on Christmas Eve and had done my last bits of shopping on the 23rd, because I didn’t want to repeat the bad flares that exhaustion + cold weather + extra holiday cooking, etc., have caused in previous years. I’d also planned to get a taxi home on the 23rd, to try to mitigate the exhaustion part, but there weren’t any available, so I’d had to trudge home, in the ice, carrying far more shopping than I could really manage and, consequently dropped exhausted when I got home and spent a sleepless night in terrible pain.

Nevertheless, on Christmas Eve, I trudged back in the ice to the chemist, asked for my prescription, was handed the familiar green paper bag and walked home.

You don’t tend to open the bag at the time in the chemist: you accept the prescription you are handed, on faith. That’s something I won’t be doing ever again! I opened it when I got home and found that it wasn’t the Gabapentin, it contained Fluoxetine.

Back in August I’d had to go back and forth to the doctors umpteen times because a prescription had gone missing. At that time I did NOT have (had not yet made the arrangements) for the surgery to send my prescriptions to the chemist, so it was definitely the surgery who “lost” it … well, this was it, at the chemist all that time.

So I had to phone the chemist to see if they still had the prescription for the gabapentin. It had JUST come in, so it hadn’t been there when I’d called earlier. I gave the pharmacist an hour to get it made up and this time, ordered a taxi to take me up there, wait for me while I got the prescription and then bring me home again. Just having to go out again was enough, I couldn’t possibly have walked all that way for a second time in the same day. Of course, it cost an arm and a leg, but I hoped that some pain relief would “relieve” the shock of this extra expenditure.

So, Christmas Day, I started off knackered, I started on a new drug – which gave me a recreational quality, but very unpleasant “high” – and also started on a week of eating all the wrong things. It was a recipe for a bloody disaster, wasn’t it?

When I read the label, I discovered that the gabapentin contains lactose and I’m  lactose intolerant. You’d think it would be such a small amount that it wouldn’t cause a problem, but I get relevant symptoms as soon as I’ve taken it, so I’m sure that it does and is adding to the increased severity and incidence of the IBS attacks.

Also, on the second or third day of taking it, I started getting severe chest pains and tightness again. At one point I was lying in bed and I could hardly breathe (and certainly couldn’t move to get help.) Apparently, this is a possible side effect of the Gabapentin and one that I should have sought immediate medical attention for.

It’s certainly not the first time I’ve had chest pains and whilst I am sure that various drugs have sparked off new episodes, I think these chest pains are all part of the fibromyalgia and ME/CFS. These symptoms; chest pain, shortness of breath, tightness of the chest, palpitations, are also part of the cardiac arrhythmia - ectopic beat (or cardiac ectopy), also known as Premature Ventricular Contraction (PVC) – that was discovered when I had a 24 hour ECG done back in October.

Amongst other data, one reads thatIn a PVC, the ventricles contract first, which means that circulation is inefficient.” This makes sense, finally, as this fits in with my generally low blood pressure, the orthostatic intolerance and low blood volume (that cause blood pooling and pain in my legs). The trouble is, I’m already taking all the medications, supplements and dietary modifications that could help with it.

And, since (amongst many other things), mitral valve prolapse (known to be co-morbid with fibromyalgia / me/cfs), magnesium and potassium deficiencies, adrenaline excess, lack of sleep/exhaustion and stress (all also noted as related to / symptoms of) are cited as possible causes of PVC, it’s all a bit “chicken and egg”.

Did the PVC cause the fibro, etc., or did the fibro cause the heart arrhythmia? Will I ever know? I doubt it. Will I ever find a cure? Even more doubtful, I reckon.

I’ll see how it goes and what the GP says at some point, but otherwise, I’ve been advised that I may need to give the gabapentin three months before its therapeutic effects may be apparent. So, no, it hasn’t had any pain relieving effect yet.

Quite the contrary: I’ve suffered worse pain in the last few days than ever before.

Saturday, the 1st of the month and the year, I managed to check and update my meagre finances, pay the odd bill and generally “potter” a bit on the internet.

Yesterday, I couldn’t even manage that. I woke up too early, from not enough sleep, feeling already absolutely and utterly exhausted. By mid-morning I gave up. I couldn’t sleep, because I’d gone way beyond tired, but I couldn’t do anything productive either, so I lay down to half watch some banal TV that I didn’t need to think to follow.

Today, I wrote this, but otherwise, it ain’t shaping up to be a much better day. In what way can I see any of these things improving in 2011? Frankly, I can’t.

(Oh, the one piece of potential “good news” I have discovered so far this year is that one possible side effect of the Venlafaxine is weight loss, which is fantastic, since one of the potential side effects of the Gabapentin, apparently, is weight gain! Oh boy!)

Pamela is a former accountant, recovering journalist and international cat herder, disabled and chronically sick with Myalgic Encephalomyelitis, Fibromyalgia and Cervical spondylosis, fluent in three languages; English, Spanish and Rubbish. Mostly writes in the latter. She likes Genealogy, Model Railways and Cats.

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