Today I Don’t Feel Like Doing Anything (Nothing At All)

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Today I have no spoons.  I don’t think.  I just don’t care enough to do anything – not in a bad way, mind you, I’m quite mentally alert and with it … I just … can’t be bothered.

I still did stuff.  I walked the dog at the paddock, did my feeding rounds, did some googling on light weight equipment.  I did my exercises, as prescribed by my physio.

Now I’m home and I’m thinking it’d be nice to do some writing (of the fiction kind, not this rambling mess I call a blog) and I can’t be stuffed.  I don’t want to watch TV, I don’t want to read fanfiction (or fiction … or anything).  I don’t want to knit or crochet.

I used to experience this a lot, but with more gloom.  Now I’m just feeling this but there’s a sort of … peace, contentedness almost, with wanting to feel like an amorphous blob for a bit.

I’m wondering if this is how depression is going to manifest now that I’m on anti-depressants, or if I’m just burnt out (new or continuous, who knows!  I’m sure I’ve been burnt out and barreling forward for years).  I don’t know if finding the root cause will change anything, there’s not a huge amount I can do about either depression or burnout other than what I am doing – which is continue to do the things I must, not do things I don’t, drink water, do light stretches (and the daily walkies) and do relaxing things that I enjoy.

Fibromyalgia and the Sequelae of Stress

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Two days ago I had a very stressful day.

It was an intensely busy day at work, with a very short turnaround on the preparation of some complex documentation to finalise an urgent process the next day.  This is what I’m best at.  I cut my eyeteeth in one of the busiest teams in my first firm in one of the busiest times they’ve ever seen before or since.  I excel at very quickly grasping the scope of the procedure, understanding the interconnectedness of the parties, and logically organising and processing multi-party documents.  The way I work also results in me being prompted to cross-check the information several times before the documentation goes to the person / people I’m working for and so improves accuracy while saving time.  My brain goes a mile a second, checking and cross checking, tracking progress on each party’s bundle, planning two steps ahead so the second I’ve finished one, it’s off for checking and onto the next, and constantly finding ways to optimise the process.

It’s exciting.

The next day?  Not so.  I woke up and my legs didn’t quite want to work right.  My hips and knees had poor stability – I had to walk slowly and carefully to ensure each step was solid and my hips wouldn’t suddenly go whoop out to one side and cause me to fall or slam into something.  I could have walked normally, but that would have involved a massive amount of effort, and I did not have that kind of energy.

Getting my food from my plate to my face was hard.  Every movement I made was shaky and jerky, like my muscles would do one tiny portion of the movement and then stop for a microsecond and then do the next tiny portion of the movement, and so on.

I went to work.

I struggled with putting paperclips on paper.  My arms, hands and fingers were jerky and shaking, my fine motor movements inaccurate.  My entire body trembled.  I had a tiny muscle going tick tick tick tick in my right buttcheek.  I had to walk slowly and carefully and ease myself into and out of my chair.  When I re-stocked paper, I couldn’t crouch like I normally do.  Any bending over required additional support to make sure I didn’t topple, and I relied a lot more on counter-balance rather than on my muscles to hold me stable.

And it was a busy day that day, too!  Only have of the procedure was complete, and I had to finalise the other half, as well as finalising another urgent matter, and receiving (optimistic) instructions to start and finish another the same day (we said nope, that’ll be Monday if we’re lucky), on top of the usual end of the month wrap up.  I took no breaks, half my usual lunch time, and left late.

All the while fighting an extreme muscle weakness, nausea, exhaustion and entire body instability.  By the time I got home last night I was done.

This morning I’m still pretty unstable through the hips and legs, and my movements are still a bit jerky, but nowhere near as bad as they were yesterday.  The weather is pretty crap this weekend so it’s going to be snuggle up on the couch and nap most of the weekend away.  Hopefully I’ll have recovered enough by Monday to do it all again!

Amitriptyline – Two Weeks In

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I have now been on amitriptyline for two weeks.  Well, I will take my 14th pill tonight.  It hasn’t been quite the upheaval that beginning fluoxetine was, but it has been an interesting time.

I’m on amitriptyline while my doctor is awaiting my blood results to rule out other things that can cause fatigue and muscle pain in a similar manner to fibromyalgia.  It’s used to treat both nerve pain and to improve sleep – sleep being one of the more important factors in determining your ambient pain levels during the day.  It succeeded on both counts!  With some … interesting effects.

The first morning after I began taking amitrip it felt like all my muscles were limp noodles.  Walking was an interesting experience.  My hips swung wide and I caught myself on my dresser, on door frames, on couches …  and it was hard just getting my toast from the plate to my mouth.  Nothing quite wanted to cooperate.

I felt a little spaced out.  Not as much of a space cadet as fluoxetine, fortunately.  I didn’t feel like I was permanently lightly high.  I just felt … lighter.  The physical effects of amitrip definitely contributed to the overall light feeling.  I also slept really well.  For the first week at least.

The second week was a bit rougher.  My sleep became more interrupted.  It was harder to fall asleep on the couch at 8.  It didn’t help that I had a lot more commitments in the evening that week, so I wasn’t able to relax for a bit before dozing off.  I started to feel flat, like I wanted to do nothing and be an amorphous blob again.  I began having difficulties concentrating, my words jumbled up.  I felt sluggish.  My body felt heavy, I was sore.  I still had limp noodle muscles first thing in the morning.

Last night (for reasons I’ll blog about later) I had one of the best sleeps I’ve had in a long while and I am now out of a state of pure exhaustion and into a place of just normal tiredness.  The sluggishness, difficulties concentrating, and issues with words were mainly a result of the fact that I was utterly knackered.  Getting some seriously good sleep took that extreme edge off, leaving me with a more normal tiredness I know how to deal with.

The amitrip still makes my muscles noodles, and it’s lovely, because when I wake up in the morning I am not stiff and in pain.  It leaves me a bit wobbly for a few hours, but that is getting better with the exercises my physio has given me for stability.  I am also definitely sleeping better, although not as well as I did during the first week.  I still wake up during the night, just not as frequently.  I also really notice when I have and haven’t slept well the night before – I notice a huge increase in ambient pain levels through my hips and legs and up my back when I’ve slept poorly.  The amitrip only does so much for the pain.

All in all, it’s been an okay couple of weeks.  I’m hoping things continue to improve now that I’m getting better sleep, and the sluggishness goes away the better rested I get.

When You’re Tired – Rest

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I have been a mix of not quite exhausted but very tired this last week, with a mixture of no particular reason and plenty of good reason.

Earlier this week my heart ran a marathon without me, leaving me at first puzzled, then panicked, resulting in an 8 hour stay in the emergency ward and the trauma of an attempted catheterisation.  Fortunately we all concluded that the likely reason for this was the amitriptyline, and I haven’t experienced tachycardia like that since.

It’s phenomenal just how much that utterly wipes you out.  I went straight back into work the next day, so I didn’t take the time to rest and recover.  Work has been quiet the last couple of months (which has been amazing), however we’ve just started picking up in the last week.  There was a seminar that has produced even more leads, so now we’re well and truly under the pump.  Things really kick off when it gets to spring.  Which is good, but also not so good.  I stay busy and I don’t get bored, but I expend a lot more energy during work hours and so need to rest more in the evenings and weekends.

Which is exactly what I’ve been doing.  I’ve been doing as little as humanly possible after work and feeding the menagerie, which basically involves lying on the couch and being sat on by a cat until I fall asleep.  I have to say, it does feel like the amitriptyline is helping – I’m able to get to sleep a lot quicker, and it feels less interrupted.  I still wake up to shuffle when I’m having a flare up and I’m uncomfortable, but I wake up less during the night overall.

It’s important to listen to your body and do what it’s telling you to do.  Right now it’s saying ‘rest, rest, relax’, so that’s exactly what I’m going to do for as long as that’s what my body is saying.

Adding Amitiptyline

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Yesterday my doctor undertook the ‘prod test’ for fibromyalgia.  I reacted to some of the control points (I’m not surprised, my muscles are always tight) and really reacted to enough of the fibro points that he’s sent me off for bloods to rule anything else out.

There’s one point, 2cm caudal to the femoral trochanter that he only had to brush against and I was howling.  The other side, he didn’t so much find it because he knew where it was but because I would start yelping when he got there.

The upside is he’s given me amitriptyline, which has been identified as better than placebo in some trials with regard to fibromyalgia pain.  I’m now on fluoxetine in the morning, and amitriptyline in the evening.  Because they interact, I have to be careful of serotonin syndrome, which is a very serious problem involving too much serotonin.  Fortunately I am almost always around someone who knows what I’m taking, which is so important while my body gets used to the new balance.

So far it’s made me very sleepy in the evening, which is great, because sleep was one of the big problems I have been having.  Fluoxetine is a stimulant and has really taken my easy sleeping days and turned them upside down.  Add the discomfort from fibromyalgia and you’ve got me waking up 5-6 times a night, and that does not make for a happy bunny in the morning.

In the mornings, however, moving is hard.  My muscles don’t quite want to work.  They’d much rather remain in a relaxed state.  My legs wish to retain their noodly ways.  My balance is a little off.  My brain is sluggish and prone to going completely blank.  My reaction times feel a bit slower.  It’s similar to how I felt when I first started fluoxetine, just quite a bit less severe, so I’m interested to see how this progresses.

I had my blood taken today for testing, which is never a fun experience.  I’m very not okay about needles.  They always hurt, the sensation makes me want to jump out of my skin, and I’ll occasionally faint.  Today was no different, although hooray, there was no fainting.  I warned them I’m a sometimes fainter and sometimes puker, and they were very good about putting me on a bed and using the tiniest needle, and keeping me talking all throughout to distract me.  It still hurt quite badly, I still went very fuzzy (and would have fainted if I hadn’t been horizontal), and the site is still incredibly tender.  Because my body has realised it’s been ‘injured’, the rest of the elbow has also flared up and become somewhat painful.  The joys of being tender, I suppose.

Now I just sit tight and wait for a few weeks.  I’ll hopefully know whether or not I likely have fibro by about this time next month.  In the meantime, I get to adjust to amitriptyline!