Sunday, 26 July 2015

Amitriptyline to control pain? I'll pass, Thanks.

Occasionally I write about medical stuff. Either because I'm frustrated, or annoyed and venting, or because it's something which might be useful to someone else.

In this case I'm aiming for the former, but the latter is a motivator.  This is my personal experience, from my point of view and if it's useful, insightful or interesting, ace. It's not designed to be advisory.

I wasn't going to write about this- I'm not exactly delighted with the outcome and I'm surprised by how badly this "experiment" went. However, I would have felt better if I'd known that my not-so-positive experience is actually pretty "normal", and not me losing my few, remaining marbles.

I'm reasonably open minded in terms of medical stuff. I can be sceptical but I'll still give it a go. I'd still try things out, but perhaps after this I'd ask a few more questions before hand.

The scenario:
I've been having stomach/abdominal pain for years now as a result of my Thyroid becoming under active, kicking my metabolism into what felt like reverse and damaging my stomach in the process. The thyroid is now under control with Levothyroxine and my stomach should now be behaving itself, Physically theres nothing wrong with it (Stomach issues are common with Thyroid conditions- essentially anything autoimmune is a likelihood, so I know I'm lucky that this manifests as "IBS type" symptoms, sickness and pain, not Crones, Diabetes etc) but I'm ill most days now and in pain all the time.

The background thinking-The consultant at the hospital wanted to try something new:
There are journals, published in the last few years which suggest that Amitriptyline can be used to "reset" the nervous system, as if nerves are constantly sending a "pain" signal they can become disrupted and the receptors inflamed/"broken" so your body still perceives a problem, even though it's actually fixed.
Amitriptyline isn't really used as an antidepressant any more as one of it's more unusual side effects (Other than psychosis) is that it affects the nervous system- and therefore stops you recognising pain properly.

The planning:
I read the side effects list through, and although it's huge, it makes for less scary reading than the contraceptive pill. I take medication every day and have not experienced any side effects so I mostly laughed them off.
The hospital warned me that they'd make me "tired". I already experience fatigue so I wasn't delighted by the prospect of feeling more exhausted than usual.
The box had a sticker on it that said "You may not wish to drive when taking this medication" I figured that related to tiredness and decided to be responsible, and give myself plenty of time before going into work to make sure I was really awake.

It turns out that I seem to be very receptive to these kinds of drugs. Nothing could have prepared me for  developing the whole list of side effects on day 1. On day 7 I almost had a head on crash and so gave up taking the tablets, after consulting my GP...I will explain later.

The outcome:
I want to preface this by saying that I believe that my mental health is actually pretty good. I get stressed out or down occasionally but on the whole I'm happy, and level headed. You can see from the sheer volume of things I do usually that I'm pretty motivated and enthusiastic.
Taking these was like a brain transplant. my body was still running at usual speed but my mind was in reverse!

I couldn't concentrate to follow conversations, I'd forget that I'd done things, I'd forget to eat, I lost my keys, I couldn't watch TV because I couldn't work out what was going on in the TV show. I couldn't crochet or craft because I couldn't get my hands to do what I wanted.I was late for everything, I forgot peoples names, It was pretty weird. And a bit scary. I'd find myself unable to deal with "normal" everyday things- I couldn't remember how to use the washing machine, my spacial awareness was bad and I poured boiling water on my foot. I couldn't buckle my own sandals.
When I went paddle boarding I launched the board and went to jump onto it but missed completely and threw myself into the lake.

Writing this now it sounds kind funny.
It was like being really drunk, but without that uninhibited feeling.
It was pretty isolating.

The days felt really long, so even if I'd had a text or a call or seen someone in the morning, by the evening it felt like I hadn't spoken to anyone for a week. I started to get jealous when I saw posts online or friends said they were meeting each other- but I couldn't deal with being with people, because I couldn't follow their conversations or carry out normal things very easily but seeing other people together made me feel lonely. Because the days felt so long, I started to think people were avoiding me (Even though they were doing what they usually do in terms of texts/calls/seeing them). By about day 3 I was pretty convinced that all my friends hated me.
I had a good cry about it on Traff who was throughly alarmed.
On Day 4 I cancelled all my future plans with my friends because I truly believed that they didn't like me or want to see me anyway and I'd somehow forced my unwanted company on them. I told Traff he hated me. He wore his expression of "kicked puppy" and I had no emotional response. Actually he dealt with it all very well.
By Day 5 I'd turned into a complete emotional mess. I probably managed to confuse and upset almost everyone I speak to on a regular basis. My coordination was totally shot and following normal conversations was nigh on impossible. I did an awful lot of nodding and smiling. Day 6 and Day 7 passed in much the same way.
Except on Day 7, on my way to work, I pulled out in front of a car. I was thinking "Brake" but my foot did not hit the brake. It stayed on the accelerator. It was very scary.

I made an appointment with my GP (Who I'm still avoiding, because he keeps telling me how overweight I am and how I should eat less food) I explained what had happened and he just raised his eyebrows and said "The medication is resetting your nervous system- Of course thats going to mean that sometimes signals don't get to the right place".
In fairness, The tablets were issued by the hospital, and perhaps they should have made that a little clearer.
He told me I would have to stop driving.
I asked how long for, and he explained that I'd need to take at least  1 30 microgram tablet every day for it to manage my pain. Possibly forever but at least for 6 months. He explained that as I was on 10 micrograms currently, I'd take that for 4-8 weeks until I'd "Got used" to the side effects, or they'd subsided (Theres no way to know if they will, and it's pretty 50/50) then they up the dose, wait 4-8 weeks for you to learn to live with it and etc etc.
Basically, at best, that mens I wouldn't be able to drive until the new year- so I wouldn't be able to visit my family, or my friends and I'd be reliant on them coming to visit me if I wanted to see them. It would also be a complete fucker for work.
Couple that with all the other side effects (Imagine them 3X worse!) and I said I couldn't do it.
I quit.

I'd rather be in pain and ill than mental, incapable and probably still ill.
The pain I can manage, it just makes me grumpy and sometimes means I have to cancel plans. Being unable to perform simple tasks or drive or do my job or deal with any social situation is a rubbish trade off.

It's not something I'd rule out completely. Maybe with a different drug I wouldn't end up in such a pickle.
But I wouldn't take that again! Even if you paid me lots of money!

So, you'll be pleased to know that I'm more-or-less back to my usual self.
It's taken a while but I'm feeling much better. It's safe to post your pictures of you having a lovely time with other people. It won't make me cry any more.

Thank you and sorry to everyone who's had to deal with me when I've been a raging neurotic nightmare.
I am really grateful for your support, especially the phone calls and texts. They were always timely- you must all be psychic. As soon as I'd got myself into a dark place someone would send me some encouragement. It really helped just knowing that someone had thought of me- it made me challenge my own negative thoughts.


The only up side to the whole experiment is that I had the best 7 nights sleep I've ever had in my whole life!








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