Sunday, October 27, 2013

Rifampicin, Agitated Depression and Pottsville

I didn't want to make it known just how bad I got mentally but hey what the heck, it is my life and that's what happened.  When your ability to make decisions is obliterated by feelings of desperation and physical sensations of anxiety, the only thing left is endless days of pacing the floor and praying for the oblivion that deep sleep can bring.  I was only sleeping for few hours a night though and not at all during the long days of torture.  I had severe gastritis and no enjoyment from food. I didn't mind losing weight.  I was prescribed a couple of anti-depressants which only seemed to make the gastritis worse and some suggest one of them was making my agitation worse.  Later I was put on Effexor which did not aggravate the gastritis.
View from Tropical Fruit World, Duranbah showing Wollumbin Mt Warning
I stopped all my oral lyme treatment because of the gastritis, the pressure from non-lyme doctors and because my mental state could have been aggravated by the anti-biotics.  Clarythromycin has anxiety listed here as one of its side effects. Dr Legend had also reminded me earlier when I was complaining about anxiety that lyme disease and its treatment can involve a worsening of mental symptoms.  In fact when I returned to him he did not restart me on that phase of treatment so that I have been left wondering whether the cysts via the Fasigyn (Simplotan) and the L-form via the Clarithro... were ever gotten rid of.  I did eventually notice a return of my fibromyalgia pain that's for sure.  Bummer.

I continued to take the Bicillin injections fortnightly except for one which I skipped because of a panic attack. But that is all I was being treated with.  I was far too upset to deal with diet or my supplements and I have learned not to spend much time reading about the suffering of others on Facebook Support Groups.  I didn't want to know about Lyme disease....especially if it was causing this mental breakdown.  There is one thing for sure ......I have never ever been that bad with depression and never ever had depression take the form of agitation.  Once upon a time depression meant that I could sleep the day away.  That was not possible because I could not even sit still.  I could not read or use the computer.  All I did was feel this horrible feeling.  My only real friend J did her best to support me even with meals.  But most of the time I was going even crazier feeling confined to the house.

My sister came up to care for me for a couple of weeks or more and I really appreciated it so much.  I followed her around like a sheep when we went out with no real desire to do anything except kill time.  She tried to get me out every day.  She cooked for me and made decisions for me especially what clothes to wear and whether or not to postpone the flooring job that was to be done on this unit.  By the time she had to return home to pack for her big move, the medication was starting to kick in.  Everyday life became so much easier and it was hard to remember how or why tiny things could be so difficult to achieve when they had suddenly become second-nature again.  I caught up with Connor who had broken his arm falling out of a tree and I went from doubting my ability to drive to agreeing to meet my family (Mum and sister) a couple of months later in Pottsville, NSW.....a 2 and a half hour drive plus break time.  I also put on all the weight I lost in just a few weeks.  I was told it was the medication giving me a craving for carbs.  I've still got it then.
Mooball Creek, Pottsville
It was not smooth sailing maintaining my independence because when I cut back on one of my meds called Olanzapine I began to relapse.  I wasn't slow to get mental health advise this time.  Going back up 2.5mg made all the difference after another uncomfortable week.  Actually that happened twice because I tried to cut down again while I was holidaying in Pottsville (with the blessing of my GP).

I had a nice time in Pottsville and surrounding areas.  Mum, sis and I tripped around visiting places most days and often eating out.  We went to Byron Bay, Crystal Castle, the Kingscliff markets, Kingscliff shops, Fingal Head, Tropical Fruit World at Duranbah, Pottsville markets, Bangalow markets, Brunswick Heads and suburbs north called Ocean Shores and South Golden Beach, Tweed Heads, Murwillumbah Rainforest Centre, Murwillumbah Gallery, a marine education centre, Hastings Point, Cabarita Beach Hill and Minyon Falls in Nightcap National Park.  S and Connor caught the train and buses down for the last weekend and I am glad they both got to catch up with Great Nana also known as GrandNan.  The worst thing about the holiday were the stairs in the holiday house.  They damaged my knees somehow and they are still not allowing me to do a full squat but I am getting there.  The best thing about the holiday was realizing that I no longer got fluey exhaustion from being fairly active.  I am now able to walk reasonable distances and continue to do so.
Fish and Chips on the deck
After the holiday was over and I was back home, I had agreed with Dr Legend to begin taking an antibiotic called Rifampicin.  It is not easy to get so it took a few days to organise. This treatment was being used to treat my clinically diagnosed Bartonellosis.  I've mentioned it before as a co-infection of Lyme Disease.  I was surprised by being told at my last visit that I have finished my Lyme treatment and that the Bicillin injections were now considered "maintenance" only.  All I apparently have left to do is complete three months of this Rimycin (Rifampicin).  But so far it has not been easy.
Minyon Falls
Stupa At Crystal Castle
My friend J has noticed a decline in my mental health since I came back from holidays and started the Rifampicin.  There is also a known interaction between Rifadin (as Rifampicin is known in the US) and Olanzapine which I am taking for anxiety.  I told Dr Legend my anxiety had been getting worse again and he told me to put up the dose to make up for the lower levels of this drug in my system as caused by the Rifampicin.

Significant interaction possible (monitoring by your doctor required)
olanzapine Oral + Rifadin Oral
Rifadin Oral will decrease the level or effect of olanzapine Oral by altering drug metabolism

The above is taken from WebMD drug interaction checker.

Rifampicin interacts with many other drugs including the Losec I take, in the same way, and Losec interacts with Olanzapine as well.  Dr Jo, who is managing my psych meds agreed with putting up the Olanzapine so now I have 7.5mg daily.  I had been feeling more depressed as well but she would not put up the Effexor because she said I was already on the maximum dose.  After an initial improvement a week after putting up the one for anxiety, I have continued to remain low in mood and am battling especially in the morning.  I have been making a real effort to get out and indeed I have been going to a ladies friendship group every Wednesday but last week I found myself close to tears while there because I felt unable to socialise with them.  I make these efforts to get out like everyone says but it seems like a big cover-up job.  Yesterday I took J for a drive to the Bushland Botanical Gardens and then Eudlo for lunch.

The fact remains that I am not very happy and I am still getting adrenalin surges like anxiety attacks.  I can't get my brain working in the morning especially because I can't seem to wake up properly.  I am not dysfunctional but I am not comfortable.  And get this.....the side effects of Rifampicin include agitation and tiredness which is nothing to do with any drug interaction.  So two things could be going on with the medication.  And I know I have had more headaches or rather one low-grade permanent one.  It all makes deciding whether any of what I am experiencing is a herx mostly impossible.  I just hope the bad days are a herx and that the bugs are being destroyed in my brain!  The only interesting thing about Rif is the fluoro-orange colour of my urine.

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