Monday, September 17, 2012

Sleep 'n' drugs

Dr. Nelson gave me some sleeping tips at our meeting last week, most of which, I am already doing:
  • exercise early in the day
  • caffeine early in the day
  • drink warm milk 
  • go to bed at same time every day
  • don't take naps
  • don't do work or watch t.v., etc., in bed [definitely guilty of this but I have since moved my computer to the desk...]

I wonder if any of these things really apply to me. It's not that I'm not sleepy, I lie in bed very physically and mentally tired, get to the point just after which I would ordinarily be asleep. But my body either just stays in the 'almost asleep' state, or more often, slides up and out of it again, back to the start. If I'm tired during the day, I can lie down for hours without falling asleep. All these things are entirely new. According to Dr. N., there's nothing about chemotherapy itself that causes insomnia, other than mental stress. I don't feel stressed (well, other than the last couple of days!) Yet during my first round of treatment in Jan/Feb, I slept a lot, especially toward the end, 10 or 12 or more hours. And before this ordeal began, I was a champion sleeper. I don't even enjoy it anymore, possibly because it's usually drug-induced or not very deep. It's kind of like a job now.

Friends in my bedside drawer:
Trazodone, Benadryl (diphenhydramine),
valerian, melatonin, lorazepam (Ativan).
I asked her for a prescription to Trazodone, recommended to me by two people as a sleep aid.  I have since looked it up and seen that it is an anti-depressant that makes you sleepy. It's supposed to be non-habit forming, but Dr. Nelson seemed dubious about that! I don't feel like I'm much of a risk for addiction, but I'd prefer take something not narcotic/less likely to affect me the next day. On the other hand, it seems that I feel sleepy the day after I take the Traz. Perhaps I'll try to take half? And even melatonin (10mg, kind of a big dose) makes me feel depressed the next day, so I have stopped taking it...

Smoking marijuana has allowed me to go to sleep a few times. Dr. N. said, as I suspected she would, that smoking a small amount isn't going to effect the tumors in my lungs. She also said most of her patients use it for nausea, and they eat it. But I'd rather smoke it...and I don't want to eat brownies or whatever it is they put it in.

Last Tuesday night, no pills, just a couple of puffs of mostly ashes, and then I fell asleep. But last time, after chemo (I felt quite manic!), it did not make me at all sleepy, only ravenously hungry, which is why I haven't liked it, recreationally speaking, for decades! Of course the lethargy was also part of what I didn't like, but now I'd like only that part please.

Wikipedia currently says: The effects of [cannabis] sativa are well known for its cerebral high, hence used daytime as medical cannabis, while [cannabis] indica are well known for its sedative effects and preferred night time as medical cannabis.

Not great writing...but I wonder which kind I have?

They gave me a "Volunteer Identification Card" letter during chemo on Friday. It costs $103 to get the card. Not sure if I really want/need it? It's not like it lets you travel with marijuana. (The whole deal in terms of the legality seems a bit...hazy, and subject to the discretion of the Feds.) Of course, this city seems to be well stocked with pot smokers who show little concern, judging by the aroma/smoke clouds one occasionally walks through. Since I'm smoking a tiny amount, once or maybe twice a week, by myself in my house...arrest doesn't seem much of a risk, and I don't think I need a card for supplies

It's funny, when they gave me the letter, there seemed to be a vague sense of embarrassment all around, even from the medical people. I'm assuming it's because there are so many people who are not really sick who have the cards? That's all you hear about really, that virtually anyone who wants a card can get one.

Some background:
Californians first approved the use of medical marijuana for the seriously ill in 1996. While marijuana remains illegal under federal law and some cities and law enforcement officials take the same view, storefront collectives were approved by the state Legislature in 2003 and operate under guidelines published by then-Attorney General Jerry Brown in 2008. 
Read more at the San Francisco Examiner:
If any of you know of any distinct advantages (or disadvantages) to a sick person having a medical marijuana card, please let me know!


  1. 1) Dr. N is wrong. Traz is not habit forming. However, that doesn't stop some people from trying to use it recreationally. To very little effect I would imagine.
    1b) If you take a regular dose every night for at least a week, the morning stupor should start to lessen. Then you need to keep taking it regularly.
    2) There is no reason for you to have a medical marijuana card.
    2b) What you have is probably a hybrid, like a lot of pot. It seems like all or mostly indica would be most helpful.

  2. I think Dr. N had seen people have trouble stopping? i didn't ask.
    Last night I took half a Traz and 2 Ativan. it was good.
    Yes, must get the sleepy pot...