Juggling Multiple Chronic Illnesses and Medications With an RLS Diagnosis
It didn't take long for me to realize I have a few medical conditions that complicate or trigger restless legs syndrome (RLS). Not to mention the treatments for those conditions are medications that literally make my RLS worse. It's a tricky pickle.
What conditions complicate or trigger my RLS?
I put this at the top of the complication list. It may very well be the trigger of my RLS because, for me, fibromyalgia and sleep issues just go hand and hand. The main issues with fibromyalgia (FM) for me are a) FM causes serious sleep dysfunction and insomnia for me and this doesn't help my RLS at all and b) a lot of my FM treatments aggravate RLS (antidepressants).
My migraine attacks have been daily for a long time. Of course, migraines also impact my ability to have quality sleep. Basically, lack of sleep is really not my friend. And pain while trying to sleep really doesn't help with that.
I wouldn't even think this would be an issue except I have quite bothersome allergies and it is prudent to manage them due to my asthma and my migraine disease. Except antihistamines are on the list of medications that aggravate RLS!!! Come on!!!
I was being treated for major depressive disorder, and one day I may be treated for it again. That can be tricky with medication complications. And mood management when you have extra issues sleeping.
This isn't the whole list of my complicated medical situation – just the situation that compounds the RLS issue. You can see that I am a bit of a complex patient. My doctor once said I was her most complicated patient. Yay? Anyway, the point is that comorbid issues and their medical treatments can conflict in various ways.
Why I do an annual medication review
I do an annual medication review with my doctor. Since I have more than a few medical issues, it can be a lot of medications to deal with the situation. That can lead to many side effects, being on medications that are not even doing anything, and complications with other medical issues. So a good solid review can cull out ones that are no longer necessary.
Antidepressants are common treatments for fibromyalgia and migraine disease, but I have severe side effects from them. I'm on a low dose of Wellbutrin for seasonal affective disorder (SAD), but it doesn't cause problems.
I need to manage my allergies due to my asthma and migraine disease. However, my sleep specialist informed me many people with asthma have chronic congestion and put me on an entirely different medication to manage that. This has helped immensely. I've avoided my antihistamine so far but will discuss alternatives with my pharmacist.
My major depressive disorder was being treated with Abilify, and I suspected it was quite problematic for my RLS. My doctor and I discussed going off it since I had been on it for some time. It was time to re-assess my mental health state. I have been fine since I have been off of it.
Timing my medication
I take my SAD medication in the morning, just in case it may cause an issue. I do the same if I need an antihistamine when my allergies are at their peak. If I can't avoid a medication, the best I can hope for is extending the time from when I take it to when my RLS kicks in.
My sleep management practices
A big problem for me with my comorbid health issues is insomnia – frequently waking up at night and poor quality sleep. Chronic pain is not my sleep buddy. And lack of sleep doesn't help the RLS or the chronic pain.
So I seriously take sleep, well, seriously. I wind down at night so my brain has time to relax. I meditate to tell my brain, "Hey, sleepy time." I encourage sleep the best I can. I follow all the sleep hygiene tips and tricks. I go to sleep at the same time and get up at the same time, roughly. I'm trying to manage my mild sleep apnea. I got myself a mouth guard for my teeth clenching issue. I also take sleeping medication, but I will be reducing that so I'm not dependent on it forever.
Living with this complex health puzzle
Unfortunately, chronic pain and other illnesses seriously complicate my sleep. I do all I can to improve the situation, but it is what it is.
So I have to find a way to juggle my health conditions and medications. It can be a complex puzzle; the hardest problem for me is the sleep situation and associated sleep problems – RLS included.
Do you feel comfortable advocating for yourself in a medical setting?