The other night at work I had kind of a ... medical anomaly? Yeah, let's call it that.

I haven't written about it here because I'm still trying to sort it out, because it's still kinda hazy, and because it's kind of embarrassing. I did allude to it yesterday, but that was just me being my usual smart-ass self. I haven't really faced it, I haven't even discussed it much. I've only talked about it, as of now, with a couple of my most trusted friends and with my doctor. I'm writing about it now because, if for no other reason, writing helps me think clearly. But also because I do want to pass along something I've learned ... something I learned the hard way ... with hopes that it might be useful to someone.

Here's what happened:

Well, let's start from the beginning. I'm a shift-worker. I work a swing shift. To keep it simple, it boils down to a week of graveyard shift, followed by a week of evening shift, and then a week of daylight. Because of that I have a hard time keeping any kind of regular schedule with anything. That can make life a pain in the ass, but it can be even worse than that if you start forgetting to take your prescription drugs.

I'm on a number of drugs, some to treat the symptoms of bladder cancer, others for other problems, like allergies. I've also been on Effexor (venlafaxine) for several years. Effexor is a drug that's designed to treat depression and general anxiety.

It's been a long time since I've felt that taking Effexor was doing me any good. I've continued taking it, though, because missing doses has caused horrible side effects for me. Most commonly, I have really awful nightmares ... but I've also experienced mood swings, depression, anxiety, etc. It's funny: I started taking this drug to deal with depression and anxiety, and eventually it stopped helping me at all, but did start causing terrible depression and anxiety if I missed a dose.

Sometimes I have to think that Tom Cruise was at least partially right.

Oh, and before I forget, one of the drugs I take for the effects of bladder cancer is oxybutynin, a drug with it's own gnarly list of possible side effects. I've been on that for six months or so.

As near as I can figure, I think I missed taking the Effexor for two days, and I might have taken too many oxybutynin tablets the other day. Oh, I forgot to mention, I'm also on zolpidem for occasional use to help me with the sleep loss associated with bladder spasms, shift work, etc. The zolpidem tablets look EXACTLY like the oxybutynin tablets, and it's possible to take one when you mean to take the other if you're not careful and if you rely too much on one of those weekly pill-box things.

As for me, my daily drugs are served up in a cornucopia.

OK, anyway, enough beating around the bush. The other night I had a splitting headache that was one of the worst I've ever had. (I've been having them for a week or so now, and I've been taking Advil Migraine for them to try to fight them off. More drugs. Yay.)

I'd had one of those headaches all night, and then all of a sudden at work I started having intense pain in my back and my shoulders on the left side. As of now, that's probably been correctly diagnosed as muscle spasms brought on by stress and poor health.

But here's the thing: When I started having that pain in my left side, I was sure I was having a heart attack. I honestly thought I was dying. No shit, man. I thought I was about to drop dead at about 3 in the morning in the damn paper mill where I work.

And so I ended up short of breath, nauseous, and having a full-blown panic attack.

Now, I have had problems with anxiety and depression before, but I'd never had an all-out panic attack before, and I had no frame of reference for it. All I knew was that I was sure that I was dying. I thought I had minutes to live. I ended up being transported to the hospital in an ambulance, with an oxygen mask and an IV and the whole thing. It wasn't until I was in the ambulance, almost at the hospital, that I began to realize that I wasn't really dying.

Anyway, to try to wrap this up, 90% of what happened was brought on by not being careful enough with my prescription drugs. I've been pretty casual about the drugs I take ... obviously too casual. I've been too quick to do stuff like buy and take Advil Migraine pills instead of consulting my doctor when I have a headache for days. And, worst of all, I've been too lax about making sure that any doctor I see knows each and every drug I am on, the exact dosage, and the reason that it's prescribed.

I saw my doctor yesterday and some major changes were made to my prescription schedule. For one thing, I'm being weened off of Effexor. With drugs like that, you can't just stop taking them. You have to have your dosage slowly decreased over a period of months. It'll probably be four months before I'm off that drug entirely.

My doctor also gave me a "put up or shut up" exercise program and diet.

So the lesson I learned is that it is very important to be very aware and very involved in any prescription drug schedule that you might be on. Make sure that every doctor you see knows exactly what you are taking, how much of it, and how regularly. And make sure that you take your pills when you're supposed to take them. And in the correct dosage.

Really, this is elementary school stuff. But morons like me never learn anything the first time.

The older I get, the more likely it is that I'm going to have to take more pills each day, not fewer. So that makes it all the more important. But regardless of your age, regardless of the number of prescriptions you are on, and regardless of how long you've had to take or will have to take any given drug, remember the importance of your prescription schedule. Don't brush it off or be neglectful about it, like I have been. You don't want to have to learn this lesson in the back of an ambulance.

So there's my cautionary tale. I hope it's useful.

Labels: Bladder Cancer, Personal