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Caught between a hot flash and a nightsweat ....

Posted Oct 06 2010 9:20pm

Oh the joys of menopause. As I try to get some normal sleep (even with the help of medication which assists with sleep), I am stuck with one of those nights where sleep is evasive, hot flashes are rampant and yesterday morning was interrupted by my inability to sleep. Kind of a vicious cycle that is difficult to get on top of. I think I know several of the causes and just thought I would take a little time to update my blog. Regarding the picture ... I don't know if the device is real but I loved this night sweat alarm ... true or false? It cracked me up!

I am in full-blown menopause having been off my HRT patch since about March or April. I also bottomed out on my Lexapro (an SSRI which can help with menopausal symptoms but was primarily prescribed to help with anxiety and depression which have been part of my disease process). I've been through a few different types of SSRIs and I have had the best results with Lexapro - until the past 5-6 months. Sometimes medications lose their effectiveness and that's just the way it is. I started on 10 mgs. Dad passed away in 2009 and that put me into a full-blown MS exacerbation (optic neuritis) and I was increased slowly to 20 mgs. This worked for about a year and a half and then I was brought back down to 10 mgs to "clean out the receptors". This seemed effective for a short while but just not enough to take away some of the negative affect and lack of motivation. I was noticing (as was CC) that it was taking me longer to get around to things and I seemed to carry the weight of the world on my shoulders without taking the time I needed for me to put up those boundaries that are a necessary evil when dealing with limited energy resources ... and of course throw in a dash of good ole guilt without good reasoning and you have a mountain that becomes harder and harder to climb and looks taller and taller. It's just the way it is ... I do what I can naturally to cope (prayer, meditation, etc) but the body can only do so much and sometimes those chemicals need to be regulated. I carry NO shame whatsoever in the fact that I take an anti-depressant. Like other medications I take (such as synthroid), I need them to function to the best of my ability. So, since the Lexapro has lost it's effectiveness with me we decided AGAINST adding something to it (like Wellbutrin) and going with a new SSRI altogether. The next choice is Zoloft. I will start on 50 mgs and titrate up to 100 mgs after 2 weeks. I am looking forward to feeling like my old self.

Mood is not necessarily bad (at least what I am told by people who see me) but I know where I am and the gift of insomnia is just one of those things that shows me that things are not in harmony as they should be. Chronic pain doesn't make it any easier and I am dealing with some pretty significant health issues. Nothing to belittle ... they are there. My goal is typically now never to really show them to the world (those face to face interactions). But they are there, and this blog is my forum to talk about them. I know I am not alone by a LONG shot and I am sure a reader or two can fully empathize.

A couple of updates:
  • It seems like the Bladder denervation through Botox is really beginning to work and I have less of those nasty bladder things that happen in between self-cathing. That is very very good.
  • I went through my cognitive testing at the end of August and just went through the first of two sessions that involved sharing results. I had baseline testing in 2003 and there were things that did not change and things that did change and moved me into either a "borderline impaired" or "impaired" category. I do have a lot of cognitive reserves through eduction and the fact that I am always trying to learn new things and stay fresh. This makes ALL the difference. My main areas of impairment are the ones that I expected: executive functions (thought organization, mental tracking, etc) and memory. The psychologist was able to distinguish that depression or other life factors are not truly contributory to them -- it's disease process. I am the resourceful type and use technology to help me adapt to some of these deficits. My ultimate wish, develop an iPhone application that will help MS'ers who deal with these types of cognitive challenges to stay organized and keep track of things. We'll see how that goes :)
  • A next meeting with the psychologist will involve both Cecilia and I making a visit and discovering perhaps other strategies for adapting that we might not be addressing. CC will also get a "Cliffs Notes" version of the breakdown which will be good. We are a team and she needs to be involved and understand. That's the way we roll. Not that she doesn't already get it -- she's amazing. But a little of the clinical background will help affirm some of the things we have been seeing for awhile. So I really am NOT going crazy. Just part of the natural changes with some mild dementia. Ever so mild.
  • My doctors suggest that I consider finding a clinical trial that might deal with a cognitive enhancing medication (most of these are used with Alzheimer's patients). I have not seen any in my area but will discuss with my neurologist given the situation. I don't want to mix medications inappropriately and have actually weaned off several medications in the past year. THIS IS A GOOD THING.
There is a great website called MSIF.org and they have a copy of their magazine that deals specifically with "Emotions and Cognition in MS" .... they put out great stuff. You can grab a copy in several languages.

I could probably go on about other stuff (like the latest on my Keratoconus) but I will save that for a later post. I will try to read and get some rest.
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