Cannot sleep

-
After the 2nd follow-up appoint, mum needed to take the extra dose of olanzapine (sometimes once, sometimes twice a day i.e. the maximum) and it was working in dampening her self-hurt urge. Her sleeping pattern, though, fluctuated i.e. sometimes she had little sleep.

However, just less than a week to her 3rd follow-up appointment, her sleeplessness was so bad that she started shaking due to anxiety. Once again she hurt herself using a peeler :( This despite having taken the max presribed dosage of olanzapine. According to my family (I wasn't there), this self-hurt urge emerged when she felt very restless but manageable if she had sufficient sleep at night. Another important fact was that it was not driven by "voices".

Since it was post-election public holiday (next two days were declared as holiday by the incoming ruling coalition after the 14th general election), my family brought my mum to the A&E department at Penang GH. In the end, the on-call doctor prescribed clonazepam 0.5mg (an anti-convulsant/anti-epileptic drug that is also used to treat panic attacks) to be taken as and when needed, to the max dosage of twice a day (morning and night). If mum's condition didn't improve i.e. restless, couldn't sleep and wanted to hurt herself, then she would be warded once again.

That night, at 1am+, my mum had to take one because she couldn't sleep and half an hour later she managed to sleep for more than 8 hours. Subsequent nights, things were ok until the night before the appointment: once again, she couldn't sleep (after getting up to go to toilet) and started shaking intermittently. Despite taking clonazepam, she still couldn't sleep. She managed to hurt her hand once by using a drawer but my dad managed to stop her from doing it any more. Took the maximum additional dosage of olanzapine. Her blood pressure was 159 but luckily she managed to fall asleep at around 2.45am. There was much anger in her because she felt she was a burden to her family.

I managed to piece some information together: the shaking and the urge to self-hurt occurred when she couldn't sleep.

The 3rd follow-up appointment summarised as follows:
  • We informed the doctor about her symptoms appearing only if she couldn't sleep
  • She was giddy all the time, with varying intensity. This was since the time in ward. All the doctors, so far, appeared to be at a lost to explain this, especially since her blood pressure was ok most of the time
  • Voices now included her own voice but it they were all "inside" (rather than verbally spoken)
  • Maintained olanzapine 5mg day 10mg night, benzhoxol 2mg day plus ad hoc 2.5mg twice a day. Instead of ad hoc, clonazepam 0.25mg is taken every night and additional 0.25mg if needed but try not to. Introduce anti-depressant sertraline 25mg day
  • If there was no improvement, then she would be warded and undergo ECT
  • We were advised to bring her to A&E if we couldn't manage her condition

Comments

Twilight Man said…
Your mum's condition is quite rare and unusual that even such strong medications could not help her to sleep at times. The doctors were baffled themselves too.
May 21, 2018 at 2:19 PM
Anonymous said…
Your Mom is having the same meds as my brother did. He was on olanzapine, benztropine (to control the side effects of olanzapine), clonazepam, and fluvoxamine (anti-depressant). He had lower dosages because he had anxiety and aggression, but he did not hurt himself. Hopefully, now that an anti-depressant is added, your Mom can sleep better (not being able to sleep it the biggest trigger factor for mental illness), and can respond more positively to her other meds. SR
May 22, 2018 at 1:21 PM
Post a Comment

Popular posts from this blog

Fell Seal: Arbiter's Mark - character build (Part 1)

-
Here are the character builds for my current run (with the help of Ban): Kyrie Fellblade/Marked Counter: Slow Secondary passives: Execute, Life Font Fellblade itself is a good class because of the various conditions it can inflict and most importantly they can inflict Sleep. Iirc, the only other human class that can do this is Gadgeteer. Their passive Malice increases the chance of landing it by 10%. Fellblade pairs well with Marked because both use ATK and MND in their offensive abilities. Also, Fellblade's abilities are mostly short range whereas Marked has some long range abilities. Execute for more damage. Life Font is for suvivability. Ban opined that with two healers, there's no need for Life Font but I discover that it enables Kyrie to survive just enough for a healer to heal her up, after having received massive damage. Ban advocated for Marked/Fellblade for superior Speed (1.00 vs 0.92) and defense (heavy armor). I resisted this for a long time because I
Read more

Fell Seal: Arbiter's Mark - character build (Part 2)

-
(continue from Part 1 ) Yates Anatomist/Wizard Counter: Cripple Secondary passives: Blessed One, Smart Casting Anatomist is the best healer in game due to the passive Legendary Healer, which also then boost the amount of self-healing by Blessed One. Although Ban thinks Anatomist's Dark spells are sufficient in dealing damage and so he suggests Alchemyst as Yate's secondary class, I choose Wizard for the following reasons: Quite often, demonic creatures have Dark immunity and other creatures have immunity to other elements. So having Dark, Water, Fire, Earth and Thunder spells enable Yates to cast the most suitable spell, especially when the enemies are vulnerable to certain elements. Flexible casting :) Smart Casting is useful so that I don't need to worry much about the positioning of the enemies relative to my other characters when using Mass Healing and the area effect damage spells. As stated in previous post , there "are so many devastating Skill ba
Read more

Strange expectorant

-
Image
An expectorant cough syrup helps you to prevent phlegem from going to your lungs by expelling it via coughing or so I heard from doctors and pharmacists. That's why for cough that's caused by phlegm, it is not advisable to take suppressant cough syrup. Given that's the role, do you expect it to be drowsy? It should be non-drowsy so that you will be actively coughing out the phlegm, right? Not this Unizet expectorant. The doctor told me that it shouldn't be drowsy and yet some of his patients (including me) reported otherwise. I read the detailed information (on the piece of paper typically stuffed inside the box) and nowhere it indicated drowsiness as a side effect. Strange, huh?
Read more