GABAPENTIN

My blog post today begins with a medicine update. I started taking the Gabapentin several days ago. This is the medicine that has a prominent warning: “You should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so.” I haven’t noticed any of these type of tendencies so far and hope that my drive for contribution to life is strong enough to overpower any such feelings. Nevertheless, I’m on the watch for any downturn in my attitude.

Although I’m taking two Gabapentin tablets three times a day, I don’t think I’ve noticed any other side effects. I can’t say that I’ve noticed any pain relief affects either yet, but I know the medicine has to build up. Anyway, I still have symptoms but it seems that it’s a continuation of my withdrawal symptoms. I would think that the withdrawal symptoms would be gone by now but I’m still struggling to keep the ship upright sometimes. Maybe Gabapentin took over where the other left off.

One good thing about being off of those other medications is that I’m down to one drug combination instead of four that acts as a sedative. Although I still fight fatigue as a result of Gleevec and anemia, I’m not nearly so tired all the time. In fact, I haven’t taken a nap in about a week. That’s a record for me since starting all this mess about two years ago. There’s one other bit of unfortunate news, as you may recall, Gleevec patients average a weight gain of over 20 pounds due to fluid retention, metabolism changes, and increased appetite. I’m glad I gained much less than that. Unfortunately, Gabapentin does the same thing. In fact, I’ve gained several pounds since taking Gabapentin without adding a thing to my diet. That doesn’t make me happy but if it’s the worst side effect I end up with I’ll be content.

A neighbor gave us some lemons and satsumas (oranges) from her father’s tree. I decided to make a lemon pie. I’ve never done that before and a friend suggested that the medicine is affecting my mind for me trying!! Pie making apparently isn’t my calling. I think the pie turned out fine but I started with a recipe for two pies!! I was trying to get the mixture to thicken. I boiled it and boiled it. Then I noticed that half my mixture was gone. So I stopped cooking it. I went to pour the mixture in the two pie crusts but only had enough for one!! I then attempted to make meringue. It was a disaster. After scooping the meringue back out and off the pie filling, I put the pie in the refrigerator. It has thickened up and looks good. We’ll have to see later how it tastes!!

THE FROG AND ME

My oldest brother took me out to the woods today. He was going to be hunting deer while I brought a camera and a video camera. I’ve never been much of a hunter. I was stationed in an elevated shooting hut while my brother was in a tree stand about a hundred yards away. I climbed the stand and opened the door. One of the first things I noticed was a little tree frog on the back of a chair. I moved the chair to a better position but just left the frog alone. Soon though, he was on the ledge of one of the windows. I took its picture.

Just sitting there is what I did for several hours. Time passed by quickly though as I watched for deer, looked through binoculars, did some texting, and just sat and thought. My brother said, “He does his best thinking in the shower and tree stand: The tree stand uses less water.” That kind of applies to me too. The serenity of being out in the woods is amazing. It gave a lot of time to just sit and think. At times I just sat there and looked at the frog on the ledge.

Soon the sun went down but I hadn’t seen a single deer. It was time to pack up and head back. I guess the little frog had to leave too because I checked on him just before I climbed out of the tree stand. He was gone. My brother drove the four-wheeler with me on the back through the paths in the woods and then on the dirt roads back to the car. It was a great afternoon chatting with my brother and being in the shooting hut for several hours with just the frog and me.

DUAL ENROLLMENT

Our youngest daughter is a senior in high school. She plans on studying business in college with a specialization in finance. During her high school years, she has taken some Dual Enrollment classes which are college classes which give both high school and college credits. Having been preparing for college through high school, she has not only taken several college classes but she has fulfilled all her high school requirements a semester early. Therefore, she has decided to take a full load of Dual Enrollment classes at a local college for her spring semester of high school.

The good thing about Dual Enrollment classes is that it is funded through the high school. Therefore, there isn’t additional cost to the student/parents for the classes or books. Again, the classes are actually college classes so they count both for high school and college. The dual enrollment college classes our daughter will be taking this spring are College Chemistry, Economics, Accounting, Statistics, and Psychology. She’ll have her hands full but she is a hard worker.

Our daughter’s choice to take dual enrollment classes will save her time and money in college. After this spring semester, she will have 43 semester hours of college credit upon graduation from high school. That’s just a strong semester worth of credit hours away from having completed her first two years of college while in high school.

BRIGHT FUTURES

Many state lotteries have sold themselves by advertising that they fund education. Of course what usually happens is that monies made by the lottery are offset by other cuts to educational funding. So, rather that the lottery being a big boon for education it is really a boon to the general fund. Nevertheless, Florida is one of the states that decided to use some of its lottery money to fund a special scholarship program called Bright Futures. It’s one of the few non-needs based scholarships left; it’s achievement based. Originally if a high school student attained a certain grade point average, scored high enough on the ACT/SAT, and did a prescribed number of community service hours, then Bright Futures would pay either 75% or 100% of in-state tuition, depending on the respective achievements. At the 100% achievement level, $300.00 of book expenses was covered too. Those were the guideline when our three oldest children began college. Now things have changed.

A few short years later as our youngest child is about to begin college, the 100% level has dropped to 56%. The 75% level has dropped to 42%. The funding has dropped almost 20% in the last year. It’s not a case that the lottery business in Florida is hurting. Once again the state’s general fund is siphoning off money that was intended for education. It’s hard to trust legislators with finances.

THE DOCTOR’S CALL

I thought about not giving the letter to my family doctor and just wait to talk to him at my appointment in two weeks. I decided that I can just tough it out until then. However, as the weather began to turn again, I decided I better stop being relatively passive about my arm and force something to give. So, after going to Whataburger for coffee with a friend, I drove to my doctor’s clinic and gave the letter to the receptionist. I asked that she makes sure that my doctor gets the envelope. I had put the letter in an envelope with his name on the outside. I wrote “personal” at the bottom of the envelope and underlined it with a yellow highlighter. I then went home to await a call from his office. I don’t imagine he’ll get a chance to see it before lunch so I’ll make sure I hang around the phone until after the lunch hour. If they don’t call by then, it could be later in the afternoon…if at all!!

So, I started this blog post while I wait for the call. While I’m waiting, I want to share part of a conversation I had with our oldest daughter yesterday. She commented about me referring to Gabapentin as my “suicide” medication. She reminded me that I raised them on positive concepts and didn’t tolerate possible negative self-fulfilling comments or thoughts. I laughed when she said that as I thought, “Hey, maybe some of that stuck with the kids after all!!” So, I told her that she was right and that I wouldn’t call Gabapentin “suicide” medication any longer. The point is that if I have to actually take Gabapentin, it’s not a good thing to have programmed my mind that it is “suicide” medication. I suppose I should practice what I preach!!

Okay… I waited by the phone until after the lunch hour. Then I left the house for about an hour. When I got back there was a message on the answering machine from the doctor’s office. I called back but got the voicemail. Later in the afternoon the doctor’s nurse called again. She assured me that the doctor had responded to my phone message but apologized that the office dropped the callback. She said that she was out of the office that day and the next several. The doctor had given the substitute nurse his directions for me. She didn’t follow through in calling me. The nurse again apologized and said that if I ever have any questions to ask for the direct line to her; don’t leave a message with the message center. Then she got down to what my doctor wanted me to do. She said that the doctor wants me to follow the neurologist’s recommendation but come off the Tramadol and Lortab slowly. She said that the doctor himself has taken Gabapentin and was confident I’d tolerate it fine. Since I already have an appointment in two weeks he’d check with me then, unless I develop problems with it. I told her that I was already off the Tramadol and Lortab for a week although I might decide to take one now and then if these withdrawal symptoms don’t go away. The nurse reiterated that the doctor wants me off of it so not to use it too often.

Now I wish that I hadn’t been calling Gabapentin “suicide” medication!! I’ll suppose I’ll probably start taking them once I get my mind right… because I need to do something.

THE SAGA LIVES ON

As you’ve read my last several posts about my medications, you probably think the discussion has run its course. Not quite so fast. Until I get my medications settled, I’m likely to have plenty to say yet!! As I still endure some of the effects of coming off not only Tramadol and Lortab, but coming off both at the same time, I’m not very happy with the way this has transpired. Similarly, I’m not happy to be facing this colder weather without some help. So, I blog on about the culprits in this situation.

First of all, the neurologist: He knew that I had been taking both medications for years. For all he knew, I was desperately taking maximum doses instead of minimal to moderate dosages. If what I’ve been going through in the form of withdrawal is any indication, God help those who are heavier users trying to go off the stuff. Anyway, it sure would have been nice if the neurologist would have warned me or offered me some help. I suppose he didn’t think I’d give the narcotics up, so he didn’t bother. I hope that isn’t the case but I have little else to explain it. I don’t know whether I feel abandoned or like I was sent to slay a dragon with a pea shooter. Meanwhile, I still have my unused “suicide” medication sitting next to me. For new readers, that is what I call the Gabapentin that I’m supposed to take two tablets of three times a day. The reason I’ve labeled it such is because the warning on the medication says: “You should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so.” Calling it “suicide” medication might be a little too uncharacteristically negative of me, but right now I’m not sure I’d take a Milky Way candy bar if the neurologist prescribed it!!

Secondly, there is my family doctor’s office. I’m still giving the doctor the benefit of the doubt and presume the communication problem is in the bureaucracy of the office. However, I know this kind of poor communication happens to a lot of people and doctors shouldn’t tolerate it from their staffs. As life often presents itself, I have an appointment with my family doctor in two weeks. We’ll have a nice chat then. Meanwhile, if his office would have answered my questions about me going off the Tramadol and Lortab, and going onto Gabapentin, I could have been spared my “cold turkey” drama. Since I followed the neurologist’s admonitions while waiting to get it confirmed by my family doctor, well, I had some unnecessary troubles. Surely, my doctor would have helped me come off them correctly… if he agreed for me to come off them at all. It’s too late though; I’m not inclined to go back onto them until and unless there’s no other way.

Thirdly, there is myself. When things were getting a bit tough, Eileen suggested (several times) that I take a dose to help ease the pain in my arm and the withdrawal. She didn’t use the word “withdrawal” and the word never really entered my head until I was through the worst of it. I suppose it is because the arm pain and stomach pain can make me rather ill. I wish I would have thought of and researched “withdrawal” much earlier than what I did. As usual, I should have listened to Eileen instead of finding a fine time to follow the neurologist’s directive: “Stop taking the Tramadol and Lortab.” Nevertheless, it shouldn’t be left to patients to research and double check their doctor’s pharmaceutical advice. I instinctively don’t like taking medications and I guess I was a bit jubilant in the opportunity to get rid of two medications that were adversely interacting with each other while adding one that didn’t interact adversely with any of them. Only later did I find out what it was that the neurologist wanted me to take instead… and what going off the medications would be like.

Well, life goes on but prescription drugs are pretty serious things to be inattentive about. Chalk it up to another lesson learned at the hand of my doctors.

UPDATE: After another rough night, I decided to write a letter to my family doctor. Tomorrow morning I’ll deliver the letter his office. It’s a very gentle letter as I continue to give the doctor the benefit of the doubt, but it makes the point. I’ll let you know what happens.

DRUG ADDICTION

With great interest I read the article by John Roberts, “Report: Prescription Drug Deaths Skyrocket.” The article said, “In 2008, the most recent year for which there are statistics, there were 20,044 overdose deaths from prescription drugs. Of those, 14,800 were from narcotic painkillers.” “It’s astonishing”, says Dr. Frieden. He adds that many addictions begin innocently.” “Despite modest inroads, CDC researchers say the epidemic of prescription narcotic overdoses has continued to worsen. In today’s report, they caution doctors to only use narcotic painkillers in patients who are carefully screened and monitored, and for whom non-narcotic medications are insufficient.”

There are a lot of people who have terrible pain and they don’t really care if they are addicted to the pain medication or not, as long as they get some relief. However, I’m sure they do care if they die from overdosing because the addiction requires more and more to get the same effect!! I’ve had my share of narcotics and narcotic-like drugs, but I’ve never been to the point where I craved more and more of them. It’s probably because I despise them so much that I’ve taken as little as I could. Nevertheless, coming off my pain killers has not been delightful. Knowing what I know now, I’m sure there was some sort of physical dependency. I wish the neurologist would have given me a little more guidance in coming off the Tramadol and Lortab since I had been taking them for years. Earlier today I read:

“Tramadol withdrawal can be extremely unpleasant. It can be so uncomfortable that people start taking the drug again in order to relieve these symptoms. In order to limit withdrawal, you should not stop taking Tramadol "cold turkey."’

“Even when Lortab is prescribed and used in the correct way, stopping the medication will still involve withdrawal symptoms.  Recovery from these withdrawal symptoms, takes effort and time, and is best done at an outpatient detox facility. The dependence makes it very difficult to stop or dramatically reduce the dosage, due to the occurrence of traumatic Lortab withdrawal symptoms.”

That information might have been useful before I went through the heebie jeebies, cold sweats, palpitations, lightheadedness, shakes and such!! Thank God I have a determined (stubborn) streak!! I’m pretty well over it now but my system hasn’t totally calmed down yet. What’s worse? Although I’m going to give Advil and perhaps the “suicide” medicine a chance, I could be back on Tramadol and Lortab if this is a rough winter. When things get bad enough, addiction is only a problem if you can’t get enough medication or it makes you dysfunctional. It’s too vivid of a memory for me of when I’ve been in situations when I wouldn’t have much cared about being addicted if that is it took to get some arm relief. Having said that… I will endure a lot before going back on them. The above mentioned article is a little scary.  I would be sorely disappointed in myself and my role as a husband, father, and grandparent if things progressed to the point that I lived the life of a drug addict.