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Ugh re: Dextroamphetamine

Stop me if you’ve heard this one…

Dextroamphetamine was working pretty well for me for a few days. Then last night I had some pretty bad insomnia accompanied with a major panic attack. So I think I’m going to hold off on it again and only using it 1-2 times a week, and not on adjacent days.

Why is my metabolism like this?

Probably for the best though; while on it I was getting super-productive again, and having pain flareups as a result. I need to find a good balancing point.

Today’s ADHD medication discovery

Dextroamphetamine on its own has been working pretty well for me for the last few days, and my blood pressure has been only slightly elevated (not to the point that I could feel it).

Today I decided to try using a small amount of cannabis as well, and within half an hour I felt my blood pressure spike. It’s “only” 140/90, which is pretty elevated and enough for me to feel it, but not enough to worry about.

Anyway, I looked it up and there have indeed been a couple studies that have found that THC and dextroamphetamine interact to cause a blood pressure spike. Oops.

I don’t remember which particular strain I had loaded up in my vaporizer; it’s either Harlequin (which is 95% CBD) or Lemon Smac (which is 100% THC). So I’ll need to try a more careful experiment in the future to make sure I’m even using the right strain to begin with, but I don’t think I’ll be doing that any time soon. I’ll also probably want to try it with something that’s nearly 100% CBD just to be relatively-safe.

Dextroamphetamine, day 1

I took my little 10mg capsule when I woke up at 8 AM, and I felt it kick in during my shower. It’s led to a feeling of clarity and less chaos in my brain. I did a few put-off chores before work, and at work I’m not feeling totally overwhelmed by stuff. I’m still not focusing on what I mean to be working on, though.

Blood pressure is 131/89, heart rate is 65. Slightly elevated from my baseline but definitely nothing to be worried about. My hands are also slightly shakier than usual but not, like, alarmingly so.

This shows some promise and I’ll be working to adjust the dosage and timing accordingly. I might try supplementing with a caffeine microdose later today.

Also, last night was my first dose of fenofibrate, which hasn’t solved all my pain issues overnight but I’d expect that to take a week or so to be effective.

Pain, fatigue, and focus

Two weeks since my last ketamine infusion and my anxiety is… present, again, and my chronic pain never went away at all but now I’m feeling a lot more aware of it.

I went back and tried Adderall again and it didn’t mess me up, although it also didn’t help me like it did the last time I tried it. But neither Adderall nor caffeine are messing with my blood pressure or increasing my anxiety, so I’ve reopened the conversation with my doctor regarding other meds for ADHD. In particular, I asked about Dexedrine and Desoxyn. Both of them seem promising at the dosages I’m looking at, although my insurance won’t cover Desoxyn (which is unsurprising, there was a TV series about it) so we’re trying Dexedrine first.

Regarding chronic pain, my doctor went over my chart and he noticed that we never really did anything about my high triglycerides, and then he had a thought: what if my high triglycerides are contributing to my fibro symptoms? Doing some cursory literature search found that it’s plausible, at least, so I’m also going to start on Fenofibrate to lower my triglycerides and hopefully get my body in some sort of balance there. He’s also ordered some more labwork to see if I have any gaping vitamin deficiencies.

Have I mentioned how much I cherish this doctor? Of all the doctors I’ve seen, this is the only one where I feel like he actually listens to me, doesn’t talk down to me, understands that I know my body and have done my reserach, and is willing to try things to attempt to treat these complex, deep-seated issues that have caused me problems for the past 25-odd years. It’s a lot easier to be patient as a patient when the healthcare provider treats me with respect like this.

He’s definitely a rare breed.

Ketamine 4.1

On the plus side, my focus is way higher, and my anxiety is the lowest it’s been in a decade.

On the minus side, my chronic pain still sucks a lot, and this is still making it very hard for me to do my job.

It’s still been a huge net benefit for me though. And supposedly it takes a little while for ketamine treatments to have an effect on chronic pain. I’ll get there eventually.

I spoke too soon

Maybe I should have been checking my blood pressure more frequently. I didn’t check it at all yesterday like I should have and just assumed it was fine, because I just woke up at 4:40 AM feeling a bit off and on a hunch I checked my blood pressure… which is now 169/86.

Wellp, so much for my last chance at being medicated.

Vyvanse continuing

So I’ve been on Vyvanse for many days now. Four total, one last Friday and three this week.

So far it isn’t really helping me, but it also isn’t hurting me. This is also just like the lowest possible dose for trial purposes, though.

It makes me feel awake and a bit alert. I also feel like I’m a bit more prone to irritation and feeling stressed, but that might just be other situational things happening right now. It hasn’t really helped with focus at all.

My heart rate and blood pressure are slightly higher than usual but not alramingly so.

I think it’ll be worth trying the next dosage up at some point. I have a followup with my doctor next week to discuss that. It’s promising.

Today I drove for the first time while on it and boy howdy did that feel weird. I’ll probably want to go without it during my trip in a few weeks.

We’ll see how I feel this weekend.

Vyvanse, day 1

Today was my first day trialing Vyvanse, just a single 10mg dose in the morning. I took it at around 9 AM, and felt it kick in at around 10. It gave me a slight headache, and a slight vague spacy feeling, with maybe a bit of… something that I’m having trouble describing. Almost like my spine was being squeezed from the inside? I don’t know.

My blood pressure and heart rate did rise up a little, but not to concerning levels; my rest pulse is usually 50-60 and my BP is usually 120/80, and on Vyvanse it peaked at around 75 and 135/85, respectively. Nothing terribly concerning, and not so much that I could feel it myself.

I don’t feel like I’m specifically more focused than usual, although my headspace is at least a bit less cluttered. And I’m definitely more alert than usual. It’s not quite how I felt on the two good days of Adderall, but it’s also not like, say, Concerta or Strattera which had me feeling frustrated and, well, colicky, for lack of a better term.1

Anyway. It was good to try this experiment on a day right before a weekend, since that means it won’t mess up the rest of my week if something went wrong, and also this was on a day I wasn’t expecting to be very productive anyway, what with the everything. I’ll be skipping it over the weekend but now I’m feeling a lot more optimistic about resuming it on Monday.

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Armodafinil followup

Just a followup, I ended up staying awake for over 25 hours, finally fell asleep for a bit today at 10, woke up again at 11, and mostly I’m feeling like I have a gigantic hangover.

Apparently armodafinil’s mechanism of action is identical to cocaine’s, so it actually IS stimulant-based and not just “a wakefulness agent” and I wish i’d known that before embarking on this. I don’t know why my research failed me this badly this time. Probably me being desperate for something that works.

I’m definitely not interested in continuing with armodafinil, in any case. Advice for dealing with this massive pounding headache would be appreciated.

sleepless from armodafinil

i feel like crap and i;m wide awake and i want to sleep but i can;t sleep

i;ve been having electric pains through my nerves all night and i feel like i drank three pots of coffee and i am not sleepy at all but i am very very tired

on the plus side i’m having no apnea symptoms tonight but that’s because i’m not getting into a state of relaxation which allows it to occur in the first place

why is my body so awful at processing medications

Charting my armodafinil response

Just to keep track of stuff here for onlookers

Time Systolic Diastolic HR Notes
9:11 120 76 59 Just took dose
9:13 119 78 59 Validation check
10:01 136 90 52 Felt it starting to kick in
10:02 132 86 51
10:20 130 93 52 Feeling a bit bad
10:38 142 99 55 Feeling quite bad
10:46 147 102 54 hi
10:50 136 67 64 the ratio
10:59 140 100 54 am i going to die?
11:17 148 87 50 yeah probably
11:21 151 91 54 if i hit 160 I’m going to the hospital
11:30 156 95 55 really shouldn’t have taken this on an empty stomach, huh
11:38 158 96 55 but hey at least I’m very much awake
11:56 171 109 61 911 is being called right now
12:15 170 87 68 EMTs don’t seem to be very worried
12:17 152 89 60 Called doctor, seems the EMTs were right
12:20 156 96 65
12:26 144 86 60 Out of the woods? I’m feeling better but just shaken
12:57 142 89 57 Still feeling really shaky but at least I’m pretty sure I’m not gonna die today
14:36 145 94 56 feeling like garbage but I also still haven’t eaten which might have something to do with it
16:56 147 91 62 still feeling shitty but at least I’m stable, hopefullY I sleep really good tonight
18:56 139 86 62
23:46 137 01 59 bedtime

Armodafinil, day 1

A few weeks ago I learned about armodafinil as an alternate non-stimulant ADHD treatment; this seemed pretty compelling to me because stimulant-based meds have always been troublesome for me for various reasons.

Unfortunately, it’s only off-label for ADHD; fortunately it’s on-label for a bunch of other conditions I have, and the theory of it working for ADHD is that it treats underlying sleep conditions that make ADHD worse, rather than treating the ADHD itself.

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Melatonin experiments

Last night I came across a pop-science video about the link between ADHD and sleep disruptions, and it raised an interesting point: many of the ADHD symptoms are also symptoms of sleep deprivation, and the sleep disruption aspects of ADHD might actually be the underlying cause of many of them.

I’ve always had great difficulty with sleep, with trouble falling asleep at night but then being incredibly fatigued during the day. And I can’t help but wonder how many of my other issues are just plain due to crappy sleep. Maybe my chronic pain isn’t because of an underlying neurological cause, but is because I’m not properly sleeping and healing at night?

I’ve had three sleep studies at this point. The first in-home study vaguely diagnosed me with obstructive apnea, and is why I got a CPAP machine. The CPAP machine didn’t help at all, so a second study to rule out narcolepsy happened. Then the third one verified that CPAP doesn’t actually make a difference for me.

Anyway, one of the things mentioned in the video is that there’s been some success with treating some forms of childhood ADHD with time-release melatonin. So starting tonight I’m going to try taking time-release melatonin and see if that helps me any.

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ugh meds, ugh work

I’ve been on guanfacine for about a month now, and I still haven’t stopped feeling drowsy and tired all day, to the point that I’ll often just fall asleep in the middle of things. Even when I’m doing things like grocery shopping I’ll suddenly feel really tired and need to take a couple moments to brace myself. It’s almost like it’s causing narcolepsy or something.

Last week I talked about this with my psychiatrist and we decided to try combination therapy with strattera, a stimulant-based med, since my ADHD responded well to the Adderall (aside from my blood pressure spiking badly).

So far, it hasn’t been helping at all. I’m getting the panic and anxiety from stimulants, while also being drowsy all day. What’s even worse is I’m also getting frequent muscle spasms, which is apparently a common reaction to some ADHD meds. And ironically, the treatment for that? Guanfacine.

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Guanfacine and naltrexone updates

I’ve been on low-dose naltrexone for a whole month now, and I don’t think it’s really helping with my pain.

And I’ve been on guanfacine for two weeks, and while I’ve noticed a slight improvement in my focus (and a general lowering of my blood pressure, which is of course to be expected), holy cow am I drowsy all the time. Like, to the point of nodding off while sitting still or whatever. I hear that this effect goes away after a couple weeks, and I really hope it does soon, because even though I’m generally getting a full night’s sleep every night I still wake up exhausted and end up taking little mini-naps throughout the day. Heck, even while going grocery shopping I occasionally feel like I’m going to fall over.

On the plus side, caffeine doesn’t give me as big of a panic attack now (although I still feel a bit of one) so that’s at least filling in the gaps while I try to stay awake at work.

Bonus thing: yesterday I tried coating my glasses with soapy water (based on seeing an article in Glamour) and it actually works pretty well! The article suggests thoroughly cleaning them, but I just mixed a little bit of liquid hand soap with a glass of water and dunked my glasses in them and let them drain. It’d probably also work pretty well to dilute some dish soap and swap it on with a cotton swab or something.

Miscellaneous goings-on

I’ve been on guanfacine for a few days and so far I’m not noticing that my focus has changed any, but on the plus side my blood pressure is great now. So, that’s good.

I don’t know if it’s from the naltrexone or the guanfacine but my dreams have been pretty vivid and weird, but usually in a good way. Unlike when I was on the Wellbutrin and my dreams were vivid and stressful.

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So much for Wellbutrin

Yesterday I was feeling pretty off, in a “wow I think my blood pressure is spiking again” way. And I happened to have an appointment at the pain clinic, and they measured my blood pressure at 160/90, which is, you know, Pretty High. At the time I chalked it up to having walked over there in a hurry, but throughout the afternoon and evening I kept measuring it and it remained that high.

And then all night long I had a hell of a time sleeping. I only got around 3 hours of sleep total; most of the time I was just lying awake, blood pounding in my ears, feeling like I was going to die. At 3 AM I also checked my blood pressure again and it was 160/100. Yikes.

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Current state of affairs

I’ve been on Wellbutrin for a couple of weeks now and the effect has been interesting. I’m definitely finding it easier to focus on things like chores (and heck, my kitchen is the cleanest it’s been since the remodel got finished, and my dining room is well on its way to not being a disaster), but on the other hand it’s disrupting my sleep a lot and I end up feeling tired throughout the day. My dreams have also been way more intense.

Right now I’m feeling sick with my usual winter sinus crap, so I’m a bit wobbly and a lot nauseous.

Between the Wellbutrin and playing DDR my pain levels are a bit lower but still not amazing, and I’m still finding it easy to hit a fibro wall™. Tomorrow I have a followup with my pain doctor to try to finally get on low-dose naltrexone. I also have the next two weeks off from work and hopefully I won’t end up just working too hard on personal projects instead. (That said, I have a couple of creative output gift swaps with deadlines coming up that I really should start on at some point.)

Anwyay I guess I don’t have a lot else to say. Oh well.