Wednesday, July 6, 2016

A Reluctant Diagnosis

I don't know why I was persisting in denial for so long over what was the obvious. After all, I was naming it to myself even as I told myself it wasn't that. Perhaps if I did nothing it would go away? Say, after the knees finished healing? Maybe it was just a temporary side effect?

I'm talking about RLS, Restless Leg Syndrome. It's what was keeping me stretching out my painkiller supply as long as possible, taking fewer a day, cutting pills in half for a lower dosage. My thinking there was that the supply was definitely finite, and maybe the whole thing would go away if I just dealt with it my way for as long as possible.

It was intermittent when it started, but the pattern quickly emerged. Sometime in the afternoon the legs would start a deep ache, and I'd need to move them - more and more often - in order to find a more comfortable position for them. Of course, the ache kept keeping up with me. When it began, I took it as a signal that I needed to go to bed. I was tired. Even if it were just a short nap, I'd wake up without it, but especially if I could manage to sleep through to the next morning. It would take about half a day to return. And the percoset worked. Mostly. At least I could get some sleep.

Then it changed. Sleep wasn't the cure for what was happening. What was happening became what was preventing me from getting sleep. I take that very seriously, since lack of sleep seems to be my primary trigger for A-fib attacks, and the last one, a year ago, scared the crap out of me.

I finally decided a trip to see my primary care doc was in order. But not before a bit of an internet search. Was I consistent with the recognized symptoms? Were there lifestyle things I could do in the meantime to help?

Yes. And yes.

I needed to move more throughout the day, get out and walk, and more than just down the hall and back. That's a bit tough when outside temperatures overheat me in the two minutes I go out with the dogs while they empty what needs emptying. After all, I'm just sitting then, even if I do take my big elastic band out to help stretch my knee. Meanwhile, just keep changing positions.

There was a list online of possible causes other than sitting still too long, and some I could do something about. I might be low on iron, or folic acid, B12. Kidney function may be impaired, and while I get their function levels tested regularly, they may have changed. My diabetes may have advanced from the pre- to the actual stage. All of those things meant some lab work was in order, reinforcing my need to visit my doctor.

A couple of causes went beyond lifestyle. Nerve damage might be the cause, and I know some have been damaged, i.e., sliced through, during the knee replacements. Cause/effect? Who knows? And as for a genetic component, Mom had it during her later years, which is how I even knew RLS existed in the first place.

I had to wait out the holiday weekend to see my doc, but got in easily on Tuesday. He ordered lab tests, results to be back in a week or so, and gave me a prescription.

Normally I don't bother too much with all the information on the sheet stapled to the bag holding the meds, but when the words jumped out at me that this was primarily prescribed for Parkinson's, and sort of as an afterthought also for RLS, I decided to read it all. The page and a half of possibly life-threatening complications was more than sobering. I read through it twice, and am keeping it close at hand for referrals. The "usual" side effect is drowsiness, which is why it's to be taken before bed, either an hour per the pharmacist, or 2-3 hours per the internet. At any rate, make sure I'm settled in. Oh, and hey: insomnia cure maybe?

Had the first pill last night. Woke up nauseous. Never actually threw up, but just plain felt sick. Carried a plastic bucket around the house with me all morning. Couldn't stomach the thought of breakfast, but tried some crackers late morning. Normally I can just gobble those down, but this time I didn't eat more than a third of my carb-conscious portion.

I didn't remember nausea as one of the listed side effects, so I read through the info sheet again. (It's about the only thing I managed to concentrate on for that long all morning, and I'm in the middle of a good book by a favorite author.) Nausea was not listed. Not the first time I get a side effect not on the list. Lucky me.

I'm waiting to see if I actually get hungry later in the day. Lunch was a tiny snack, and I pushed myself on the last two bites. Supper is to be in a restaurant with friends, saying "Good-bye" before we head north, and while I don't think I'll have to cancel, there may be a big doggie box heading home.

I'm also waiting to see if the RLS actually goes away. It it doesn't, I see no point in continuing the medication. If it does help, I can take a half tab and see how I react to that dosage, per the nausea. (Yes, half-dosage is per the doctor.) Once the lab results are in and we're up north, I'll check in with my old much-trusted doctor and see what she has to say. I know other meds are available for RLS. Between that and the nausea, if I have to go with one for a couple weeks, it won't be the nausea. I still have percoset half-pills I can take late in the day when my share of the driving can be declared done, a choice making the trip tolerable. That's my immediate primary goal.

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