Fists of Fury

    My bout of Seratonin Syndrome left me more than a little rattled. I had always known how dangerous my pain was but now the very things that were supposed to help me deal with that pain have shown themselves to be just as, if not more, dangerous. By this point I had dealt with so many disappointments from the dozens upon dozens of different medications I had tried. There was always the hope that they'd bring relief and virtually all of them had either been ineffective or came with intolerable side effects (like death). Dealing with that constant disappointment was hard enough but having my own medications make me so sick was disheartening to say the least.

     It was the winter break of 2013 and my family planned a ski trip in Alberta. I didn't really want to go. Why turn down an awesome family skiing trip you may ask? Well mostly because I can no longer ski. For a person who can't ski, one of the best ski hills in the world is the last place they want to go. Maybe my parents were still worried about leaving me alone at that point and so I was somehow convinced to go. Skiing was my favourite sport and I was quite good at it if I do say so myself. I would love going on these ski trips and would always be the youngest in the 'adult' group going down the huge double black diamonds of Alberta. I would go skiing every Sunday in the winter with a skiing school called Snow Hawks. To go on a ski trip in Alberta and not go skiing was unfathomable for me. Even travelling there and back was torturous. Having to wake up early, wait in huge lines and walk around the airport is not my body's idea of a vacation. I'm not sure if it was this trip or a different one but at some point my family just pushed me around the airport in a wheelchair. Most of the actual trip consisted of me staying in our hotel room on the computer but there was one shining highlight. We went dog sledding! I love animals, especially dogs, and so it was a great experience and something I could do despite my legs. Was it worth the trip? Probably not, but I haven't a clue if I would've felt better or worse if I just stayed home alone.

     Soon after I had what would even by my warped standards be considered an especially bad day. It was one of those days where I couldn't sleep from pain but forced myself to go to school. My efforts turned out to be pointless because I couldn't absorb any information which in itself is extremely demotivating. Back then these days weren't exactly uncommon, but for whatever reason it was this day that culminated in me surpassing my tipping point. I got home very pissed off at my situation and found I couldn't bringing myself to turn on my computer and distract myself from my problems like I normally would. I simply sat there brooding for awhile, which eventually turned into weeping. It'd been years and my pain hadn't gotten any better. I couldn't manage a decent sleep even once a week. The medications I tried to fix it almost killed me and meanwhile my doctor's and family are telling me my pain is caused by a mental disorder which seemed to erase any hope of what I knew was my actual physical problem being fixed. I didn't know what was physically wrong, only that something was. I could only insist my mood was a result of my pain rather than the other way around. I couldn't possibly count how many hours I spent googling my symptoms trying to find something, anything, that would support my case. Even with all these things on my mind my sadness didn't last long... because it quickly turned to anger for all the very same reasons I was sad. What was different this time is that I wasn't angry at myself, I was angry at everyone else. I did what my doctor's instructed and it got me nowhere. I put up with them convincing my family I was crazy in the hope they'd be my salvation. They failed, and almost accidentally killed me in their failure. I was furious, and began pacing around my room kicking things over and pounding on the floor. I burst open my door and went downstairs. In retrospect I think a subconscious part of me wanted to go where someone might find and help me. Even if this was so, the rest of me had entered a blind rage. Now realize that I don't use these words 'fury' and 'rage' lightly. If you consider these things a synonym of 'mad' and 'angry' you are mistaken in the same way I was before this day occured. I had never even come close to being in such a raging fury my entire life and if that day never happened I likely would never know what those simple words truly meant. I imagine most people never will, for I was literally frothing at the mouth and thrashing wildly. I can only imagine this is the kind of state parents who see someone trying to kidnap their kid would enter. With the noise I was making those who were home rushed over and started trying to calm me down. My dog was attracted by the commotion and started rushing up to me until a parent shooed her away so she wouldn't get too close to my fists pounding on the floor. I was dimly aware of this occurring and as my mind processed it my emotions once more started giving way to sadness. The fact that my parent felt the need to shoo away the dog who I loved so much was heartbreaking and deflated me.

     When I next saw my psychiatrist and told him about what happened he rendered me speechless by saying it was a good thing. When he explained his reasoning though, it made sense. He said up until that moment I had been taking my shitty situation out on myself by being miserable. When my sadness turned to anger I was redirecting my aggression on those who might actually deserve it. He said my doctors, including, him, were supposed to help me and so it is perfectly normal to be frustrated and angry with them. He also said the scale of the event can be explained because my frustration burst out all at once after I had internalized it for so many years. I think he was right because nothing even comparable has happened since that day in 2012.

Nightmares Both Real and Imagined

    I started school at the small private school again in September and continued making up for the lost time spent in hospitals. I returned to see my sleep specialist with the complaint that although my sleep quality has improved somewhat I am still waking up so late (12-2pm) that I missed half of summer camp. Not to mention it's hard to make any plans when you start school at 2 pm and end at 7. He put me on a new medication called Tryptophan which is a naturally produced chemical like Melatonin. I didn't find it particularly effective and so we kept raising the dosage. Eventually something did happen but it was far different than what we were hoping for. I started having very strange nightmares, far more visceral than anything i'd experienced before. The one I remember is me being in a basement at the bottom of a staircase. I felt the urgent need to get up the stairs; perhaps something was chasing me. I tried to begin ascending the staircase but when I tried to move it felt like the force of gravity had increased one-hundred fold, pushing me towards the ground. My vision took on a dark green hue and was shaking as if there was an earthquake. As all this happened there was a high pitched ringing in my ears and when I tried to crawl up the stairs I woke up drenched in sweat. It was then I remembered I had an exam later that day.

   The nightmare was pretty disturbing and left me feeling tired but I had enough physical problems to deal with to let emotional ones stop me from going to school and taking my exam. As I prepared to begin writing it I started feeling quite ill. My stomach was hurting and I had a feeling of malaise and feverishness. I was still able to think clearly and knew the material quite well ( I had worked my ass off studying the past week) and so began writing as if nothing was wrong. Over time my stomach continued to worsen, cramping awfully. I began to sweat but forced myself to keep writing. I suddenly urgently needed to go to the bathroom and so stopped writing to do so. It was horrible, and had by this point developed into the worst stomach ache of my entire life, diarrhea galore. I almost couldn't breath because of the cramping but went back to continue writing. Then I had to run to the bathroom again and this cycle of writing a page then running back and forth repeated many times. I was obviously very embarrassed especially when the staff had to come and ask if I was O.K. Eventually though, I finished the exam and rushed home right away. I think I asked a parent to pick me up because I was at that point extremely concerned.

     With my stomach temporarily cleared I was able to go to out for dinner with the family but this is when I began feeling irritable, which caused me confusion. Sure I had been irritable before like anyone else but it was always for a clear specific reason. I thought of anything else that was out of the ordinary which could be related and remembered the new medications along with my nightmare. I googled my symptoms along with my new and old medications and lo and behold, many results for something called Serotonin Syndrome appeared. This syndrome had occurred as a consequence of my Mirtazapine medication interacting with the tryptophan.  I had never heard of it before but quickly learned:"Serotonin Syndrome is a potential Symptom of any number of life-threatening drug interactions which may follow therapeutic drug use, combination, or overdose of particular drugs."
Cognitive effects: headache, agitation, hypomania, mental confusion, hallucinations, coma
 Autonomic Effects: shivering, sweating, hyperthermia, vasoconstriction, tachycardia, nausea, diarrhea. Somatic Effects: Myoclonus (muscle twitching) hyperreflexia (manifested by clonus), tremor." The progression of this typically starts with a feeling of illness followed by a severe stomach ache and then mental changes like agitation. At this point people mentally deteriorate very quickly, causing victims to essentially go mad until they potentially die. Thankfully I only got to the point where I started feeling irritability. To top it all off I found many people who went through their own episode of Serotonin Syndrome mention their own strange nightmares. The life threatening part was more than a little concerning so I got in contact with my sleep doctor who confirmed my suspicions as correct and of course advised to discontinue both medications immediately. I went back on Mirtazapine later but didn't touch Tryptophan ever again. Googling your own symptoms on the internet will end badly the vast majority of the time but this time thinking to do it may very well have saved my own life. At least it turned out with me getting 90-something on an exam I did while suffering a life threatening drug reaction. It just goes to show how awful I would have to feel to give up on something. If I ran away every time I felt like shit I wouldn't get anything done. Unfortunately it appears once in a while such perseverance can be dangerous...