Suddenly Being Sleepy

A new version of an old side effect surfaced during my recent stay in Los Angeles. Fatigue is one of the more common side effects of Hep C Treatment and I have been experiencing it in mild and severe forms since beginning the treatment study. It has generally built up during the day and peaked in the afternoon at which time I have to lay down and take a nap or I have a hard time functioning mentally or physically. What I noticed over the weekend was that the fatigue started to come on very suddenly. One moment I was functioning more or less normally with my usual moderate level of energy and attention. Over just a few minutes I would be yawning uncontrollably and have a strong need to sit down or lie down. I just didn’t have the energy to sit up and pay attention much less walk around and function normally. This could happen in the early afternoon, mid afternoon or late afternoon and did not seem to directly relate to the intensity of the activity that had been occurring.

This is not something that has been occurring up to now and presents a new challenge for managing the treatment and the side effects. It is going to be a bit more difficult to plan activities if I do not know when I am going to become tired or how suddenly the fatigue will be coming on. This is not a welcome development, to say the least, and I am not sure what it is related to.

I recently resumed injecting a full dose of interferon. Since that time, I have noticed the return of two symptoms that occurred earlier in the study but had since disappeared. I have a mild rash on various parts of my body, mostly the arms and legs, which itches. The itching is not severe and I can usually ignore it. I also have headaches that I tend to feel mostly behind the eyes. I had both of these symptoms in the first several weeks of the study and I had thought that their gradual disappearance was my body acclimating to the interferon and ribavirin. About 6 weeks into the study my neutrophil count and lymphocyte count had dropped to the point that my dose of interferon was reduced to 135 mcg. from 185 mcg. It occurs to me now, that the disappearance of those symptoms corresponded to the reduction in dosage and perhaps that was the reason for the disappearance as opposed to becoming acclimated to the drugs. If so, now that I am back on a full dose I my have a more complete menu of side effects to look forward to for the duration of the treatment.

It also makes me wonder if the new, more sudden, onset of fatigue is related to the increased interferon dose. Since fatigue is a known side effect of the drug, and the longer you take interferon, the more you feel the side effects, perhaps this is also caused by the return to a full dose of interferon.

I am also going to start taking more acetaminophen (Tylenol) with the interferon. I had been told by a lot of people that taking acetaminophen before injecting helped relieve the pain associated with the injection site and generally in the limb that you injected. I usually take ibuprophen instead as I have never experienced much of a pain relief effect from acetaminophen. In doing further reading, it has been reported that taking acetaminophen at the time of the injection can help relieve the fatigue associated with interferon, especially the fatigue that occurs 24-36 hours after the injection. I will definitely try it with my injection this Thursday and report my results. I hope it works; I am definitely tired of being sleepy, especially on short notice.

Was It The Chocolate?

Valentine’s Night was a lot more like Halloween night, pain angst and tossing and turning. We had a lovely Valentine’s evening, my wife and I. We exchanged gifts, had pizza – not necessarily what some would call a romantic dinner, but we didn’t have to make reservations, we had a cozy romantic setting at home and we could take our time without the spectre of the hovering waiter and the waiting fellow customers hoping we were going to finish up and leave soon.

Among our gifts were the requisite chocolates which we sampled liberally after our grilled chicken, mushroom and bell pepper pizza. We eventually retired later in the evening and after falling quickly asleep, I kept waking up all night long.
First it was aching and pain all along my left side. So I rolled over, fell asleep and woke up with pain all along my right side. After a bit of short dozing on either side was interrupted by the pain, I tried sleeping on my stomach. Fine for a while until my back locked up on me. After stretching that out, I tried sleeping on my back to avoid sleeping on either aching side. That worked for a few hours until I woke up with my back aching, my sides aching and my legs stiff.

I finally broke down and took 3 200 mg ibuprofens…and eventually fell asleep. I know that ibuprofen is not thought to be good for the liver, but I can’t imagine that sleep deprivation is any better for you. I have never had that level of pain and tenderness in my muscles since having some morphine during my last bout of diverticulitis. I have noticed that the last few injections of interferon have been increasing the level of muscle aches within the first few days of the injection. Maybe that was the case. Maybe it was the sugar or caffeine from the chocolate? I don’t know, but I am not looking forward to tonight if it is anything like last night.

Definitely no Chocolate tonight.