Wednesday, October 31, 2018

Ashwagandha Experiment: Day 13 and the End

The ashwagandha experiment has ended for me, though my husband is still considering it.

End results for me:
My asthma is worse, my allergies are worse, and I definitely have my GI allergy symptoms (stool change, stool color change, some abdominal cramping) going strong now with no other possible cause since this is the only new thing I've introduced.

The first few days, I had less pain, more energy, and I really thought it was something I could take that would help.  The rebound headache when it wore off, though, was definitely a problem, as were the sleep issues.  I felt more rested when I took it at night, but the tracker said I had absolutely no deep sleep those nights, and it was a lot harder to fall asleep (when it already is difficult).  Switching to taking it in the morning helped a lot for a couple of days.  In trying to ease up the bad headache in the evening (well, worse headache since I always have a headache), I split the pills to stagger dosing, and it didn't seem as effective that way.  Going back to taking a whole pill in the morning did not help my pain like it had before, and my allergy symptoms definitely started getting worse.

Another side effect for me was massive lack of appetite.  I've been forcing myself to eat even a little and finding that my appetite comes back when it wears off in the evening, which is not a good thing for my weight or metabolism at all.  I just didn't want to eat, didn't even think of food as something good (which is weird for me).  I do wonder if, for people on medications that make them hungry all the time, it would help counteract any of those symptoms.  That isn't the case with me, though, and while it helped me stay in a better calorie range for me, it didn't help with weight loss because of when I was finally hungry and able to eat.

Conclusion: I'm allergic to it, and I'm stopping taking it as of today.

End results for my husband:
He stopped taking it a couple of days ago, mostly due to the bad headaches he was starting to get.  We aren't sure if those are due to the ashwagandha, actually, so it's more that he's put it on pause to see if, after this weather system goes through and he tries it again, it works better for him.

He definitely was having GI symptoms, too, though.  Worse gas, some abdominal pain from gas cramping, and his gas smelled much worse.  We're not exactly sure what it was doing to our gut biomes, but it was doing something.  He hasn't had the lack of appetite to the same degree I've had, but he definitely has not been as hungry until it wears off.

Conclusion: My husband thinks he needs a smaller dose than the 600 mg we've been taking (Garden of Life) and a different formulation.  He's going to try taking it again in a few days and see if he has the same symptoms, and he possibly will be taking half pills instead.

Monday, October 29, 2018

The Ashwagandha Experiment: Day 11

Things have gotten interesting in the Ashwagandha Experiment in our house.  I've messed with taking it at different times and splitting doses, my husband is trying it now, and we have learned a few things.

Thing 1: It really helps to take it in the morning for us.
Taking it at night made it so I didn't get any deep sleep and took forever to fall asleep.  I did feel like I had slept really well, but the tracker says I didn't, and the brain fog says I didn't.  We both take it in the morning, though we have found it helps to take it a bit later in the morning due to Thing 2.

Thing 2: It is not fun when it wears off.
I tried doing a divided dose for a few days in hopes that it would make the evening easier when it wears off, but instead, it just made it not work as well overall with the headache still hitting hard in the evening.  My husband didn't take one yesterday (as part of his experiment), and his headache was bad all day.  We're both starting to question taking this at all due to the almost-rebound-like headaches when it wears off.

Thing 3: Divided doses did not help, but taking the one pill didn't help with a bad weather/rainy day, either.
In other words, it definitely is no miracle worker for me.  Yesterday, it stormed and rained all day, and I had zero energy and really bad pain.  The ashwagandha did nothing to help with that at all despite going back on a full dose.  Honestly, the longer I'm on it, the less effective it seems to be, which is weird.  I'm going to stay on it the full month to see if that changes.

Thing 4: Both of us are finding that our allergies and GI issues are worse on it.
I've been starting to wonder if I'm mildly allergic to it, especially since my allergies and asthma are worse and my GI symptoms are starting to look more and more like they did with soybean oil (which I've become allergic to).  I'm not quite there yet, and it is fall (and a usually bad time of year allergy-wise for me), but if my asthma keeps acting up, I will have to stop taking it entirely.  If my husband keeps having the GI issues he is, he's going to stop taking it, too.

In conclusion, over a week later, and I'm not seeing the benefits I did at first.  There is the possibility that it's the dosage or the configuration we're taking, but if I'm really allergic to it, then it doesn't matter in the end at all if it works or not.  So, I'm going to continue on it and watch everything carefully.  If the allergic symptoms continue or worsen, I will have to stop taking it and then see what happens.

Tuesday, October 23, 2018

The Ashwagandha Experiment: Day 5

Today has been interesting.

Last night, the ashwagandha seemed to wear off around 8:30 (putting it at a ten hour range or so), and the headache got really bad, almost like a rebound headache.  The fibro pain came roaring back, too.  I got super sleepy at 8:30, managed to stay awake through kids' bedtimes and all, but when I went to bed, I had a hard time falling asleep.  According to my tracker, I did get deep sleep, though, once I fell asleep.

This morning, I felt more like I usually do and had the same hard time waking up as usual.  My husband and I had discussed the rebound stuff, and I decided to take a half pill this morning.  I did feel more energy, and the pain started letting up a bit, and by the time I got to my neurologist's appointment, I felt decent.  I even was able to bend down and pick things up fairly easily without my muscles screaming.

Then, I went through the more thorough neuro test as part of my appointment.  That got the tremors going hard, and the fibro was all ticked off the rest of today.  My husband had the good idea tonight that I should take a half pill in the morning and then half a pill after lunch to help with the worst time of day (late afternoon).  I'm going to try that tomorrow.  It definitely didn't help enough with the pain today, so maybe going back to a full pill but in a divided dose will help more.

Another interesting side effect: lack of appetite.  I just haven't been as hungry since starting this experiment, even to the point of not finishing what I am eating.  I am a lot more thirsty, and with my kidney, I have to be concerned about that.  I was even down a pound this morning and could fit into jeans I haven't been able to wear in awhile.  Given that, if I want to lose weight at all, I can't eat much more than 1300 calories a day (long story), this isn't a bad thing.

The sleepiness is starting to hit here at 8:30 again.  We'll see how tomorrow goes.

Monday, October 22, 2018

The Ashwagandha Experiment: Day Four

I've read in several places now that the Indian herb, ashwagandha, can help quite a bit with fibromyalgia.  Given the price and how other experiments in herbals have had less-than-stellar results, I just didn't even try it.  This last summer, in an effort to get more use out of the herbs I always plant, I started researching herbal tinctures and teas.  I've made holy basil and lemon balm tinctures, and the sage oil is still steeping.  Next up (and last given the turn in our weather) is an oregano oil.
Anyway, I tried taking a blend of the holy oil and lemon balm tinctures.  Bad vertigo.  Really bad vertigo.  Maybe it was too much, maybe it's the alcohol, I'm not sure.  Next, I'm going to try taking them separately and see if I can figure out which one did the vertigo or if both do it.
In going back through some of my fibro resources about herbal treatments, I kept seeing ashwagandha mentioned repeatedly.  It's an adaptogenic herb that has shown some success in helping with fibro symptoms.  When I was at the Natural Health Center (great store here in Kalamazoo) getting my multivitamin that I was out of, I saw they had an ashwagandha blend on sale and decided to give it a try.

I had to look up when and how to take it (not on the bottle), and the results were mixed.  For some people, ashwagandha gives them energy, so they should take it in the morning.  For others, it really helps with sleep and should be taken at night.  Given that most of my reactions lean towards the sleepy side, I decided to try taking it at night.  My first night was this last Friday night.  According to my fitness tracker, I had only a few minutes of deep sleep on Friday night, and I woke up feeling rather refreshed (and so was surprised at the lack of deep sleep, one of the hallmarks of fibro and considered a possible cause).  Given the nasty storms all day Saturday, I was in surprisingly decent shape, and my pain wasn't anywhere near as debilitating as it would normally have been.  I took it again on Saturday night, and according to my tracker, I had absolutely no deep sleep.  I felt like I had slept hard, though, and my husband said that the couple of times he woke up that it seemed like I was sleeping hard.  Weird.
Sunday, I had a bit more energy than usual despite the lack of deep sleep the night before, but then the fatigue and pain hit hard again in the last afternoon like it always does.  My headache was bad, and so I had a Pepsi with dinner in the evening, and then I took another of the ashwagandha pills with my bedtime pills.
It hit hard last night after I took it, the energy and total inability to sleep. I couldn't fall asleep for hours (not tired in the least though I should have been). According to my tracker, for the second night in a row, I had zero deep sleep.  I did finally get some deep sleep when I fell back asleep this morning, after I think it wore off because I suddenly became exhausted.

I've changed the time I'm taking it to the morning to see what happens during the day. Oddly enough, my fibro-induced occipital neuralgia these last few days has been more annoying (feels like pop rocks going off on the top of my head, and it feels cold but isn't), but the pain has been less.
Today is the first day I've taken it with my morning pills, so we'll see what happens.  So far, I feel more awake, but it's like part of me is still tired and in pain.  It feels weird, but we'll see what happens.

Thursday, September 13, 2018

Once you're a student of mine, you're always a student of mine.

Before I went on medical leave and ultimately had to resign from my middle school teaching job due to disability, I taught high school and middle school kids for a total of ten years or so.  Sadly, the fibromyalgia has taken away most of their names from my memory and even some classes and such, but I remember so many of them.  I easily taught around two thousand students in those years, but I stay in touch with several even years later on Facebook and Twitter.  Great kids who have grown up and moved on with their lives.

They're still my students, though, and I still worry about them.  I have a pair of former students, married parents of one and one on the way, and I had to break out the knitting needles yesterday when I read that she is having some troubles with the pregnancy.  Didn't even stop to think much beyond what colors I know both like and what I had in the yarn stash and then look through some baby sweater patterns I have on hand.

In explaining it to my husband last night as I was trying to at least finish the hood on the top-down sweater before going to bed, I found myself thinking that people outside of education might think it odd.  I haven't taught them in 7 years, haven't seen them in real life outside of social media online, but they're still my students even after all this.  Thankfully, my husband didn't even question it (he's awesome that way).

See, we don't teach machines or widgets in some factory.  We teach people, and those people touch our lives as much or even more than we touch theirs.  They take over huge areas in our hearts, and even after graduation, we find ourselves as teachers wondering how they're doing, what they're doing now, hoping they're okay.  I've talked with teachers about former students and shared what I have heard, and they have told me of family members and the latest news.  I have never known a teacher not to worry over former students, be proud of them for every achievement, and cry over them when they die (yes, we do keep track of that, too).

So, I'm still knitting on this baby sweater in hopes that it will fit okay and let that little baby know that his mom's teacher cares about him, too, even if I won't ever get the chance to have him in a classroom.

Saturday, August 25, 2018

The New Year Cometh and Cometh Right Soon

The ESL program I volunteer teach for starts back up the second week of September, and I still struggle with a basic concept: what am I supposed to be teaching?

If I listen to the state of Michigan, I am to teach CASAS test prep so that the adult students learn ESL quickly and move quickly through the test levels, testing out and then moving on to a GED or a TOEFL program.  If I listen to CASAS, I would work harder on teaching the Common Core CCR (College and Career Readiness) Standards.  If I listen to my program director, she would add that I need to teach the textbook because students feel more accomplished if they finish the books and also need to use the new software our parent program paid for.  If I listen to my students, I would just teach pronunciation games and work on conversation skills so that no one would make fun of their accents.

In going through the mountains of CASAS standards (seriously--there are hundreds), it's clear that we volunteer teachers are facing a more than slightly uphill battle.  We are to get our students to completely assimilate into US culture as well as be entirely fluent (speaking, reading, writing, listening) in English to a native speaker's 8th grade level.  Having taught 8th grade ELA, this is a bit more in my wheelhouse.  That said, these are adults, and they have many different levels of fluency in both English and their primary languages.

This year, I'm thinking of having my students read a book in addition to textbook work and work on the computers.  I'm strongly leaning toward Steinbeck's Travels with Charley.  I know it's a problematic piece (racist against First Nations peoples and black people, for example), but he does a good job of explaining American culture and describing the US geographically.  The reading level is perfect, too.  Apparently, a former teacher used to teach Maya Angelou, and while I love her work, I wonder if it's a good first text to tackle after doing so much book work for so long.  If that goes well, I want to start lit circles after we finish that one and then do a class text in January (no idea what to do then), followed by lit circles.

It is important to read a culture's most important texts, but these days, our canon in the US is undergoing real change.  Books written in the vernacular are difficult for adult ESL learners (at least, they would be for most of my students), so that makes many great YA books and solid American books (like one of my favorites, Their Eyes Were Watching God) not the best in this situation.  Mark Twain is right out, as is any 18th C. American writer due to vocabulary level and complex syntax.  Having never taught American lit, I'm at a bit of a loss.

So, I am asking my readers, what books do you suggest?

Wednesday, August 1, 2018

Let's Talk Pain.

 Pain has been in the news a lot lately due to the concerns of the opioid epidemic and how illegal use of prescription pain medications and illegal heroin and fentanyl are killing so very many, especially in the Midwest.  The government has cut back, not only on the actual supply of opioids made for legal use, but also on what doctors can prescribe, and chronic pain patients have been speaking up.  So, let's talk about pain, something I have lived with for over half my life now.  More specifically, let's talk about how medical types (doctors, nurses, support staff) deal with patients in pain.

First, as a point of explanation, I cannot take pain medication.  I am not allowed to take any NSAIDs due to only having one kidney and that not doing as well as anyone would like.  I cannot take opioids because they don't work (it's a genetic thing--thanks, Dad!).  I cannot take the psych meds often prescribed for pain, also due to genetics.  I have horrific reactions to them (one made me start to go blind by the third day--yes, I get those kinds of reactions).  So, I do not take any pain medications for my severe fibromyalgia, chronic daily headache, and other painful conditions.

I have had a lot of experience with medical types, from having been married to an internist (we dated in college, married in med school, stayed married through residency and his first couple of jobs as an attending, and he left me for a nurse--it's a rather banal, common story) to having chronic pain for over 22 years.  I had chronic appendicitis for ten years that was misdiagnosed as endometriosis (8 doctors missed that, so I don't really blame anyone), two major surgeries in a year, lost my right kidney and three inches off to two ribs to a large kidney tumor, and more.  I'm a compliant patient who sees her doctor more than once a year for kidney checks, etc., and I do my best to do whatever my doctors tell me to do.

I've got several doctors involved in my treatment these days, and I've been through tons of tests.  I used to be flat-out terrified of hypodermic needles, but two surgeries in a year and all the follow-up kicked me of that phobia.  I'm not an easy stick, so any time I have to get an IV, they have to stick me, on average, three times.  A few people have gotten my IV in on the first try, and the record is seven sticks before getting one to work.  I've been assaulted by an ultrasound tech doing a vaginal ultrasound, I've had good doctors, I've had bad doctors, I've known great nurses, and I've known callous terrors.  I've been through a lot, and it isn't over (especially if/when my kidney gives out).

I know pain.  My average pain level these days is a seven, and no, I'm not exaggerating.  See, I know that many med types think patients exaggerate their pain levels to get meds (which I can't take) or attention (don't need that), but I have refined my pain scale over the years.  My personal pain scale:

  • 1-2     Barely ever have this anymore.  Honestly, I never use these numbers  because they don't exist for me.
  • 3-4     Slightly annoying.  Easy to ignore for long stretches, but then it reminds me it's there.
  • 5        Used to be my average.  Easy to ignore for an hour or so, maybe longer in cases of emergency or if my kids need me.  I'm still fairly functional but start finding attention and recall to be difficult.
  • 6        The pain is getting harder to ignore.  I can still ignore it for up to an hour, but it's much harder to do so, and it comes back with a vengeance when I do.  Recall gets harder here, especially.
  • 7        I can ignore this pain only for half hour bursts.  It grabs my attention whenever I try to do something normal (like, walk), and it makes thinking, listening to conversations or videos, and recall difficult.  It's also the pain level I had after my exploratory laparoscopy without pain control and the beginning of labor in both of my natural deliveries.
  • 8        I cannot ignore this pain except for a few minutes at a time.  I can still smile, but it's harder to hide the pain.  This one was later in labor when the contractions were harder and closer, what my ovarian cysts often hit me with, and what my headache can go to randomly.  I'm functional but barely.  I have a lot harder time remembering anything or following any conversation or what I'm reading.
  • 9        I start having trouble talking at this pain level.  Breathing is a chore, and I start to go inward, really struggling to deal with the outside world at all.  This was my last year of appendicitis daily level and what months after my kidney surgery were like.
  • 9.5     I stop being able to talk at all.  It's scary, so I have to fight down a panic response at the same time as deal with the pain.  I can scream in my head, and I do, but everything slows down, and I can't get words out.  This is what my natural births got to at the most painful parts and what my first day after the kidney surgery was.
  • 10      This is when I start seeing stars and start passing out.  Yes, it's possible to pass out from pain alone.  I have, several times, and it's very unpleasant.  My body is overwhelmed with the pain level, and it shuts down on me without my permission.  This was the pain level I had when I woke up early in recovery from the kidney surgery (again, with no pain control), and they rolled me for the x-ray.
I know pain.  I've had ovarian cysts (2+ a year) since I was 22, had appendicitis for 10 years (intermittent for the first 9, solid for the last year, almost went insane from the pain), have had surgeries without pain control, broken bones, and I have fibromyalgia now, so my body thinks pain is a normal state.  Even little things hurt, from certain sounds to someone grabbing my arm too hard.  My skin feels like it's sunburned all the time now (allodynia is a fibro thing), and the pain from that waxes and wanes as my fibro flares up and down.  I have a constant headache now, and that can go from easy to ignore to crippled by it depending on the day.  Every muscle hurts.  I don't even have to do anything for that to be true.  It's just my reality.

So, let's talk how pain is seen by med types.  Some are truly caring.  I will never forget the urgent care doctor who got tears in his eyes when he realized that he couldn't do anything for my pain when I broke my elbow.  He was horrified that I was in that much pain and shrugging it off, but it wasn't like I could do anything else.  He was a real doctor.  My primary care doctor, an amazing internist, truly listens and cares and doesn't like it that he cannot do anything, same with my neurologist.  They are all great physicians.

Then there are the ones who don't believe me.  My ex told me that my pain was all in my head for years when it was appendicitis and a kidney tumor.  I've had doctors roll their eyes when I tell them what my pain level is.  I have had ER doctors try to accuse me of being a narc seeker until I tell them to read my chart and then watched their eyes go big when they see the long list of meds I can't take with all opioids right at the top.

Here's a recent example: the phlebotomist at 2 a.m. who ripped skin off with the tape and didn't notice.  I don't know how she didn't notice considering she was looking closely at my arm, prodding for a vein for a blood draw, but she didn't.  When she decided to use the same vein, she firmly wiped the entire area, including the area she had ripped skin off of, with an alcohol wipe.  I gasped loudly in pain, and her first reaction was to blame me.  She said, "You have a strong reaction to pain, don't you?"  I said, "I have fibromyalgia, so yes, but anyone would after you put alcohol on ripped skin."  She then looked closer and said, "Oh, I guess you must have a bad reaction to tape or something."  I said, "No, you ripped skin off when you ripped off the tape."  She shook her head and didn't believe me, instead going forward with the blood draw and then telling me she would put the tape on a different way.  Thankfully, my night nurse was more than understanding and upset when he looked at it and gave me antibiotic ointment to put on the area.

I've had nurses hit nerves when trying to put in IVs (classic signs--severe burning sensation running up the nerve) only to tell me that it can't be true when I tell them that.  I've been yelled at by doctors and a dentist for crying in pain.  I've been told that I'm overreacting more times than I care to count.  I've been told that blood pressure cuffs don't hurt (until I show them the bruises), that they will get an IV in on the first try because they're the best and then get angry at me when they can't and start pulling the tourniquet tighter and tighter each time (bruising me more each time), that something won't hurt that does and then blame me for it hurting, and more.  The ultrasound tech who assaulted me didn't even look at me as she was doing it, just stared at her computer with a blank look on her face, and when I talked with the head of the practice, the doctor told me that it was my fault for not telling her to stop, ignoring that I was at a 9.5 and literally seeing stars and couldn't talk.  

See, many medical types find that the only way they can do their jobs is to otherize their patients, to become callous to cries of pain.  They start saying all patients lie, that all patients are narc seekers, that all patients are just weak and it doesn't hurt that badly.  They lie to themselves so they can keep going to work every day and hurting patients in hopes of helping them get better.  They have to blame the patients: if they start looking too closely at what they're doing to people already in pain, they won't like themselves anymore.  I understand why they do it, but let's at least admit that they're lying both to themselves and each other.

When we talk about pain, let's at least be honest.