It’s time for an update on some trying times I’m going through
right now, since it may well impact my plans to travel later this month. I have
written about my struggles in the past two years to figure out where my future
lies with the CFP, but now it’s back to basics to discuss a new health
challenge. I am two weeks and three days
into this new challenge that is supposed to last five weeks, though some of the
literature I’ve read says it may last a good deal longer, and some has said it
may be all resolved in the new few days.
First,
the good news is my annual physical with Dr. Markowitz on the 2nd which I passed with flying
colors, my blood pressure, cholesterol and weight all within acceptable enough
levels that he’s giving me another year without Crestor so I just stay the
course and keep the diet and exercise program going. The challenge is that, six days before that, I
had my 6 month exam with my apnea doctor.
My usual doctor had been reassigned so I am with a brand new guy this
time. Ten years ago, Dr. Sak, my
original apnea doctor, after 19 years of struggling with pain and fatigue every
day, put me on a drug called Klonopin to see if that would relieve the
symptoms. I had been on a lot of
different medications for the pain but they all had had limited
effectiveness. But the Klonopin worked. It worked almost immediately. For the first time in two decades I was 95%
out of pain and it’s stayed that way ever since.
Klonopin
is a controlled substance so I really didn’t want to stay on it any longer than
necessary. However, Dr. Sak, Dr. Ella,
Dr. Cowan and Dr. Markowitz have all been of the opinion that it was the reason
why I was out of pain so why mess with it.
I chose to believe that it was the C/PAP that was really responsible for
my recovery, that getting restorative sleep for the first time in my adult life
was why the pain had gone. The doctors
had two opinions: (a) you’re finally
doing well, why change? And (b) the dosage is so benign that even if it wasn’t
doing me any good it also wasn’t doing me any harm. It was finally last October that Dr. Ella
said it was okay to wean myself off the stuff and, if the pains came back, I
could always just go back on it.
Klonopin was supposed to knock you for a loop and have all kinds of
nasty side effects. But for me,
zero. It was like a sugar pill,
absolutely nothing. For the entire ten
years, absolutely nothing. So I was
happy when Dr. Ella gave me permission to come off it. Unfortunately, very soon after I got
thoroughly swamped with the CFP class and internship program, then the accident,
which pretty much changed all my plans for the whole year.
In
March I saw Dr. Ella again and she repeated that I could wean myself off any
time of my convenience, but no urgency.
It was a benign dose so I could stay on it indefinitely if I
wanted. And it was soon thereafter that
I started having these chronic stomach problems that were caused by the trauma
of the accident so I planned to get that under control before stopping.
On the
26th I saw Dr. Ella’s replacement, Dr. Najar, and he shocked me by
expressing disbelief that they had put me on Klonopin in the first place. He started me immediately on a four-week
course to get me off. That was fine; I’d
be off by the time I hit the road. But
he certainly had a very severe reaction to me being on the drug at all, despite
the fact that I told him I had been put on it in the first place to relieve
pains I’d had for years and that it had worked.
I wasn’t convinced it was the reason I was still out of pain and I did
want off but I wanted off on my schedule, not someone else’s. I had hoped to get another 6-month
prescription so that if this experiment ended badly, I could just go right
back.
That
was not what he had in mind. He wrote me
a prescription for just four more weeks.
If this ended badly, I would not have enough to go back on unless he
changed his mind and it didn’t sound like he was going to do this. It was somewhat shocking. My other four doctors had been steadfastly in
favor of my remaining on the Klonopin; he was passionately opposed.
Thus I
got into a cycle of analysis paralysis.
I have chosen to believe the Klonopin wasn’t doing anything for me and
now Dr. Najar was agreeing with me. But
what if he and I are wrong and the other doctors are right? What if the Klonopin is the reason I’ve been
mostly out of pain for ten years? Dr.
Najar gave me no indication that there would any unpleasantness to the
withdrawal. So I wasn’t concerned about
the withdrawal. I was concerned that it
might turn out that I needed the Klonopin after all, that the pains I had ten
years might come back. Then six days
later Markowitz gave me something else to worry about, that the real withdrawal
would happen during the week following my last dose. It would not end after Week 4; the real test
would be how I was doing after Week 5. That’s
the week I’m supposed to be on the road.
The
schedule is for two weeks at half a daily dose followed by two weeks at half
dose every other day, then stop. I will
say that the old pains started creeping back in a low-key way about Day 4. But I was handling it and Dr. Markowitz said
this was normal. But for the past few
days since I’ve been on ¼ dose, the pains have been creeping up stronger, still
manageable but with increasing discomfort.
Today, Friday the 13th, they were worse than usual though
they have abated somewhat as the day has worn on. I also made the mistake on this Friday the 13th
to research Klonopin withdrawal on the Internet. The news is not good. It’s possible I’ll get through this without
the discomfort worsening. It’s also
possible that I could be in for some genuine pain in the next two to three
weeks. I found a number of horror
stories out there, even with the low dose that I’ve been on.
Now the
analysis paralysis is taking on a new meaning.
The literature seems to suggest, like Markowitz, that the real problems
begin in Week 5. I hope I’m misreading
that. I’ll be seeing Dr. Cowan on Monday
and he’ll be able to give me a detailed appraisal of what I might expect. He knows more about pain meds than anybody
else and it’ll be interesting to see if he even agrees that it’s appropriate
for me to go off this stuff. And how
does a doctor determine whether the pains are because of withdrawal and will go
away in a week or two, or are because you really need to be on the stuff? I’m hoping Dr. Cowan can answer these
questions. I’m hoping he can reassure me
that the next week and a half should not be any worse than the last two and I
need not be concerned with Week 5 at all.
Before
Klonopin, I was on Donnatol for the spasms, and it worked reasonably well if
not great. Donnatal has been on the
market since the 1940s, is very safe, and cost only $7 a month. I’d been on it as needed since 1989. Four years ago, when I got my new
prescription refilled, the cost had skyrocketed to $450 per month. Today, Friday the 13th, I checked with
the pharmacy to see if the price was still sky high. They quoted a price of $423 per month.
Unfortunately
I have too much information now and it has paralyzed me. I only know that for ten years I have been
more or less out of pain and that is now beginning to reverse. Now I’m feeling that maybe taking this
low-dose controlled substance (which also only costs a few dollars a month) may
be a very small price to pay to feel normal again. But I don’t know if Dr. Najar is going to be
flexible about this. I had really wanted
a 6-month prescription so I could do this at my own pace. I don’t know what to expect now. Am I in for trouble during the next few
weeks? I’m hoping Dr. Cowan can shed
some light. As much discomfort as I’ve
already had, at least it’s not excruciating pain (as it was ten years ago), and
I will be very happy if it just doesn’t get any worse. It’s going to be a long two weeks. It may be a long three weeks.
Just a
heads up. I don’t know if I’ll be up for
traveling after all. I’ve already
decided not to attend the annual CFP symposium in Novi this Wednesday and
Thursday as I am already in difficulty and suspect I will be all next
week. Wish me luck! I do not enjoy dealing with both this and the
stomach problem at the same time.
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