Monthly Archives: October 2014

Sleep Talking

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I used to wonder why we even slept. It seemed such a waste of time.

I remember regretting having to sleep back when I was raising young children and holding down an evening job. I would wake early, and having never been a morning person made that a hard thing to do. I’d get my kids off to school and when I got home the couch was like a magnet drawing me in. Just for a moment, I’d think. Just for a moment.

I’d wake up close to noon, astonished it was so late. Then rush to do a full day’s chores in two hours’ time. Shower, dress and drive down the block, park and wait for my kids to round the corner from the school and hop in. If I drove the last half-block to the school I’d get tangled up in all the Mom traffic and never make it to work on time.

After a few never-ending minutes of craning my neck to see around that corner, I’d hotfoot it down to the hospital, pull up at the daycare on the premises, unload my kids and my guilt for the day. Drive to the parking garage, power walk to the building, run upstairs (I could do that back then), clock in, and then wash the day away as I went about my nursing duties. Nothing else existed for me during those eight-plus hours.

After midnight I’d reverse the process, help/carry my sleeping kids inside, tuck them in their beds and collapse into mine. If I was lucky I’d be asleep by 2:00 a.m. And then by 7:00 a.m. the cycle had reset.

I slept like the dead back then, the sleep of exhaustion. I was on my own those days, my husband sailing the ocean blue for months at a time as a merchant marine. I needed a jump-start every single day. Even so, I berated myself; I could be so much more productive if I didn’t have to sleep the morning away!

I forgive myself now that I sleep the sleep of the needy. For if I don’t get enough sleep, whether all at once or in several doses, whatever aches I may have go up the pain scale. I can count on that; I can solidly bet on that.

My rheumatologist understood this before I did and offered me Flexeril years ago. It’s a muscle relaxer which has the side benefit of making you drowsy. I try my best to remember to take the small dose most nights. Sleep is crucial for quality of life and allows some wondrous processes to take place.

And with sleep, as with story writing, setting can be of vital importance. I decided I would make my bed as conducive to sleep as I could, and wondered how best to dress it. I knew hotel sleep always seems so much more refreshing, the beds plush and inviting. I wake rejuvenated, refurbished even.

I figured it had to do with the novelty of my surroundings, and the letting go of daily obligations for a while. And then I read this article. It was because of the white beds, it said. Aha, I thought, I can do that.

“These sheets feel so awesome,” my husband said, sliding between them for the first time. He’d never commented on new sheets before, or even noticed when there were new sheets. I decided not to clue him in as to why they might feel “awesome.” After all, a little mystery goes a long way.

But I’ve noted that his bits of insomnia have disappeared. He no longer complains about his new career keeping him awake. Perhaps it’s because after several months he’s settled into the job. Or perhaps it’s because of our consistently snowy bed. 

 

Time is on My Side

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We know that stress exacerbates your symptoms. Whatever is happening to you, whatever horrible, no good, very bad thing is happening to you, stress will ultimately make it worse.

My last rheumy visit in July came after a two-month sojourn to care for my one-year-old granddaughter. I expected my lab numbers to be off the charts; after all, running after a toddler is a thing for the young, not the young at heart.

I loved spending time with her and now miss her terribly, but I won’t sugarcoat the fact that I sometimes felt I needed a crane to lift me out of bed in the morning. It had been thirteen years since I’d had to put in twelve-hour-plus days, and never five days a week.

But love got me through. And though, I was happy to have this time with her, I knew I needed to be home as well. Two months was a long stretch to be gone and a lot was happening at home during that time. Each day I crossed off one more date on my calendar, tallying up the days spent with my precious baby, and then immediately counted the days remaining before I could go home. I went from exultant to torn within 30 seconds.

I figured that between the physicality of my days and the emotional tug of war, my inflammation markers would be off the charts. Imagine my surprise to learn that I’d sailed through that tumultuous ocean of stress with nary a splash on me.

At least, a medically documented splash. My calendar is full of micro notes as to what was happening to my body during that May and June. The aches and pains that came and went at their whim. One definite flare that thankfully disappeared within a couple of days. Regardless, I presented so well at my July visit that he pushed my next visit up three months, instead of the usual two.

Well. Those next three months saw even more ups and down. Physical and emotional. And again I wondered, will my labs reflect that? Will they be a tell-tale sign of sciatica pain, shingles pain (still with me on and off), and the pain felt over the loss of my father-in-law less than three months after the loss of my mother-in-law? Will they snitch on the occasional joint pain and point to the now persistently inflamed and sometimes useless left wrist?

Apparently not. At yesterday’s visit I learned my CRP is elevated just barely enough so that it can be called “high.” My Sed rate is normal, as it is 99% of the time. Those are the two markers I pay attention to as they reflect the amount of inflammation in my body, which in turn explains the pain and stiffness I feel. Or should explain.

Two weeks ago, I’d gone to see my PCP about the wrist as it was going on a month. He put me on Naproxen twice a day for ten days. I didn’t do it, of course. I took it once daily. I did do a Prednisone hit. That helped a little.

Now my rheumy said to me, “We have four choices. Do you know what they are?”

“Wait,” I said.

He nodded. Time heals.

I waited and he recited the other three choices using his fingers to count them off. “Increase the Methotrexate. Start Corticosteroids. Start a biologic.”

“No,” I said. “No biologic. I’m not ready to make that leap.” My right hand made a leaping motion and landed on its side on the desk between us. “I’ve used Humira,” I said, “and all it did was make me go broke.”

“OK.” He went back to the drawing board (his laptop) and came up with a plan. “We’ll go up to ten (pills) of Methotrexate (max of 25 mg). We’ll do the steroids. Injection or oral?”

“Oral.” He’s offered the shots so many times and I always politely decline.

“And we’ll do Naproxen.” That again!

So we formulated a three-point plan to regain my left wrist. That was twenty-four hours ago and wouldn’t you know it, today the swelling is down and it barely hurts. All this tells me one thing: Ti-i-i-i-ime is on my side.

Yes, it is.