On Thursday, I met with a psychiatrist who specializes in sleep disorders to help me find a different dosage of medicine that might help me sleep longer each night. After an hour of interrogation about how I am coping with cancer (day by day), had I considered suicide (no), my family of origin (long story), and all the other things p-shrinks ask about, she concluded that, all things considered, I seemed to be doing ok under the circumstances.
She said that the 5 mg dose of Ambien that my internist had prescribed would not be effective. I'd already figured that out, which is why I scheduled the appointment. She gave me prescription for a continual release version of Ambien, 12.5 mg. She recommended the name brand, as the manufacturer supposedly had a proprietary method of releasing the does over time. I thought that generics had to be identical to the name brand, but oh well.
For the past two nights I've taken the Ambien CR, and I'm trying to decide what kind of a difference it is making. I still wake up when I leak -- usually around 3 am -- so I get up and go to the bathroom. Unlike before, for the past two nights I have been able to go back to sleep. I may wake up every hour or so thereafter as I leak a bit more, but in between I seem to lost consciousness. I'm not sure it's real sleep, however. When I wake up for the day, I am aware that I have slept longer than before, but I do not feel refreshed. Not quite drugged, but not totally there.
For the past two days I have noticed that I don't run out of gas as early, but I do not have lots of energy, either. I also have not found that my mind is any sharper. I still find myself struggling to recall pieces of information that, before surgery, I would been able to easily recall.
I'm going to give it more time to see how I adjust. Maybe my body and brain is just so exhausted that it will take several days or weeks to begin to get better. Or maybe this is the new normal. Or maybe there is another drug or drug combination that might work better. With the trial behind me, my main focus in the near future is to improve my physical quality of life: more and better sleep; follow-up with urologists and physical therapists to see if the leaking can be stopped; continue to monitor my cancer to see if there are any distant metasteses, as well as any other efficacious (and not speculative) treatment options.
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