the id, the ego, & the single misfiring brain cell

and no, it isn't my knee. or the other one.

In the last few months, I've been fighting the slow, insidious encroachment of perpetual grogginess. It must be the Elavil, which was added to my main antidepressant* to help me sleep.

* Celexa, which keeps me from angry rampages on the interwebz and from being contentious in general.

I'm an insomniac, for those of you what are just tuning in. It began a couple of weeks before my only deployment* in August 2004, and has grown considerably worse with time. When I broke down and asked my doctor for an antidepressant about a year ago. She put me on Celexa. After a couple of weeks to a month, she upped the dosage as it wasn't killing my generalized anger.**

* So far. I'm due. Brace yourselves. It's coming.

** I don't know about other people, but my depression doesn't make me want to harm myself. It makes me want to strangle idiots and assholes. The desire to strangle someone remains even when no idiot or asshole is extant to provide a convenient target.

From the start of my dance with Celexa, my insomnia worsened. Plus, I'd just started back to school. To some extent, I could usually get snatches of sleep midday to make up for my wakefulness at night, but the erratic nature of my sleep made thinking fuzzy and ideas elusive. After I suffered for six weeks, my PCM (primary care manager) finally broke down and prescribed Elavil.

Elavil is a tricyclic, one of the original anti-depressants. While it seemed effective as such, it was difficult to determine whether people were less depressed or just so groggy all the time that they didn't know they were depressed. Thus, it is now primarily used as a sleep aid. It turns out that a small fraction of what was needed for depression is enough to help most people sleep through the night.

I had to go back and have my dosage on this doubled, too--to 20mg.

By that point, I needed sleep more than anything else in my life. A couple of days after I began the double dosage, I began to sleep. At first, it was wonderful. I just...slept. Like most of you take for granted, I'll wager. Since it worked, I stuck with it. Over the course of several months, however, I began to realize that I was incredibly groggy most of the day. As I noted before, this development was so slow that I didn't realize it until I'd gained quite a bit of weight and would often sleep until almost noon.

I've always been a morning person, and active, so I was amazed that I could get this far out of shape (and not really wanting to do anything) before I realized what was happening. At that point, I dropped the Elavil back to 10mg, hoping that I wouldn't need as much now. Immediately, I went back to insomnia, as though I were taking nothing for it.

My insomnia, by the way, is chronic middle insomnia. That is, I awake in the middle of the night and cannot get back to sleep. Immediately upon dropping my dosage, I again could not sleep. So I upped the dosage back to the prescribed level, which leaves me groggy all the time.

I've been thinking about making an appointment with my doc for a while now, but today's experience sealed it. I'd gone to the basement and done 5 miles on the treadmill, speedwalking (which I'm getting better at). I'd made a point of eating fruit beforehand for energy, and of drinking plenty of water. I had a good workout while watching a  movie (Mortal Kombat, which is silly, but has great workout music). I noted with pleasure that my speed is naturally increasing, as is my stamina. I did a few pushups, then I walked upstairs.

I realized, on the main floor, that I'd left my water downstairs, so I went back to get it. By the time I got back to the main floor (less than a minute later), my legs were showing their fatigue. I picked up some luggage from my trip to Broomfield/Boulder yesterday, and walked up to the second floor. By this point, my forearms and hands felt...funny. Tingly.

I stripped and showered. Even with long hair, I shower completely in about two minutes, maybe three. I was trained to be quick when I was a kid, and I never got out of the habit. As I washed my hair, I realized that my fingers were hard to move. My arms felt dead from the elbow down.

I finished, stepped out, and dried off. Without pausing to brush my hair, I slipped into comfy clothing. As I pulled the shirt over my head, I realized that the searing ache in my arms had spread up and across my shoulders and chest. I could barely breathe; I was sucking air but unable to get enough. I saw stars at the edges of my vision.

I laid on my back in the middle of the bathroom. It seemed politic to do so, as I might have fallen and bashed my head otherwise. My breath returned to normal after a couple of minutes. It took longer for my forearms and hands to return to normal.

As soon as I could stand up, I called Tricare for an appointment.

I don't know what it is. I've had a similar sensation before, also after prolonged exercise. Travis and I had ridden 20 miles or so on the back roads, and I'd just climbed a hill. I realized I wasn't just breathing hard; I was wheezing in an effort to get oxygen.

I am acclimated. That isn't the problem.

Then it happened again about 10 minutes later, at which point I had to stop my bicycle and stand, trembling, waiting for the spell to pass.

At the time, my doc said it sounded like an anxiety attack.

And to be fair, I haven't had one in a long time. I've had reason to believe that the Celexa was taking care of it. (And yeah...I exercised intensely and for long periods of time with no problems for months.)

So...I don't know.

Doc appointment, 1 Sept.

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