Sleep. Such a simple thing. And so horribly fickle.
At night, I can't sleep. I think the hydromorphone is paradoxically acting as a stimulant (Valium did the same thing when I took it a while back), keeping me awake. And the dose I'm taking isn't quite enough to dull the pain, particularly on nights like the last. My wrists, hands, shoulders, hips, and ankles all ached, and a chill current passed through my bones.
I'm now taking 600mg gabapentin at night, but it's also not quite doing the trick.
Adding extra clonazapam doesn't help me fall asleep any faster, though it does result in heavy sedation the following morning.
A typical night/day is as follows. Go to bed at 11:00. Try to sleep. Fail. Eventually get out of bed around 2:00 and fuss around for 30 - 60 minutes. Go back to bed. Finally fall asleep. Alarm goes off at 10:00 AM. Try to get up. Sometimes fail, sometimes make it. Am exhausted and foggy. By 4:00 PM, am fighting to stay awake. Pinching myself. Try to stay busy. Sometimes stay awake. Sometimes simply cannot and fall asleep despite myself. Wake up in one or two hours. Feel like crap. Go to bed at 11:00. Wash, rinse, repeat.
I've tried getting up at 8:00 to make sure I'm REALLY REALLY REALLY tired by 11:00 so I have no choice but to fall asleep. No joy. I think that the medication combination is somehow undermining my efforts. Which poses its own problem. If I stop taking the hydromorphone entirely, or even reduce the dose, it's likely that the pain, which is already highly distracting while on narcotics, will keep me awake. Additional sleep aids (clonazapam as well as other herbal options) might knock me out, getting tossed into the river Lethe without a flotation device isn't exactly what I'm going for either.
Anyway. To summarize. So. Frustrating.
I'm seeing my pain management doctor on Friday, so hopefully he'll sort out the hydromorphone portion. And then I need to see Dr. M to get the clonazapam sorted. And did I mention that Dr. R prescribes the gabapentin? I wish I could get everyone in a room together and have them actually collaborate on One Treatment Plan, with each other's immediate opinions and feedback. I also wish I had a unicorn.