It’s Tuesday night. I’m hoping for a good night’s sleep; I have an early physical therapy appointment in the morning, followed by a caregiving day with my aunt and uncle. I enjoy being with them, and the work isn’t difficult or stressful, but these work days tend to be very long. I try not to push myself too hard, but I usually end up worn down to a nub anyway.

Stupid RA. Stupid bursitis. Stupid osteoporosis. The combination is an energy leach, which is why my mind is on sleep tonight.

I’ve always tended to underestimate the importance of healthy sleep. When I was editing the newspaper, 12-to-15-hour-days at the office were my norm. When I finally got home at night I’d be so wound up that it would take me until midnight, at least, to relax enough to settle down and sleep. And then I was back up at 4:30 a.m. to start the whole thing over again, sometimes six days a week.

I loved it. I loved my work. It fulfilled me and gave me joy.

In hindsight, I know that my lack of sleep was self-destructive. Nuts, even. But at the time, I was proud of my toughness, my resilience. Unlike the rest of the human race, I really only needed four or five hours of sleep at night. I was SuperWren!

These days, when my pain levels are under control, I average six to seven hours of sleep each night. I say average, because I do occasionally sleep a full eight. The key, for me, is pain control. The hip bursitis pain I’ve been battling wakes me up and forces me to roll from my hip to my back to my other hip over and over again throughout the night. I drift back to sleep in between, but I never really get to sleep deeply. When morning comes, I’ve been laying down long enough that my body has become incredibly stiff and miserably achy. I get up with relief, but exhausted.

My rheumatologist prescribed nortriptyline, an antidepressant that has deep drowsiness as one almost universal side-effect. General pain relief is another. In my case, both are gifts. It took awhile (read months) to get the dosage to a therapeutic level, but once it was, the stuff worked beautifully. Finally, I was sleeping through every night! No more tossing around! No more laying there awake, aching, watching the clock, wishing that the opiate pain reliever I was taking would work like it used to so I could get some sleep. Nortriptyline saved me.

Well, until about a month ago, when I tried to refill my prescription for those magic capsules and discovered that Dr. McA had forgotten to renew it during my last appointment with him in December.

Oh well, no biggie, I thought. I’ll just get a request for renewal in to him. It won’t take long.

So that’s what I did. The first night I went to bed without my little white capsules, I was a wee bit apprehensive. Would I be able to sleep? To my pleasant surprise, I snoozed the night through without trouble in spite of my very sore hips and very sore RA hands. The same thing happened the next night. And the next. Great! thought I. Either I don’t need the stuff to sleep anymore, or (more realistically), there’s enough of the drug built up in my system to keep me going for a while.

I crossed my fingers that my reserves would last until the prescription was refilled and I had a bottle of the stuff in my hot little hands.

But a full week later, I still didn’t have a new prescription. I put another request in, feeling like a pest but getting kind of worried. And for good reason. A night or two after that second request, I resumed my miserable, ache-induced tossing and turning, losing the ability to sleep deeply and get well-rested. My magical, residual reserve of nortriptyline was totally tapped out.

And so it has been ever since. Dr. McA finally got my requests and refilled the prescription on Monday this week. Since I routinely receive my VA meds by mail, I should get it—hopefully—by Thursday.

I no longer believe that I can SuperWren through my days, handling whatever challenges that come my way on a mere four hours of sleep. I’m about 10 years older than I was when I did that for my job. My RA hurts and affects my bones and body now like it didn’t back then. I was still enjoying remission. And I didn’t have bursitis of the hips, or osteoporosis. I was tougher. And maybe I was a bit dumber, too.

So. Off to bed I toddle, hoping as usual for sleep, older and—I hope—wiser.

4 thoughts on “Nighters

  1. Yes, I agree with Polly — you are still SuperWren, you just fight different battles — a 24-hour battle with RA vs. a 12-hour work day!

    I totally “get” the value of a good night’s sleep. Here’s wishing you many in your future, filled with pleasant dreams.


  2. You have every right to want a full 8 hours of sleep. Drats! I hate when I forget to get renewals. You don’t want me going on how i could fix that problem…lack of refills and why this all happens. Yup, could write a book. And particularly if you are on mail order. I hope it arrives soon and you can get back to that deep restful sleep that we all so desperately need and crave. Wonder if anyone has done a study on the lack of sleep and ra onset? Hmmmmm


  3. Forgetting prescription renewals is the bane of my existence! I do it soooo much. And, like you, feel like a pest for calling and asking for it.

    Hope you get some more sleep soon, Wren 🙂 Just what we need: a lack of sleep on top of RA. Yeesh.


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