At the risk of courting accusations of hypocrisy, I’ll tell you that I started a new medication today. Three weeks ago, one of my doctors suggested trying two new medications – I believe that was the day I went home and wrote my blog entry about my frustrations with the medical industry’s reliance on pharmaceuticals. I told him that I wanted to think about it – but I think I knew even then that I would give these medications a shot. Today I started taking Cymbalta – I take 20 mg in the morning and 20 more at night. Cymbalta is one of only three drugs that are actually FDA-approved for fibromyalgia. Like Savella, which I tried and quickly rejected in the summer of 2009, Cymbalta is an antidepressant that is also known to have a marked effect on pain. Somewhat troublingly, my doctor could not explain to me why these two antidepressants are FDA-approved for fibromyalgia and others aren’t – he just said that all antidepressants have the potential to reduce pain.
I don’t feel like doing the research right now, but ten bucks says that the FDA’s approval of Cymbalta and Savella for fibromyalgia probably has nothing whatever to do with the chemical formula of these medications. The parent companies of these drugs probably just have the best lawyers.
In December and January, as I began to come to terms with the fact that I no longer had control of my health and my pain levels and began to accept the fact that I needed to take this leave, I slowly weaned myself off all of my medications. I wanted to see what my baseline was – what my body and mind would look and feel like without any pharmaceutical intervention. And the result was not pretty. I think I lasted about six days without any medications before I re-introduced two of them because I just couldn’t stand how terrible I felt. I remember sitting in my comfortable chair during the first few days of medical leave, surrendering to waves of dizziness as they hit me one by one, running my hand over my neck and shoulders to feel the knotted muscles and bruise-like tender points that just wouldn’t relax, no matter what. My body felt as if it weighed a thousand pounds, and I felt deeply, profoundly, transcendently sad. I don’t know if the sadness was a factor of the terrible pain I was in, or if it came from the antidepressant withdrawal, or if it came mostly from the hopelessness and resignation that I felt after finally stopping work. All I know is that it was real and it scared me, and I was willing to go back on medication in order to make it ease up a little. When I reread the first few posts I wrote in this blog – let’s say those written before February 8 – I feel that sadness woven into my sentences. Those first few entries are my reminders of why I am on this leave, and why I am taking the medications I’m taking.
(The first person to say that I am a better writer when I am TRANSCENDENTLY SAD gets a blog post about their secret sexual attraction for Golden Retrievers. You would be right, but that’s not the point.)
As of right this moment, here’s the regimen of medications and supplements that I’m taking:
Morning: 10 mg Lexapro, 20 mg Cymbalta, 250 mg magnesium
Evening: 100 mg Norflex, 20 mg Cymbalta, 3 mg melatonin
I also take Tramadol VERY occasionally for pain, and I take Tylenol PM as needed for headaches. There have been times in the last four years when I’ve taken a LOT more, but I still wish I were taking nothing, and I still mean every word I’ve ever written about how terribly corrupt the pharmaceutical industry is and how crippled doctors (and, by extension, patients) are by their reliance on it. But I am willing to admit to a little bit of hypocrisy and to a LOT of weakness. When I am in pain and upset, I want something that will make it better. The pharmaceutical industry counts on me to feel this way, and I do.
This is going to be a very, very hard cycle to break, I think.