Lease Expiration

My fracture-healed body is the foil to my sense of well being.  Now that I'm back on my feet, the the greater trochanter fracture 95% healed, I've uniquivocally slipped back into the hell of chronic insomia, with the renewed sense that I no longer have the resiliency needed to navigate life (work, socialize, etc).   This is underscored  over the past 2 week by my repeated plunges into 2 -3 day successive "rips" where I sleep between 0-3 hrs per night, then crash the next day or two.  The last 10 years of my life have been absorbed by this black hole, and I've had a remarkable 11 week reprieve.  But now, desperate, unprecedented actions are going to be undertaken in the next year to remedy the situation.  All options are on the table now, because living the rest of my life alone in an insomnia mediated semi-stupor is not an option.

Currently thinking of doing another sleep lab study, perhaps with more of a medical trail, I can investigate whether I can go on disability, maybe getting some stronger sleep med drugs, taking a three week vacation to the amazon to drink ayahuasca - probably all will happen within the coming months.  Of other more sundry options on the radar screen I will not speak.  One step at a time, all hope is not yet lost.

life's new lease?

As puzzling and crazy-making the past 10 years of insomnia have been, its relinquishment over the past two months, starting nearly to the day that I broke my hip, has been nothing short of astounding.  So for as much as I've whined and moaned about my sleep problems with my highly sporadic posts, I'd be remiss not to note its lifting, and add a couple of comments and conjectures as to what I think might be going on.

First off, because visuals speak louder than words, I'll unveil a graph that tells part of the story.  I started keeping regular track of my sleep hours every night since January 2012 (I wish I had been doing this through the whole period since the nightmare started in 2003).  The red line is a 30 day moving average of sleep hours per night.  For those of you not familiar with moving averages, to get the sleep hour data point for any given day (say, June 1), I take the average sleep hours of the previous 30 days (The period of May 1 to June 2.  For the next day, June 2, take the average sleep hours per night from May 2 to June 2, and so on.)

I am lousy at formatting, so while it may not be pretty or slick, this will have to suffice.  I fractured my hip on August 31st 2013.  Though I am mostly back on my feet right now and have resumed most activities, I am still sleeping relatively well compared to before the fracture.

Those looking closer at the graph may notice that the trend line starts heading up a bit before the fracture.  For August 16 - August 30th, I averaged 6.5 hours per night, which is way better than all the previous graphed periods, so maybe the fracture had nothing to do with it.

So here is my alternative hypothesis:  Sometime this summer I slightly altered my supplement routine - I started taking right before bed 50gm of 5-HTP and ashwaganda.  I also exhausted my stash of cheap melatonin supplements and started buying better quality brands.  So I now take 3mg of time release melatonin right before bed as well, and when I inevitably wake up (usually around 2 - 4 AM), I take 3 non-time release.  Sometimes I will supplement with additional 1MG melatonin pills as well.  Sometimes I need to meditate for 30 min to an hour to get back to sleep as well.

I pretty sure that I am utterly dependent on both 5-HTP and melatonin now, but I will choose dependency over the semi-conscious living hell of insomnia.  I'm hoping that this, in combination with my regular habits of heavy exercise and mediation, will enable me to mostly shake this bugaboo.  Fingers crossed.  The 5-HTP is tricky for me.  50mg is a low dose, but it makes me prone to having seizures and gives my odd feelings of disconcerting physiological discomfort throughout the day.  More than 50mg, the problem with seizures and auras gets worse.  I'm sure my serotonin production/regulation system is totally whacked.

I occasionally (once every week or two) use and need pharmaceutical backstopping.  From current and leftover prescriptions, I now have restoril (which I've habituated to after over 2 years of sporadic use), ativan, and lunesta (which made me depressed and gave me wicked rebound insomnia when my prescription was active) to choose from.  From my hip fracture prescriptions, I have a few leftover diazepam and vicodin, which also tend to knock me out.  From here on out, I'm hoping that I can stay on an even keel, with only having to resort to the meds 1x every 3 weeks or so, relying mostly on benzodiazapenes, but with an option of the lunesta type meds.  Don't worry, I won't try to get more vicodin to use as a sleeping pill - I'm not that dumb!

I can only pray this is the light at the end of my insomnia tunnel.  Time will tell, and perhaps on this blog, I will tell as time does.  Now, back to living life. At the age of 49, I'm trying not to cry over the spilt milk of 10 lost years.

broken bones: insomnia foil?

It was spectacularly stupid.  Riding my bike to the Saturday morning farmers market on the last day in August here in Montpelier, my ball cap started to loosen as I picked up speed down a wicked hill.  Reaching for it to keep it on my head, I lost control of my bike, flying over the handlebars and landing on my hip.   I sat in the middle of the road stunned, contemplating my sudden change of status, from healthy male cyclist to injured citizen in need of medical attention.   It was one of the few times I did not wear my helmet.

I had a hip fracture – isolated fracture of the left greater trochanter.  In other terms, I broke off the pointy part of the hipbone that juts out from the outside part of the upper leg.  It is an unusual type of hip fracture, and perhaps not as serious as far as these injuries go, because neither the weight bearing integrity of my leg nor the hip joint itself were compromised in any way.

Aside a well-learned lesson in cycling safety, the pain, recovery, and having to tolerate a hopefully small number of weeks hobbling around on crutches, the experience has had a welcome silver lining thus far:  nearly normal amount of sleep.  It is amazing – I’ve sometimes been hitting 9 hours a night for over 2 weeks now, and feel human again, other than the broken hip part. 

The pain meds certainly had something to do with it at first – the vidcodin/acetominephin combo along with the diazepam prescription for pain relief and muscle relaxation really put my lights out.   But now that I’ve been weaning myself off of these, I’ve had some solid nights, (and even a long afternoon nap last Sunday!) without the meds.  And its been weeks since I’ve taken a benzodiazapene sleep aid (current Ativan prescription, with some left over Restoril, to which I’ve habituated). 

So hope springs eternal from the physical trauma of bone fracture.

vegetative trajectory

One by one they have been move to my personal "should not do list" - otherwise healthy, sustaining activities that would benefit anyone within the normal bounds range of person to person variation.  And the last item that has moved onto the list has put me on a decidedly depressive vegetative track.  Exercise in a way was my first pillar of self-maintenance.  It only went so far in terms of what my needs really were, but in my 20's it went just far enough to keep me from completely sinking.  And now, becuase of my recent hip fracture, I need to be relatively immoblile in order to heal.

The recent red-listing of exercise follows on the heels of meditation and yoga, my most profound and puzzling red-listing events.  It was almost 10 years ago that my intensive zen meditation regime tipped me over into the hell of chronic insomnia: my sincere and enthusiastic efforts to practice as a way of coping with our overstimulated culture and society and my particular sensitivities backfiring into a vitality-depleting black hole of sleep deprivation and death-warmed-over social isolation (I've had more than one alternative health care practitioner suggest that I stop meditating altogether, which I can't quite seem to do).  And the exacerbating effects of ashtanga yoga moved that activity onto the list as well.

So now not being able to exercise on top of it all has increased my feelings of embitteredness and futulity - probably only temporarily - the hip will heal, I'll be back on the trail, running, in the weightroom within 6-7 weeks or so, but it feels like the addition of a straw to the load that is teetering on being unbearably heavy.  I feel like shouting out to the world that conventional wisdom has it all wrong, that one should at all costs be wary of and avoid meditation and yoga, and instead seek solace in drugs and alcohol.  Indeed, my only solace these past few days is that my vicodin prescription has enabled 4 straight nights of 8 hours of sleep, allowing me to access a long-forgotten memory: the feelings of what its like to not be nearly incapacitated by sleep deprivation and not be at the end of one's wits.  But my body already habituates, and vicodin sleep is already becoming more difficult to attain.

I need activities that can function as inclusive practices that allow me to socialize with others.  Now that meditation and yoga, when I practice them, result in all sorts of strange involuntary physical sensations, movements, and vocalizations when I truly relax and settle mind and body in the the practices, it compels me to relegate my practices to the privacy of my own home, depriving me of the vehicles for social inteaction that I so desperately need.

What does one do when there is no apparent way out and the years on one's life clock tick inexorably onward towads eventual cessation?

How life slows down

It takes me 90 seconds to get out of the car, 2 minutes to put on a pair of socks, 30 seconds to pick up a piece of garlic that I had dropped on the floor while preparing food.  The realm of possibility in my life has just involuntarily constricted to an impossibly, yet liberatingly tight circle.  On satruday I fractured my hip after falling off my bike on the way to the local farmers market.  A fracture of the greater trochantor was the diagnosis.  I landed on the pavement on the point of my hip, and the bone in the immediate location fragmented, injuring a key attachment point for tendons/ligaments, but otherwise leaving the weight-bearing functions of the leg intact.

So its with great pain that I now move, but as hip fractures go, I suppose its mild.

So my world of possibility is now constricted.  I need help driving anywhere, cooking.  Gone for now are the agressive daily agendas of work, food cooking, working out, meditation, tai chi, music playing, and socializing.  Now, there is nowhere to go, and little that I can do.

So is it this that has restored my sleeping pattern, or is it the drugs.  Afterall, vocidin is powerful stuff - makes me feel a little lightheaded and relaxed.  They also gave me valium as a muscle relaxant in case I get muscle spasms (which I have'nt) and super strenght ibuprofin.  No wonder this stuff is restricted.

Because I can't do I don't do, and I don't think about what I can't do.  My agenda is now almost single pointed - healing.

Maybe filling in all the needs has been too exhausting, too taxing: single homeowner, housework, full time job, weight training, music practice, tai chi, yoga, cooking food, socializing, worrying about dating, and keeping my life organized, and dealing with persistant sleep deprivation (not necessarily in that order).  Most of it has come to a screeching halt.  Maybe this fracture is worth the pain and disruption.

And now I have time for blog writing, if but for perhaps a post or two.