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!

 

When the Fog Lifts

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These last few days it has felt like the sun has finally risen in my head and a miasma of illness has cleared.  I must have been a lot sicker than I realised, because looking back, it seems as though my head hasn’t been clear in weeks.

Now, finally, I’m feeling alert, like I have some actual energy and ability to do things again.  It’s a lovely feeling after so long of not.

I’ve been taking full advantage of it while it’s here – I’m reorganising my lounge so I have my reading and crafting nook (where a large chair will eventually be placed).  The amazing human has organised his desk so he has more room and it’s tidier and how he wants it to be.  I’m keeping my eyes out for shelving I can put in various areas of the lounge so I can unpack some of the remaining four boxes of books I have.  I steam cleaned a test area of the carpet.  I’m prepping to clean all the sofa cushion covers…

Spring has sprung, both literally and within me.  I find this cycle every year – it’s not until days not only start getting longer, but we actually start to get more sun and nicer weather (especially on weekends, as I don’t get out much during the week days), that my energy levels return and I’m able to function as a normal human being.

It helps immensely that my physio made a minor adjustment to my pelvic rotation and spine.  It was a minor adjustment that has had a massive impact.  I’m able to walk a lot more easily, relax my whole back, and stand up straighter.  This in turn has helped with my shoulders and neck being overly tight (they’re a lot looser now), releasing tension at the base of my skull and resulting in a lot less neck pain and an almost immediate cessation of headaches.

I find it interesting how much a few tense muscles can affect your whole body.

Happiness is …

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If there is one thing I have learned about happiness, it’s that it is as unique and distinct to each person as their personality and looks are.  Everyone has different things that make them happy.  There may be some commonality, but there will always be a few quirks!  We can also learn a lot about happiness from other people.  They may be able to put it into words and suddenly you realise you get happiness from that thing, too.

So for me, happiness is…

That quiet on the weekend mornings before the rest of the world wakes up.  Warm coffee with honey.

Watching the sun move around my living room floor, watching the cats (and dog) chase it in varying degrees of dumpling and sprawl.

A clean kitchen and a tidy home – it’ll never fully be clean just because of the amount of cat hair (I’m looking at you, oh short-haired one) that permeates all soft furnishings, but it can at least be tidy.  Airing out the house on a sunny day.

Lying on the couch, watching terrible murder shows (like Forensic Files) and playing dinky little games (Sally’s Salon is a favourite), and then rolling over to have a nap.

Snuggling into my onesie.  Spending entire weekends in my onesie except for dog walks.

Seeing the weather is lovely outside and knowing I don’t have to do anything if I don’t want to.  Seeing the weather is awful outside and knowing I can stay snuggled up on the couch and not feel like I have to make the most of the nice weather … because it’s not.

Reading.  Anything that I enjoy.  New books, old favourites.  Going back through my favourites list on Archive of our Own and reading my comfort fanfics.  Reading the funny things people put up on Fark.

Talking to a few close friends.  Visiting a few close friends at their home for cheap and nasty and amazing takeaways and a crafty evening.  Being open about my mental health with a few close friends, and the looks on their faces when I tell them they’re no spoon people, because even when I’m totally wiped out I will still talk to them and see them and enjoy myself and feel refreshed.

Opening the curtains in my room.  Lying on my bed and listening to music or podcasts with the windows open on a sunny day.  Having a nap there, with the sun and the fresh air.  Lying on my bed and listening to the rain on the roof and watching it come down outside.  Clean sheets.

Recognising when I’m starting to feel overstimulated and frantic and knowing I can put in my earbuds and put on some white noise and take a moment to breathe.  Beginning to understand and explore my limits and live comfortably within them.  Knowing that I don’t have to attend that work function, knowing that I need to stay at home to recover from the day, or the week, and not feel guilty at all about it because I just work differently to everyone else.  Knowing that it doesn’t matter if people don’t understand, I don’t have to try to get them to understand, I can simply say “I can’t do that many people at once right now” and that is enough.

Having enough income to pay my bills and to eat a bit better.  To not have to stress about whether or not I can afford the gas I need for the week, because feeding the animals will always come first.  Knowing that there isn’t someone there deliberately trying to screw over my budget, to take every cent of surplus and more.  Knowing that I finally have the freedom to manage my own budget, to apply money to areas where I see fit, to not have to compensate for Its fuckups.

Seeing other people’s posts on facebook and instagram where they’re doing amazing things for themselves and loving them for it.  Loving their journey, loving that they are sharing this with you, loving that you can see what they’re up to, where they are in the world, the amazing scenery they are seeing, the adventures they are undertaking.  Knowing that one day (and I’m realistic in that it may not be within this next decade) I will do the same.  I will go to places I want to go to, I will see things I want to see, I will have adventures I want to have, and I will take inspiration from my friends who have gone before me, and I will take advice from my friends who have gone before me, and I will be all the better for it.

There’s one key thing here that you may have noticed.  All of my happiness involves little things, and none of them involve prescribing to someone else’s idea of happiness, of wellness.  There’s no meditation, there’s no hiking up mountains (although I do enjoy occasional hikes out with my mates), there’s no big grand thing.

Life is a series of little things strung together around big things.  Alter those little things in life so that they are things you enjoy, so that they bring you happiness.  You may enjoy taking a walk at 6.00am.  You may enjoy sleeping in until 2.  You may enjoy socialising, going to cafes.  You may enjoy curling up in bed with a good book.  You may enjoy scented candles, drawing, beading, napping, gardening, researching …  what ever it is you enjoy, whatever it is you want to do at this particular moment, do it.  (Unless it’s illegal, then please don’t.)  If you don’t have the energy to do what you really want to do right now, that is totally okay, find a TV show you enjoy and relax into it.  Have a nap.  Have a cup of tea.

Let yourself feel joy from the little things in life.  Because life is a series of little things strung together around big things.