Sleeping Pills Make Me Stupid

I am swearing off Zolpidem (generic form of the sleeping pill, Ambien), except in extreme, dire, temporary circumstances.

A troublesome side effect of Prednisone is insomnia. I periodically take Prednisone to prevent, and sometimes resolve small bowel obstructions caused by my Crohn's disease. Some nights, after sleep eludes me for two hours or more, I get up to read. And sometimes I am still up when morning arrives.  After few nights like that, each followed by a day of chugging caffeine-laced Crystal Lite and de-fizzed Diet Coke to stay alert at my desk, it just gets worse. And more miserable.

So I started taking Zolpidem if I was still awake after an hour, or if the night before had been an all-nighter.

But no matter what the literature says or what anyone tells me, following day or two are laced with brain fog.

 The first few days of our France vacation complicated the insomnia further by jumping the time of day ahead by 8 hours. And I wanted to sleep at night so I wouldn't doze off in the day and miss France.

So on night #2, I got back up out of bed after trying unsuccessfully for a couple of hours to fall asleep. I took a Zolpidem and settled down with my IPad to wait for the sleeping pill to kick in.

I put some eggs on the stove to hard-boil for morning, and made myself a warm vanilla instant breakfast, to attack sleeplessness from the L-tryptophan angle as well. Next thing I remember is spilling my warm drink on my pajamas as I was dozing off. So I went to bed.

When my alarm woke me a couple of hours later, the eggs were still in the pan (Thankfully, the stove was turned off!), a full cup of cool milk was in the dish cupboard (weird!), and the splashes from the warm-milk spill waited under the kitchen table for me to tackle with a wet rag.

Yikes!

I doubled my melatonin dose and swore off Zolpidem. If I let there be a next time, things could end so much worse. I am not willing to risk that.

I have been sleeping better at night (most of the time) and feeling better in the morning. And, I think my memory and concentration are better. I don't know if that's because I am sleeping better, or because I don't have the forgetfulness that can be a side effect of Zolpidem.

But it's better. And I'm grateful.

Staving off Obstruction in Paris

Yesterday we walked through the open market in he Latin Quarter, ate lunch at a Vietnamese sidewalk cafe, toured the crypt at the Parthenon, visited the church of Saint Sulpice, enjoyed the expansive gardens at Luxembourg square, tried to see the catacombs (but the line was so long, we couldn't get in before closing), took in the Paris Mideivel Museum, explored the immense cemetery in the center of Paris, and viewed Paris from 59 stories up, on top of the Montparnasse building. Whew! It was great!

By the end of the day, we were pretty hammered. So we came back to the apartment and had take-away kebab from a place down the street for dinner while we relaxed with our feet up.

My gut was relatively calm through the day. I sort of babied it -- drank lots of water, chose simple, low-fat foods. That doesn't always make enough difference. But I was grateful for the blessing of it. Then, come the end of the day, I was more exhausted than I thought I was. I felt it when I tried to go to sleep for the night.

Generally, when I'm on lots of Prednisone, as I am now, sleep is rare. So I've just been taking 1/2 to 1 Zolpidem (Ambien) at night so I can sleep. But it also caries its own side effects. So last night, I thought I'd try to sleep without it. After laying there for a couple of hours, though, It became clear that sleep wasn't on its way. In fact other issues started to surface. That familiar, biting, intense pain in my right-upper quadrant that generally means a small bowel obstruction is forming started up. At first it was subtle, as usual, and I tried to ignore it. After all, every other part of my body was achy. Why shouldn't that also hurt?

I'd been thirsty all day, too. But that's not surprising, given we walked who-knows-how-many miles. But once I'd re-hydrated and lay down for the night, I'd expect that to abate. It intensified instead. Sigh

So, I slid my bags full of pills (two gallon-sized ziploc bags, if you can believe that!) out of the suit case under my bed and popped 40 mg of Prednisone to complement the 30 mg I took yesterday morning. That should quell it. I've got other symptom-control meds (liquid Lortab, bisocodyl sodium laxative, loperamide antidiarrheal, ondanstetron/Zofran) I'll take with me today and hope for the best. I don't want to miss anything! And thankfully, I was lying awake to notice it coming on. The pain is gone again this morning, and my bowels moved in a relatively normal way this morning.

Fingers crossed and lots of prayers!

Trying to be normal in Paris,

Beth :-)

Yuck Alert: Don't read on if potty talk bothers you.

Remember how normal I was feeling on Monday?

I should learn by now that saying so dooms me to a different fate.

Oops!

Tuesday started out OK at first. The morning was great fun, and I was feeling so smugly normal, I rolled the dice at lunch and had something really French -- a chicken and cheese crepe. Even though I picked off a great deal of the cheese, it was still too rich for me. It sent me running to the toilette in the restaurant and then to take two antidiarrheal tablets.

Then, 15 minutes later, while walking through the flower market a few blocks away, fearing I wouldn't be able to hold it long enough to find a closer rest room nearer, I ran back to the restaurant for another go. Then, while touring the crypt outside of the Cathedral of Notre Dame, a sign warning "no toilettes" sent me into a panicking search for one. If I had been male =-- or at least been dressed like one, I'd have not wait to reach a toilet. But the women's queue was 15 - 20 minutes long. They are like that in lots of places here.

 

Note to self: French cheese and crepes are too rich for me. Don't eat them!

Feeling pretty dehydrated after that, I stayed on full, low-fat liquids until dinner the next night.

Later that evening while taking in the si†es where some beautiful, historic buildings adorn the streets, I tripped over a raised man hole (or whatever they call those here) and fell on my left wrist and hip. Fortunately (thank heaven, of course!) I didn't break anything, except my pride. I got a pretty bruise on my wrist that caught me, but it's already fading. I guess the dehydration that comes with the whole diarrhea attach thing repeated over and over through a day was too much to expect my to have sure footing as well while distracting my attention away from walking. tp look up at flower boxes on window sills and beautifully guilded balcony rails.

Dave and the kids were supportive and understanding, though. They made sure I got some juice right away, and made their own dinner when we returned to the apartment. I stayed on full liquids until dinner the next night, and did a lot better when I introduced table food at dinner the next night.

I am more grateful than ever for the wipes we brought with us and the washing machine in the apar†ment where we are staying. And for ShaNae sharing her panty shields with me.

Wednesday was amazing, too. And because of  getting stuck in such a long potty queue outside of Notre Dame, I was always on the lookout for a shorter line. Here's a secret if you go. The rest rooms that didn't have lines are in the Richard Reichart area near the scuplture gardens in the Louvre. Or, dress and and act like a man and march forward to the front of the non-existent line and do what you need to do. Your wife/girlfriend/daughter will still be awaiting her turn. Some of us revolted at Versailles today. With 15 or 20 women in line, we saw men, one at a time, without waiting, march into empty cubicles within plain site, come out, wash their hands and leave -- all before the women's line moved any closer to our goal. So some of us left the women's line and used the men's stalls. No harm done (but lots of relief received) as there were still no men waiting for a turn when we exited. They need a sticker they can put over the sign on the men's room to switch its gender when the women's room is overflowing.

Last night, I also introduced Canasa suppositories daily again. It's like Pentasa--another form of Mesalamine, that's supposed to quell the Crohn's inflammation in the small intestine. The suppository seems to also help the bowel control its contents until appropriate times).

 

Today I've been doing much better. The trick is to stay hydrated, which, of course, presents a problem where rest rooms are few and far between, and when they are so popular! The two restaurants where I didn't find lines was in the grove outside in the gardens. I only had to wait for one person. And the bathroom was relatively clean (with the exception of the toilet-paper-wasting project someone seemed to create in the corner of the cubicle (one of two) that I chose.

That's enough for now. Enjoy the photos. We are being truly blessed with comfort, good company, safety, and memories precious beyond description. What an amazing experience †o share with ShaNae, Zack & Clara!

I love them all so much! and thank Father in heaven for the time together. What a charmed, dream vacation! And, of course, it's perfect to distract me and Dave from these last few days of waiting for Samuel's release from his mission. We will pick him up on Tuesday morning! That doesn't seem any more real than any of the res† of i†. But it all is! Amazing!

Well, better sleep a while. The Prednisone is starting †ø give way †o †he melatonin and amytriptilline's sleepy effect. Being well-rested tomorrow will be a good thing!

Take care of yourself. And start learning French so you can teach it to me when I get back!

Au Revoir!

Beth

Paris

Our first full day in Paris! It still doesn't seem real. But it is! And it's wonderful, of course. Today we spent the day at the Louvre. We saw SO MANY priceless, breath-taking things, but it's such a tiny part of all that is there. I hope the people who live nearby take the opportunity to go often. I don't think you could see everything if you went every day for a year! I am grateful my guts are being calmer than usual. Prednisone has its price. But being able to enjoy the Louvre with my husband Dave, and with my son and daughter-in-law, Zack and ShaNae, and our granddaughter, Clara -- Priceless! The Lord is blessing me and I am grateful. Every toilette at the Louvre (and there aren't many) had a LONG line. The cafe where we lunched had a line, but not as long. If I'd been in trouble, many people would have suffered (or at least would have been sorry to be close to where I was). But that didn't happen. Thankfully, the biggest challenge was staying hydrated. The Louvre has no apparent (even after what I consider a thorough search for) drinking water fountains. And the only place they sell bottled water (for >$3 per .5L bottle) is near the entrance -- a good 15-minute walk from where Dave and I left ShaNae and Zack taking care of Clara while we did a water run. I did bring my own water, but I drank it before noon, of course. And found no place to re-fill it. I have to say the Louvre is not very sensitive to human needs. Besides the dearth of rest rooms and drinking water, the stairs everywhere make much of the museum inaccessible to wheelchairs (We only saw 2). The stroller was challenge enough, as Clara's diligent parents hefted it up and down stairs. The stroller did, however, get us to the front of a line on the way in. :-) At lunch, I ordered vegetable soup and hard-boiled eggs. And for dinner, some kebab with bread sounded good. That sounded safe. Apparently it was. I'm still doing well tonight. I have to credit divine intervention, though. Even though I carefully planned and prepared ahead of time my meds for the day, I somehow only brought the symprom-control, emergency stuff like anti-diarrheal and pain killer meds. Non of the maintenance stuff. I still can't find them in the apartment tonight. I honestly have no idea what I did with them. But it's all good. I have bottles and bottles of all I need in my suitcase, and I promise myself not to leave them behind again. Tomorrow, we're touring the city from a boat on the Seine and visiting the Isle de Cite. Can't wait! If I can figure out how to get some photos from my Adroid to my iPad later in the week, I'll post them. I'm not getting much cooperation between these two devicies so far. Maybe I'm just tired. Good night! Smiling in Paris, Beth :-)

Counting Blessings

After 40 hours awake, last night sleep came again. Woohoo!

By yesterday afternoon, I was getting a bit cranky, clumsy and critical. Dropping and spilling things.  Losing track of conversations (even worse than usual J). Easily irritated, and, I’m sure, irritating to others (poor Dave). Feeling lazy and tired, but not sleepy. Generally bummed out.

Sweet Dave took me to get a yummy turkey sandwich for lunch at the Honey baked Ham store (no lettuce or tomatoes, please), and our daughter and her hubby, Megan and Jeff, came over for takeout pizza at dinnertime. So that was good.

It got me thinking about God’s tender mercies – counting my blessings.

My family (except Samuel in France)
 at Megan's & Jeff's wedding last October.

Here are 10 things I’m grateful for:

1.     Family: I love, love, LOVE my family members, both here and watching/helping from the other side. So much love and support. Dave, the kids, their spouses and our first grandchild – priceless!

2.     Christ: He shoulders my every burden, has already paid every debt, righted every wrong. Sometimes I just forget.

3.     Education: It is forever ongoing. I’m grateful that my parents steered me to college, for the degrees I earned, and for all I keep learning, both professionally and personally.

4.     Senses: Vision, touch, smell, hearing, taste. Such joyful, beautiful ways to connect with people and the world.

5.     Memories: Bring smiles & comfort, teach lessons when I let them (sometimes again and again).

6.     Music: Lifts my spirit. Lets me express and feel things that have no words.

7.     Mobility: Walking, flight, cars, travel to be with loved ones, see new things.

8.     Laughter: Better than a good cry. Dave makes me laugh every day.

9.     Friends: I’m surrounded, thank heaven, by so much love!

My before-breakfast meds.
Colorful, right?!

10. Medicine: The side effects can suck, but medication keeps me here to enjoy other blessings, can relieve pain and suffering; some even cure disease!

Me today -- 25 pounds heavier
than in my mug shot on the right.
Thanks Prednisone!

And counting . . .

Take care,

Beth

The Juicer and Smoothie Maker Are In For A Workout!

This time, a new obstruction started just 10 days after the last one.

Yesterday, I took the Prednisone down to 20 mg a little early (after 4 instead of 7 days on 30 mg), silly me. That’s all it took for the distention and pain to kick back in.

So I took a 60-mg pulse dose with lots of liquids. And Dave and I took a walk. This morning I took 40 mg again. I needed some painkillers last night and this morning, but this afternoon, things started feeling better again.

Well, relatively better.

I’ll be on liquids and very squishy foods for a while again. Lots of fresh fruit and veggie juice and smoothies. And I made some custard and pudding to have on hand.

And I have two MD appointments on Thursday – one with my family practice doctor, and one with my GI doctor. I want a plan for France, just in case it happens there. I imagine I’ll just need an ample supply of my usual remedies – Prednisone (steroid), Lortab liquid (narcotic painkiller), bisocodyl USP (gentle laxative, and Ondansetron (anti-nausea). I’m sure they have liquids and squishy foods in France, though I hear that’s not what they’re famous for.

That’s one thing that I think will be challenging on this trip. French food is one of the big things travellers look forward to experiencing. But a lot if it is way beyond the richness my body tolerates. My husband, Dave, has food issues as well, so we can share that challenge somewhat.

Some people gain weight in France from all of the yummy stuff to eat. I should fit right in, except I gained the weight from steroids before leaving. I fought some clothes that fit the bigger me. It's all good.

  

Fortunately, France has a lot of other stuff that’s cool. The Eiffel Tower, Notre Dame, the Riviera – need I say more? Besides, we’ll get to see my Samuel face to face, give him a hug in person, hear his voice and see the places and people he loves. And we’ll see all of this with people we love. Zack, ShaNae and our baby granddaughter will be there to share it with us. We’ll build great memories and experience amazing things. There’s a lot more to France than food! Of course, I’ll probably beg Zack, ShaNae and Samuel to eat some really yummy stuff and tell me what it tastes like. Maybe I’ll even take a tiny bite and savor it. There’s no reason they can’t enjoy it. J

An X-ray of someone else whose capsules
got stuck, like mine did in 2004.

I have an appointment for the capsule endoscopy the week after we get back. They’re still figuring out the protocol for the capsule I have to take ahead of time to make sure the endoscopy camera capsule can travel all the way through without getting stuck, like two of them did in 2004, requiring surgical removal, along with 50 cm of intestine. So that date could change. But at least it’s progress.

So, the plan is to stay in one piece, as well as I can be, until after France. Then, I’m hoping to find out why this keeps happening and what we can do about it. Hopefully, the answer is NOT to slice me open again. That seems to always end badly.

The adventure continues.

Take care,

Beth

Time to break my blog silence.

Today I increased my Prednisone (steroid) dose to 40 mg daily. Again. For some reason, whenever I get the dose down to 10 or 20 mg daily, I get a small bowel obstruction. Ouch! I try to keep the amount of Prednisone as low as I can without sparking symptoms. Dr. Cutler, my GI doctor, says I should use whatever dose is necessary to control my symptoms. I need to be as well as I can be for our trip to France next month. So I decided not to try weaning off steroids completely before we go. I don't want to have a crisis so far from home. Besides, I want to have fun!

I got the Prednisone down to 10 mg this week with relatively calm GI symptoms. But after lunch with my daughter, Amy, that old, familiar cramping a little below my right rib cage and super-intense thirst sneaked back up on me. So it's 40 mg Prednisone daily along with my other prescriptions for now. And, as evidenced by my writing this blog at 1 am, the side effects aren't going away any time soon.  

Insomnia. In spite of taking Amitryptiline and melatonin before bed, I lay awake, mostly scratching my itchy shingles rash that appears all but gone, but feels as real as ever. In some ways even more so. Did I say it itches? Oh, and you'd think that the Benadryl I took would stop the itch and send me snoring. Not so far. Sigh.

 Weight gain. I weigh about 20 pounds more than I did on My daughter Megan's wedding day last October. Pendulous abdomen, extra fat between my shoulder blades. Four chins. Square, furry face that requires 3-4 shaves weekly. For the past 10 months, my Prednisone dose has yo-yoed in cahoots with repeated small bowel obstructions that always (so far) resolve with increased Prednisone doses.

None of the diagnostic tests I've had tell us why this happens, where in my bowel the obstruction occurs, and what sort of lesion or inflammation is occurring. One reason I speculate that this might be is because they never look for the cause while I am obstructed. It's always later when things are moving through again. Dr. Cutler wants me to have a capsule endoscopy test. I would swallow a radio-opaque capsule that is designed -- same size as the camera capsule -- to be sure that it can get all the way through. If there's a spot that's too tight to get through, it will stay there long enough to get x-rays, then it will dissolve. No harm done.

 That sounds much better than my adventure in 2004. Then there was no dissolvable capsule to test for strictures. The camera capsule got lodged in my terminal ilium and stayed there for months. I lost 50 cm of diseased bowel in the surgery to remove the camera. I saw photos afterward, and Dr. Sklow, who performed the surgery said some areas were so Crohn's-Disease scarred, the inner lumen would be a tight squeeze for a strand of yarn. He still uses the bowel section, camera and photos in the surgery class he teaches at the University of Utah Medical School.

 Thursday I have a lot going on, and I haven't had the capsule endoscopy yet, so I cancelled the appointment I had scheduled with Dr.Cutler. My thinking was that I'd reschedule for after I have the capsule endoscopy. Then we'd have new information to explore. Now I wish I'd kept it. I'll call in the morning to see if he wants me to come in after all. Maybe they didn't fill the appointment yet. Maybe this is a chance to look for a stricture while it's still there. We'll see. I just hope my first granddaughter did NOT inherit my gut!

 Enough for now. Maybe I will get a few winks in before the alarm goes off in 6 hours.

Take care! Beth