Heart surgery was easy. . .

It is 4 am.  I awoke this morning before 1 am.  After trying numerous times to get back to sleep, I gave up and am starting my day.  I return to my blog. . .

In 2002, on December 29th, my twenty fifth wedding anniversary, I ended up in the emergency room as a result of a major gastro-intestinal event. During the course of the examination the doctor remarked "Has anyone ever told you that you have a heart murmer."  "No."  "You better get that checked out."

Turns out I had a mitral valve prolapse, and was scheduled for surgery that spring.  I did my research and discovered that the surgery was being performed with a surgical robot, and found a doctor that was willing to do it that way.  I ended up being the first surgery in Spokane using this technique.  I checked into the hospital early Wednesday morning.  The surgery lasted a long time and it was late in the evening that I began to awake.  However, because the whole surgery was performed though a series of 1/2 inch incisions the recovery was almost instantaneous.  By morning I was walking around the floor.  I was discharged from the hospital on Friday.  My doctor asked that I remain in Spokane over the weekend.  On Saturday the kids came to visit and we spent the day walking around Riverside Park and riding a four person bicycle car.  When I got home to Sandpoint on Monday, I had a funeral for a young child who had died while I was in the hospital, and I resumed a full work schedule.  Open heart surgery had been a piece of cake.

 It is amazing to me that I could undergo heart surgery on Wednesday, be riding a bike on Saturday, and back to work on Monday.  And yet after nearly two decades of treatment, I still cannot sleep.

"I can knock you out."  my doctor said.  The problem is to find a medication that will enable a healthy sleep cycle, and that is sustainable.  At one point, fearing that I had become dependent on alcohol for sleep (I had) I asked my doctor for an alternative.  I was prescribed a sleep medication.  When I went to the pharmacy to have the prescription filled, the pharmacist took me aside to emphasize that I should only take the medication once every three days or so.  If I took it everyday, I would become habituated to it and it would no longer work (at least without increasing the dose beyond what was appropriate).  Furthermore, there was a risk of addiction.  Not to mention that it also carried a risk of liver damage.

So I was faced with two choices.  I could take the medication that was habituating, addictive, and caused liver damage, or, I could drink alcohol which is habituating, addictive, and causes liver damage.  I began taking the medication one night, and drinking two nights, which at least reduced my alcohol consumption by 1/3.  When my wife would complain about my alcohol consumption I would be quick to point out that my choice was not whether or not to use drugs to sleep -- it was simply a choice of which drugs to use.

After undergoing treatment for chemical dependency, my doctor has been very committed to prescribing only medications that are non-addictive.  This has severely limited the choices.  Basically, almost all of the sleep medications are potentially addictive and so we've been using other drugs such as anti-depressants that have a side effect of making one drowsy.  This has had the effect of enabling me to go to sleep.  Staying asleep is the problem.  We changed meds this last week to see if we could find a more effective treatment.  It is worse.

Less than a week after open heart surgery I was going full speed.
Two decades of treatment for insomnia has been ineffective.
Something just doesn't seem right about that.

The hardest thing about this whole experience is fighting off the urge the think that a full night's sleep is only a couple of drinks away.  The last time I tried that I nearly entered into "eternal rest" which is an entirely different problem than waking up too early. . .