Sam's Magical Mystery Tour

Sam Hart

2007-09-04 17:19:18

So, I've mentioned before that I suffer from some sort of insomnia. It's been that way my entire life. Recently, I've been trying various medicines and things to help me sleep better. I said a couple of weeks back that I've tried various things like Ambien, Lunesta and herbal remedies like Kava. Nothing has worked.

My big problem isn't staying asleep, as is the case in a lot of insomniacs. Once asleep, I'm good. My problem is falling asleep. I fight sleep every step of the way so even the most harsh medicines are less than effective simply because I can overpower them with my will and desire to not sleep. This isn't a conscious decision or effort, it's not something I can control and I usually am not completely aware that I'm doing it.

Anyway, because I have also had a tendency towards medicines affecting me very strongly, especially in the form of side effects (for example, Paxil, Zoloft, etc. all gave me severe tremors and vicodin makes me severely "wonky"), and because medicines that do work for me usually work too well (resulting in me effectively losing the next day due to excessive grogginess) my doctor decided to have me try Sonata which had relatively few side effects and has a biological half life of about an hour (meaning it should be mostly out of my system by the next morning even if I do have bad reactions).

The problem? Sonata is expensive... and my insurance company didn't want to pay for it. Read on for more...

You know, I'm always amazed by insurance companies. Here's my doctor, who went to school for some obscenely long period of time to get his medical degree. He's no dummy. In fact, I've been to a lot of doctors in my day, and I'd have to say that my current doctor is probably the smartest guy I've ever had for a doctor.

So he's been my doctor for like 2+ years now. He has a pretty long case history with me. He's kept notes and a detailed record of what my issues have been, what allergies I've had, what reactions I've had to medicines, etc. If anyone is qualified to make a decision as to what medicines I should (or should not) take, he is.

So he makes a prescription for me, I take it to the pharmacy, and what happens? Why, my insurance company second guesses him!

Sonata is too expensive, and we haven't run me through the gambit of scripted medical solutions as detailed by Insurance Form 27b/6. After all, humans aren't analog creatures, and scripted medical solutions work.

Part of my insurance company's scripted medical solution for insomnia is to run through several of the benzodiazepines before moving to the more expensive Sonata. Benzodiazepines have a tendency to be less expensive (at least, the ones on their script are dirt cheap), are highly addictive, and have such nasty side effects as "mania, schizophrenia, anger, impulsivity and hypomania". Probably not the best to give to someone who already suffers from manic behavior and anger issues.

But hey, some staff nurse employed at my insurance company must certainly know more about my medical situation than the doctor I've seen for 2+ years.

So they said they'd give me temazepam AKA Restoril instead and that I need to try it for 30 days before I can even hope to qualify for Sonata.

30 days!

Is it me, or does this seem reckless considering Temazepam taken for longer than 2 - 4 weeks may result in a strong physical dependence with a resultant benzodiazepine withdrawal syndrome? Benzodiazepine withdrawal syndrome is a particularly nasty thing which can result in nightmares, Hypnagogia-hallucinations, muscular spasms and/or seizures.

Anyway, they gave me Temazepam which has some noteworthy side-effects, including the following:

I only mention these because I seem to have hit every single one of them.

I took my Temazepam at around 10:30pm on Thursday night. I remember trying to play my DS in bed but that it was difficult to concentrate on the game. After that, I remember having an insane number of dreams. I don't remember the details of most of them, but the ones I do remember were kind of crazy.

In one, my father and I were part of the Spanish Inquisition persecuting Jews in 1700s Mexico. In another my wife and I were intergalactic explorers witnessing the end of our universe as the last remnants of it collapsed in onto itself. We had tremendous power and managed to survive the "big crunch" only to become all powerful devourers of worlds (a story which I knew I'd heard before).

The next thing I vaguely remember is waking up the next morning. My wife had to force me to get up, and I recall feeling like complete and utter shit. I vaguely recall stumbling into my office (I work from home, remember?) and I have a hazy recollection of talking about Temazepam side-effects and why I was taking it with a friend of mine in the #fgij IRC channel.

After that, the next thing I remember semi-clearly is being in the kitchen, making a breakfast of toast and jam. I remember hearing loud shouting that scared me. At first I thought I wasn't alone in the house (which scared me because I should have been the only person in the house) but soon I realized the shouting was me. Apparently, I had begun to argue with my toaster.

I don't recall it, but I apparently took this information to #fgij:

2007-08-31 09:32.47 <@ criswell> | wow... I just found myself yelling at the top of my lungs in the kitchen at the toaster...
2007-08-31 09:33.00 <@ criswell> | yelling so much I felt viens popping in my head
2007-08-31 09:33.07 <@ criswell> | I wonder if it's the drug?
2007-08-31 09:33.16 <@Lancer-Koal> | criswell: seriously.. take it down a notch
2007-08-31 09:33.24 * | criswell doesn't normally yell at toasters...
2007-08-31 09:33.30 <@Lancer-Koal> | heh.. no, it's just you :-)
2007-08-31 09:33.49 <@ criswell> | it was shocking... it was like I had come into the room to find someone yelling
2007-08-31 09:33.53 <@ criswell> | like it wasn't me
2007-08-31 09:34.09 <@ criswell> |
2007-08-31 09:34.21 <@ criswell> | Neurological - Agitation and hallucinations
2007-08-31 09:35.02 <@Lancer-Koal> | oh, maybe you should tell your doctor.. he could probably convince the
unsurance company that it's not worth keeping you on it for 3 months

After that, I don't remember much of anything. However, I've been able to piece together what happened thanks to my wife's observations as well as my IRC logs.

Apparently, at some point I called my wife. I have no memory of this. Whatever it was I said to her on the phone made her decide to take off from work to come home and check on me. She said she wasn't so much worried about me going apeshit and hurting myself or others, but she was worried I'd fall down or something and hurt myself inadvertently. Additionally, she knew I had a work conference call later on that morning and she said I sounded "drugged out". So she wanted to prevent me from making the conference call.

When she got home, she apparently found me naked in the bathroom laughing hysterically with a towel on my head. We have no idea how long I was in there, or how long I had been in the shower. I insisted that the UPS man had come earlier (I've been waiting on a box to ship my Xbox 360 back for repairs) but that I hadn't gone to meet him because the dog was barking at him and making the walls vibrate (which frightened me).

She got me out of the bathroom, and I apparently started to dress, because I managed to get a shirt on. However, I kept insisting that the UPS guy had come and that I needed to check to see if he left anything. She kept trying to assure me he hadn't come, and that she'd already checked for a box, but I didn't believe her.

Instead, I marched straight for the side door (nearly falling down on the way there) and proceeded to go outside to look for the UPS man and/or any packages he left for me. I did all of this with no pants on.

Concerning this, a friend in IRC said:

2007-08-31 10:39.44 <@ schultmc> | living next to the high school he could be branded a sex offender :)

At some point after this, I proceeded to get onto IRC and tell everyone how much I loved them. I also kept insisting that I had a conference call to make and that I shouldn't listen to my wife anyway because she was just a hallucination.

Somewhere in there I laughed hysterically again. I laughed so hard I actually went into the bathroom and threw up. Elsewhere in this drugged out state I insisted on calling my parents.

Anyway, the next thing I remember was the sudden realization that I was sitting in the doctor's office waiting room that afternoon. For the life of me, I couldn't figure out why I was there or even how I got there. I remember most of the rest of the day, but I was horribly groggy and even a bit nauseated for the rest of the night.

All in all, my insurance company's scripted medical plan cost me one day of productivity at work, my wife a day of work, and gave me some severe side effects.

Seriously, I have no idea why these stupid insurance companies do this. You'd think the risk of a lawsuit from creatively re-interpreting prescriptions and causing some serious problems would far outweigh the possible cost reduction from not providing more expensive drugs...