Doing it on the DLNO SWEAT!
Night sweats. A particularly annoying condition that just about everyone with HIV deals with at some point in their illness.
Night sweats are not symptomatic of any one ailment but can mean any number of things. It could be a sign of something serious going on in the body. Or, it could mean nothing at all, just another one of those "quirks" that come with HIV that doctors, for now, have no explanation.
Only a doctor, usually through lab work and other tests, will be able to tell if the night sweats are a sign of a potential problem, or just a quirk. If one's night sweats are determined to be little more than just an "HIV thing," there's some good news, an effective treatment has arrived.
Ever since I was first exposed to HIV sometime during the mid-1980's, I have been dealing with night sweats. On average about four nights out of every seven. And when I say sweat, I mean SWEAT. It's a scenario familiar to many: I'm dead tired and the moment I'm about to fall asleep, sweat begins to seep from my head and chest area.
Soon, I'm damp; the bedding is damp and it's impossible to sleep. I move to a drier spot on the bed, begin to fall asleep, and it begins all over again. This can go on for hours. While night sweats aren't life threatening, the condition can be a serious drag on the quality of life for a person with HIV.
Why I sweat so profusely is an HIV medical mystery. Lab tests show I have no active infections. I'm not co-infected with anything like hepatitis B or C and have had an undetectable viral load for several years. Yet, I can have night sweats like a PWA on his last leg.
Then my doctor, AIDS specialist Lisa Capaldini, heard of a new treatment for night sweats, using an old drug. "Glycopyrrolate" has been around for decades and is used primarily to treat stomach ulcers but, as a side-effect, it stops sweating as well. As was explained to me by Dr. Capaldini, "it dials down the body's ability to sweat."
I was initially skeptical. First, I consider my total pill burden onerous as is and didn't want to add yet another. Second, I didn't want the additional drug in my body. I held that prescription for a few months as the night sweats continued.
Finally fed up with the entire situation, I filled the prescription, took the medication and to my surprise, it worked! Glycopyrrolate is a tiny, 1MG tablet taken just before bedtime. Then, No Sweat! For the first time in years I'm able to remain dry throughout the night.
So far, no ill effects. There's no "drug hangover" the following morning and my doctor says there's no problem with long term use. What's ironic, this medication has been here all along and could've alleviated some of the suffering of thousands of people with HIV, yet no one thought to use it till recently.
If you have nights sweats, and it's not symptomatic of a more serious problem, discuss Glycopyrrolate with your physician. It may be one of the most important treatment decisions you make.
Night Sweats poster courtesy Stop AIDS San Francisco.
It's the rare man or woman with HIV that won't have a serious bout of depression at some point in their illness. With all we have to deal with—health issues, money issues, family issues, relationship issues—it's difficult not to get depressed.
I've been in and out of depression for all the years I've been dealing with HIV. I've been through a number of antidepressants over the years: Paxil, Wellbrutin and a few others I've forgotten. Then, my doctor prescribed a new antidepressant that had just come on the market: Cymbalta. It's a different type of antidepressant. There was also a difference in how it's to be initially taken. The dosage is modulated. I had to work my way up to the final dose, in steps.
At the same time I was dealing with depression, I was also dealing with a painful side-effect of the HIV medications I was taking: neuropathy in the heels of my feet. Neuropathy is something that plagues many with HIV. The pain was so bad at one point, I avoided putting weight on my heels and walked on the balls of my feet. A strange sight indeed to anyone who saw me walking in public during that time.
However, it was discovered that Cymbalta provided an additional benefit: It has the ability to alleviate pain.
Not only did Cymbalta pull me out of my depression but it relieved the neuropathy as well. And it did both rather quickly. While other antidepressants can take weeks to work, Cymbalta kicked in within seven days. It was the first antidepressant that didn't make me feel disconnected, numb, or "weird." It appeared to work invisibly and I felt normal.
It worked so well that after about two years I stopped taking it because I felt fine. However, while the neuropathy did not return, after perhaps a year, the depression did. I decided to go back on Cymbalta—but didn't modulate the dose. I had some pills left over and jumped back into it full strength, and had a terrible reaction: I had an urge to kill myself. You hear about it happening most often with teens but it's not limited to that group exclusively.
There was no gradual build-up. I didn't become increasingly more anxious. It was as if an emotional switch had been thrown. One second I was "normal" and the next I was in this "other" frame of mind. It was as if I had already done all and any contemplation about "the act." I was at the point: "Do it, now!"
The ONLY thing that stopped me, was my being aware this was only a "thought" that was inside my head. I would have to do something "physical" to complete the act. And I knew I wasn't going to do that.
The writer in me observed what I was feeling. I was both frightened and fascinated at the same time by this very powerful urge. I'd never felt anything like it before and it was a struggle to remain in control of it, instead of it being the other way around. I hope I never feel anything like it again. And now I know how an immature teen mind would be overwhelmed by such a powerful emotion—and I feel for those kids.
I remained in that state for about a half-hour before it gradually subsided. I haven't touched Cymbalta since. I have an emotional/mental "block" about it now. When I discussed it with my doctor, I wanted to know where did that urge come from? Did Cymbalta manufacture it or did it merely release feelings that were buried deep inside that I wasn't consciously aware of?
She said the medical community is grappling with that very question and no one has a definitive answer.
In any case, what happened was not the medication's fault. It was mine. While I'm not currently depressed, or taking any antidepressants, I'm sorry that Cymbalta is lost to me when, and if, the depression returns.
Cymbalta is a good drug. Just follow the dosing instructions!