I have now for years always taken my final medication for the day at 7pm, I started taking it at that time as I was up daily at 4:30 am for work so it fitted well into the required cycle. 7pm is also the time that I always switch mentally from daytime mode to night time, I pour out my glass of coke and replace the contents of my glass with a well deserved Gin and Tonic. Well deserved then as I would have been working from 5am almost to 7pm, and now as I have got through another day of this illness, well that’s what I tell myself anyway. My routine has changed dramatically and as you know I have been finding staying awake in the evening really hard. My thinking was that if I moves my dose of Amitriptyline and MST from 7 to 8 I might be more able to stay awake to 9 rather than sloping off to bed at 8o’clock as I did yet again on Monday. Amitriptyline on it’s own makes you drowsy along with the Gin it should make you even more drowsy, but after 11yrs of this routine I know all to well that had never happened, but I wanted to try delaying my Amitriptyline and MST to 8pm in the hope I could then stay and be more awake through to 9pm. It sounded like a good plan to me, and to make it work I had moved my morning MST to 8:30am in preparation for the change, but there was one thing I missed out and that was my memory, yes I forgot to take it at 8pm, but I was awake at 9pm and I was more mentally awake as well, although ready for bed, so that was where I went.
So far so good, but I hadn’t been in bed for more than 5 minutes when I started to feel really terrible, it hadn’t taken long for my body to go full steam ahead in showing me what happens if you miss a dose of both of them. I guess I hadn’t noticed the slow build up when I was sat in the living room as TV and conversation had been enough to mask the mild starting affects, I got up and headed to the kitchen for both, expecting that it would take about 20 mins at most for them to kick in, which I thought shouldn’t be that bad, wrong. It actually took about half an hour to kick-in, during which I had growing symptoms of withdrawal. It’s hard to explain but my entire body felt as through my skin was on fire, not the isolated areas I often have, this was everywhere. Worst of all was the fire in my lungs and chest area right up to my neck and down my arms to my elbows. I was cold and clammy and I could feel my heart pounding, at the worst part I found myself sitting up on the edge of my bed actually trying hard to pull information from my mind as I was then doubting myself, had I actually taken them earlier? Had I just taken a second dose? Which would have been incredibly dangerous, as I am taking 60mg of MST twice a day, 60mg once is enough to kill some people so a second tablet within one or two hours could be a little dangerous to say the least. My mind was racing as to what I should do. Could I be sure I had taken a second one or was this still the withdrawal? If I had taken 2 how long would it take for me to feel it for sure? What would I feel? I normally feel nothing at all when I take them, other than less pain, so what was I looking for? How bad are withdrawal symptoms? How long does it take for my medication to take any actions 20, 30, 40 minutes? Surly not that long? To call it a mild panic would be close to accurate, the problem was I just didn’t know how I should feel and what to do if I had taken a second, so I did the only thing I could think of, I lay back down and I waited. I couldn’t for some reason lie on my back where I always sleep, lying on my side seemed to make the symptoms more bearable, then suddenly and I do mean suddenly I felt normal, pain gone, shivers gone, absolutely exhausted, so I rolled onto my back and went to sleep in seconds.
I still can’t tell you exactly how long it took to go from taking my meds to normality but I would guess at about 35 minutes, believe me it is not something I want to do again. It is as thought I am totally incapable of making any change to anything any longer. This isn’t the first time I have tired to shift things and failed, it is the first time that I felt so terrible and I am guessing that had more to do with my MST than my Amitriptyline. I appear to be totally unable to move to new routines, my life has been so set as it is for such a long time that I guess a lot of people wouldn’t be able to make a change just like that. I know that I have made it slightly harder for myself because everything is set out in little bundles, points in the day where I do several things together. I did my usual things at 7pm apart from taking two of my meds, but therefore in my brain I had ticked off 7pm as done. It was no surprise then that I didn’t remember to do the missing step at 8pm, as I didn’t have anything missing. Questioning if the way I felt was due to either withdrawal or overdose was a real quandary, luckily I made the right decision, but it could have been very different.
I know some of you will be thinking that there is an easy answer to this, just get one of those boxes that you set your daily medications out in sections for each period in the day, the problem with those is that some of my medication is in liquid form. I do have one of those already and I did try using little counters that I moved as a symbol for the liquid meds, not actually swallowing them meant sometimes I didn’t move them even though I had taken the medication, the other problem was that who ever makes the boxes had missed one other possibility and that was that you need to take handfuls of meds, not two or three tiny ones, horse-pills don’t fit into the boxes. If you have been lucky enough to have spent your life without your own personal pharmacy in your home, will think this is really not a problem and I’m making a molehill into a mountain, if you still think that all I can say is please read the first three paragraphs again, it is a real issue for an awful large number of people. Unlike last nights experience for me, many have made the wrong decision and well they aren’t here any longer.
Medication and how and when you take it is a problem for far too many, short of having someone else responsible for making sure you take what you should when you should, there is no way of not having to worry about it ever. I don’t think it is fair to move the quandary onto Adams shoulders, you don’t have to have a bad memory to make mistakes, as they say to “err is human”, something we all are.