A little knowledge is a dangerous thing

As is the ability to use Wikipedia at all hours of the day! Last night, I couldn’t sleep (again), which was pissing me off as I return to work today and would have liked a good night’s sleep so I feel awake and refreshed, not groggy with the anti-histamine hangover I have today (more on this later).

The reason I couldn’t sleep – worry, secondary to chest pain.

Yes, I’d had chest pain since waking up yesterday. Central, crushing chest pain. Now I didn’t do anything like call 999 (do as I SAY, not as I DO) because I’m pretty sure it was due to too much coughing. It’s still hanging around now, though not so bad, as I’m doing less coughing.

This chest pain kept going through the day, alongside the niggling thought that I know people my age who’ve had MI’s at my age and, oh my, my neck is starting to hurt worse (though that is probably due to the infection), perhaps I should get checked out SHUT UP BRAIN if you’re that worried I’ll do an ECG when I get to work tomorrow (i.e. today). But it all worked out fine, my heart hasn’t snuffed it yet, and I’m feeling much better (though not better enough for a night out at Nando’s, perhaps my favourite resturaunt – I must really be ill).

So as usual, I went to bed at the end of the day (rock and roll lifestyle FTW). Did the crazy drug routine – 2 paracetamol, 2 erythromycin, lamotrigine, salbutamol inhaler, simple linctus and codeine linctus. That should sort the ill right out.

And then, as usual, I couldn’t sleep. So then, as usual (you see where this is going, right?) I decided to surf the web on my phone until I could find something dull enough to sleep or I just wore myself out (giggidy).

Wikipedia always provides boredom! Lets look up how erythromycin works. Ok, so what side-effects does it have? Oh, it interacts with drugs which lengthen the QT-interval. And by interacts I mean causes cardiac arrest. Not good.

Do I take any such drugs? My pocket interaction checker (comes bundled with a PDA formulatory I use for work, I’m not that sad!) says no, other than a slight risk with long term use of salbutamol, which I don’t. Ok then. But I vaguely recall that recent work shows that lamotrigine can cause lengthening of the QT-interval, though being recent hypothetical work it wouldn’t make it into such checkers yet.

Argh, I’m going to die! What to do, what to do? I know, more codeine (still coughing, will help that too) and some Nytol (old school anti-histamines still have their uses). Night all….

So now I’m suffering. Once from the anti-histamine hangover mentioned earlier, though coffee and paracetamol seem to be dispensing with that. And twice from my own stupidity – I really should, again, practice what I preach and read around. Latest work – Lamotrigine does not prolong QTc in a thorough QT/QTc study in healthy subjects (QTc being corrected QT-interval as QT depends on heart rate – essentially the think I was talking about). Though now my paranoia strikes – firstly that research was funded by Smaxo, who make the drug; and secondly, am I a “healthy subject” with my already crazy heart (who else of my level of non-fitness can sometimes have a resting bradycardia, yet a day later a resting tachycardia at the same time of the day, as well as my pre-existing sinus arrhythmia than people just love to take)…

STOP WORRYING BRAIN! SHUT UP! LOTS OF PEOPLE TAKE THESE DRUGS AND DON’T DIE!

I can’t wait until I do medicine, then I will hopefully properly understand all this jazz. Right now all  have is a basic overview, which means that I don’t understand any of it to enough detail to make actual rational decisions. I keep trying to tell myself this, but my brain keeps getting itself worried. Stupid brain.

Out of interest…

… Does anyone else get ill when they stop taking Lamictal?

For about the last month or so, I’ve taken to hiding all the drugs in the house away (go figure), which has the unfortunate side effect that it can be hard to remember to take them, especially on busy days. So at the end of last week, I pretty much took no lamotrigine – yes I know I’m a naughty boy, shit happens.

On Friday afternoon, disaster struck. I was stricken by a sudden bout of the deadly Manflu (or so I thought). Couldn’t sleep (dreaming about work, kept killing people), couldn’t regulate my body temperature, couldn’t walk long distances, couldn’t stop coughing, sore neck, photosensitivity, what have you.

I seemed to recover a bit over the next few days, but now it’s back with a vengeance. Same style dreams waking me up every quarter of an hour, horrible hacking cough bringing up all kinds of funky multicoloured jazz, wheezy crackly chest, and a throat so sore that I’m amazed I can actually swallow any of the drugs I’m trying to pour down there. Chest infection anyone?

Now is this just co-incidence that I got infected when I stoppped the lamotrigine? It’s an occupational hazard I face at work, getting ill, given my job is to go around picking up sick people (at one point I was worried it was meningitis man back to haunt me). And my normally ridiculously hardy crewmate came down with something over the weekend too. So perhaps it was nothing to do with the Lamictal?

But then again, lets look at past history. Last time I felt this bad was last year while writing up my thesis. And guess what, it was when I stopped taking Lamictal for a few days! Horrible Manflu that progressed into a chest infection (that the receptionist in the doctors’ surgery diagnosed as viral for me for about two weeks before letting me have an appointment – it’s amazing the training they get nowadays ). At least then I could work from home, or to be more precise, the bath with a remote login to the labs. With this job I can’t exactly do the same thing, it’s kind of necessary for me to be there to do all the lumping and bumping (tele-carrying-people-down-stairs?) and to be in the back of the ambulance for when things go wrong, as they invariably do on my shift (we haven’t got round to installing those robot arms for doing surgery remotely yet in the ambulances).

But I digress. Ok, so there’s plenty of evidence to the contrary – the number of times I’ve stopped my lamotrigine by accident (and a couple of times on purpose, weeeeee hypomania) where I didn’t get ill. But the fact that the last two times I got this ill, in this particular way, were when I’d suddenly stopped Lamictal makes me suspicious. Looking back, the last time prior to these two episodes I felt like this was in first year, when I contracted Freshers’ Flu.

I’m not saying that stopping lamotrigine makes me ill. But does stopping lamotrigine weaken the immune system or some such, making it easier for me to get ill?

So the point in this long rambling diatribe is to ask, has anyone else who is on/has been on Lamictal suffered anything similar? I can’t find anything in the literature (by which I mean Google), though this may be because of people who either don’t understand apostrophes or just can’t find the right key writing “I’ll” as “Ill”. If anyone has any answers then please let me know!

[And yes, I am writing this at four in the morning. Told you, I can't sleep!]

Me? Exercise? You know nothing of the crunch!

I (or rather, Ana) have noticed that my once fairly thin belly is taking on a rather distinctive pot-like shape, and pretty soon I might need to consider a training bra. So I have decided to do something about this, and start on…

Drumroll please…

An exercise routine!

All is well and good with it, until I near the end, and encounter my arch-nemeis – Crunches. For some reason, I’ve never been able to do them well, and now with my extra padding the extra exertion leaves me worried that I have given myself a hernia after just a single situp. However, it does give me an excuse to post this:

(Which can also be seen here, if facebook has blocked out the embedded video)