A Serious Case of Insomnia

When my grandfather died last June, I had 12 days off in a row because I was able to avail of bereavement leave in combination with my regular days off. That threw off my sleeping patterns which continued through my visit to the Philippines in September when my mother died, and several weeks afterwards until early November. That insomnia would be understandable because of the emotional upheaval the death of loved ones caused.

Then all of a sudden, my body seemed to have rebooted itself and I started sleeping well again during the day when I worked nights, and during the night on my nights off. About three weeks ago everything suddenly changed again even though there were no significant events that would have caused the renewed insomnia. I’ve had a hard time sleeping at night no matter how I try to maintain a proper sleep/wake pattern. When I would normally fall asleep at about 11:30 p.m., I have not been able to do so lately until 3 or 4 a.m. And even though I wake up as usual at 7 a.m. in hopes that I would fall asleep at my usual time the next night, it hasn’t worked. One night I tried taking a Benadryl based sleep aid and it didn’t help. It just made me feel jittery, which was one of the possible side effects. Drinking wine didn’t even give me a couple of hours of sleep, just a few minutes of drifting off and more hours of wakefulness. That has left my brain foggy at times and never 100% when I’m supposed to be enjoying my days off from work. Taking a low dose of a benzodiazepine made my mind relax but didn’t help put me to sleep.

If there was one positive thing I can say about this, it is that I am able to stay awake and mostly alert at work in the middle of the night while some of my coworkers whose names I won’t mention, are dozing or drifting off. One consequence of staying awake is the extra eating, and of course that’s not good if you are on a restricted diet. Instead of being asleep for 7 or 8 hours, hunger pangs arise in the wee hours of the morning.

                So at the moment, whatever advice is out there about promoting proper sleep, I probably tried already and nothing has worked. I am not inclined to ask my doctor for a sleeping pill because those sometimes have a side effect of sleepwalking. There have been cases where some people have even driven to places and done things that they were not aware of. So all I can do is hang in there and hope that my body reboots itself again sooner than later. Unfortunately I don’t have a Ctrl-Alt-Del button on my body so I can do it as needed.

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T’was The Night Before Christmas in the Psych Ward

T’was the night before Christmas and all through the psych ward not a creature was stirring except for an occasional loonie who was med seeking. The patients were doped up on their meds with care, with hope that a few more patients like Nick or Claus soon would be there.

The patients were nestled all snug in their beds, while visual hallucinations danced in their heads. The computer screens made the  nurse’s faces glow, and work on the ward had begun to slow. A potluck dinner was had by the staff, and all of us gained at least two pounds and a half.

   

When out from the parking lot arose such a clatter. The ambulances had arrived and the doorbell was rung. The staff’s ears perked up to listen to what was the matter. Davonna had arrived with a patient in tow, with three more coming, all in a row.

No Dasher, no Dancer, no Prancer, nor Vixen. No Comet, No cupid, no Donder, nor Blitzen. Instead through the door in came the EMT’s. Along with patients named Dander, and Blunder, and Fix'em (names changed to protect the insane), none dressed to a tee.

We started work and had patients sign admission papers. While the nurses took care of medical matters. The patients brought clothes and all sorts of things in our presence. Alas, St. Nick they were not and the staff got no presents. We sent the patients off to their beds, all taken cared of, thanks to their meds.

As dawn approached with no sight of St. Nick, we’d done those admissions, I’d say pretty quick. But the intake office called out of the blue, saying five more patients were all in a queue. Without a full moon in sight yet we were getting patients all night, we couldn’t wait till 7:30 to bid the psychos Merry Christmas to all and to all a good night.

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My Experience With Lipitor and the Resultant Myopathy

I went to see the doctor two weeks ago for a follow up on my body’s response to Atorvastatin (generic Lipitor). A few days before that I had my blood drawn for a cholesterol level. At the doctor’s office, I was told that my cholesterol  level went up from 133 to 164 and LDL from 44 to 70, which is understandable because the doctor halved my dose from 40 mg. daily to 20 mg. To add to that, I had been eating almost indiscriminately on Thanksgiving and the days that followed. But that was not what I was concerned about. In the last few weeks, I noticed that whenever I worked out, my muscles seemed to recover more slowly than usual, meaning that the soreness lasted longer, and the left thigh injury I had suffered from running several weeks ago wasn’t healing well. I’ve read about the side effects of Lipitor and myopathy was one of them but I minimized it, thinking that because I try my best to keep physically fit, such a thing could not happen to me. Well, it turns out exercise cannot overcome this side effect because as time went on, my muscles have become more sore. I even feel soreness when I do my usual aerobic workouts nowadays consisting mainly of treadmill hill walks and stationary cycling. Since there are no other factors that could possibly contribute to the soreness, I can only assume that it’s the Lipitor that’s causing it.

During my visit to the doctor, I mentioned the soreness so he decreased the dose to 10 mg. daily. However, that hasn’t seemed to have helped because my muscle pain has become worse since then. It’s so hard to believe the breakdown happened so fast since it’s only been over three months that I’ve been taking Atorvastatin. I’m now seriously considering calling the doctor up to tell him that I’m discontinuing the Lipitor and see if my muscles could recover before permanent damage occurs. I’ll have to start eating healthier again and see if I can maintain the decrease in cholesterol levels I’ve achieved since taking the medication. It would be terrible not to be able to workout due to being debilitated by muscle damage. Heck, I need my daily cardio fix after all, even if it’s not from running.

                Here’s the catch though: drug companies advise that once you take Lipitor or any other statin, you have to take it forever. Of course they have a vested interest in this approach since they make money off it. There is of course an opposing view that in the absence of other risk factors, it’s not worth continuing taking the medication if the side effects affect your quality of life adversely. I’m just stating that here briefly since there is already too much information about this issue on the internet. I’m not getting into coenzyme Q10 and vitamin D and how those might help with the myopathy, or neural pathways of the medication. That’s easy enough for anybody to look up if so interested. Here is a good article on statin myopathy and exercise though : http://www.medscape.com/viewarticle/707898 . The title is: Are Physically Active Individuals Taking Statins At Increased Risk For Myopathy?

                So anyway, I’m planning on stopping generic Lipitor and hope that my LDL doesn’t get out of control. It is at a manageable level now at 70 and not the 138 it was in August. As my high school classmate who is a doctor advised: more psyllium J.

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An Unfortunate Sexual Incident At Work

I have three fears in this Psych Unit business that I’m in and I’ve touched on this in a post a few months ago: first, death of a patient by suicide, second - sexual behavior between patients, and third - being out of a job. That is why I walk a straight and narrow path and have always remained as vigilant as possible in the 30 plus years I've worked in my position as a mental health worker. I have never relaxed and that's the reason why I don't do overtime work - because working just two days in a row, I give 100 percent all that time. However, in my opinion, you can’t catch them all because things can happen in an instant with just a brief turn of the head or being in a partially blind corner. As much as we attempt to be omnipresent, which is an impossibility, we still miss things. Case in point: on December 6^th just before 7 a.m. I was assisting a phlebotomist by escorting her to the patients’ room so she can draw blood and give TB tests. Neither I nor my other coworkers noticed that a male patient had slipped into another male patients’ room. See, we don’t allow patients to visit in each other’s rooms even though they are of the same sex. Just before 7 o’clock, I excused myself from the phlebotomist to do my second to the last rounds of the day before the end of my shift. When I checked one particular patients’ room, I didn’t see him there, which was not unusual because they come and go all the time. I proceeded to check on the other rooms that I was assigned to and when I opened one of the rooms, I saw one male patient lying on his bed in the knee-chest position while another male patient was facing him with his genital area directly positioned towards the lying patients’ buttocks. If that was too graphic for you, I apologize. Well, in a psych unit setting, sexual behavior is a no-no, regardless of whether it’s heterosexual sex or gay sex. All I could do was ask the male in the dominant position to get up and leave the room. He arose and pulled his pants up and left the room while I asked another staff member to call the charge nurse. To complicate matters, we were aware that the dominant male was infected with something I shall not disclose. I described what I saw to the charge nurse and she wrote a report about it.

This is the kind of patient incident that can get someone fired because you may be blamed that you had not done your job well for something like that to happen. I went home agonizing over the incident even though I thought that I had done the best that I could in checking on my assigned patients. I ruminated about how it could have been prevented, so much so that I did not sleep well. Upon waking from my restless sleep, I had three voice mails awaiting me, all saying to call my supervisor so I could give my input on what happened. I composed an email explaining what happened, sent it to my supervisors, then called them. Both calls went to voicemail so I left a message telling them I sent them an email. While waiting to return to work in the evening, I kept on checking my email for a response, but didn’t get any.

If there is anything that would probably support my telling of the event, it would be the omnipresent cameras recording our every move on the unit. The video would show that I was indeed with the phlebotomist and at the time I said I caught the two patients in the act, I was also indeed doing my rounds then. I don’t know what else I can do to prove that I was doing the job I was supposed to be doing. Regardless, I lament that we were not able to prevent it from happening and assigning blame is fruitless because it was a collective failure. I’m awaiting the fallout with trepidation.

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