My last post, gabapentin and.....
A few things have happened since my last post.
Firstly, my friend, Shelly, contacted me to make sure I was okay. Something about the post worried her. She thought it sounded like I’d given up while at the same time being sure that I never would.
Then a couple of days ago I made this comment to my husband:
“You know, I can understand why people with cancer decide to suicide, even when they haven’t reached the point where they are terminal. I used to see cases like this when I was a cop and it always confused me. Why give up when there was still hope? Now I understand. It’s about control. It’s a way to avoid this endless uncertainty and the potential cycle into a long, slow death. It’s a way of beating the cancer because you can decide when you’re going to die rather than letting cancer do that……..not that I’m thinking about suicide. Not yet. But I might in the future. I never understood all of this before now.”
Wait. Did I just say ‘suicide’?
When I was a police officer working in child protection I sometimes used to speak to groups of parents about their teenagers. One of the pieces of advice I gave them was to always treat any conversation about suicide as a flag, even if that conversation was hypothetical or third person. Conversations that seemed to accept suicide as reasonable should ring alarm bells. Further investigation, probably with the help of a psychologist, was the best course of action.
So some part of my brain raised a tiny flag. Shelly’s comment prompted me to take a moment for self analysis. I knew I hadn’t given up but something was definitely going on. I had burst into tears when I went for a massage. I had left there and gone over to my Mum’s place and had another good cry. I wanted to put this down to some kind of natural grief process. It would be reasonable after everything I’ve been through. I’ve been practicing ‘Acceptance Commitment Therapy’ techniques and making room for the sadness rather than fighting against it, which would have been my habit previously.
My brother came to visit with his wife and adorable son. I found myself hoping that he wouldn’t say, “How are you?” because I would have burst into tears. He didn’t. The minute they’d left I wanted him to come back and ask me. I put it down to just feeling blue but when I ran my own personal audit I realised that something was off.
You might recall that my surgeon recently prescribed gabapentin for my nerve pain and peripheral neuropathy. This seemed to be effective when I was in hospital. She prescribed a lower dose and it really didn’t seem to be making any difference. I googled it. This is part of what I found:
In 2009 the U.S. Food and Drug Administration issued a warning of an increased risk of depression and suicidal thoughts and behaviors in patients taking gabapentin, along with other anticonvulsant drugs modifying the packaging insert to reflect this. A 2010 meta analysis confirmed the increased risk of suicide associated with gabapentin use.
So first of all, what packet insert? The packet I have says “Take as directed by a physician” and the pharmacist issuing it said, “Do you have any questions?” That’s the sum total of the information I received. I wasn’t worried because I’d already had the drug while I was in hospital without any adverse reaction. Of course I was simultaneously off my dial on pain medication.
When I saw my surgeon today and told her about his side effect she replied that I’m the first patient she’s ever had with that kind of reaction. I wonder. Maybe I’m just the first relentlessly optimistic patient for whom any hint of suicidal thoughts raises an alarm.
I stopped taking it yesterday. The sun came up this morning. My black mood lifted. I am myself again.
I wanted to write this post as a warning to anyone else on gabapentin, or anyone caring for someone taking it. Monitor your mood carefully. ANY thoughts about suicide, even hypothetical or third person thoughts about suicide, should be taken VERY seriously. Talk to your doctor.
The other thing that’s happened in the last few days is that a number of people have brought this story to my attention:
http://medicalxpress.com/news/2014-09-breast-cancer-specialist-advance-treatment.html
In summary, it’s about the success of stage three trials in the USA where they’ve added new medications to the chemotherapy for women with triple negative breast cancer and greatly increased the number of women achieving a full pathological response. A full pathological response means complete tumour death prior to surgery and it means that your survival odds improve dramatically, your risk of recurrence decreases and so does your risk of metastatic disease.
I didn’t get a full pathological response.
It looked like I might, but I didn’t.
If you read my last post you’ll probably recall that I spoke about the ‘bleeding edge’ of cancer research. It’s possible that if I was diagnosed this year instead of last year I would have been offered this treatment. That makes me sad.
It gets worse.
Because I’m the kind of person that researches everything I was aware of this research when I started chemotherapy. I took a copy of a report on it to my oncologist the second time I saw her. I wanted to know if it would be possible for me to have these drugs added to my chemotherapy because the early trials had been so promising. It wasn’t.
This is what it’s like to have cancer, to survive cancer and to face the future risk of cancer coming back. Timing can be everything. Location matters too. Most of the research into triple negative breast cancer is happening in the USA and the UK. That makes me sad too.
But what it doesn’t make me is suicidal!
Comments
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What an interesting and important read Meg.How are you travelling otherwise? CheersxxxRobyn0
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What an interesting and important read Meg.How are you travelling otherwise? CheersxxxRobyn0
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Wow, I awoke this morning a just finished reading your posts. You write so clearly and succinctly.
Suicidal thoughts, I've had many, my GP gave me anti depressants and increased my medication for pain together with medication for nerve damage together with an increase in thyroid medication and a recommendation of natural therapies to help with the sudden onset menopause.
I felt worse, much worse, crying at physio, crying at hydro, crying at the store, now too afraid to leave the house, believing I had lost my mind, I could not function, did not want to.
I came to this site, consulted dr google, spoke to my pharmacist, stopped everything except thyroid med cold turkey. The gloom started to lift slowly, the pain remained. Now on pain days I rest when I can and work thru it.
Thank you for writing and sharing, I'm glad your doing better and I hope you continue to do so. Best wishes, susan0 -
Thanks for asking, Robyn. Now that I'm off the gabapentin I feel fabulous! I'm healing well and back at yoga. Life is good.
Love
Meg
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Thanks for asking, Robyn. Now that I'm off the gabapentin I feel fabulous! I'm healing well and back at yoga. Life is good.
Love
Meg
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Oh Susan, what a nightmare! I'd recommend you check each of the meds you were on to find out if any of them carry a depression risk. Gabapentin is often prescribed for nerve pain so we might be in the same boat. There is no reason why they shouldn't be able to find you some good pain relief that doesn't reduce you to tears. I'm currently on naproxen with no problems at all. Even regular doses of paracetamol or iboprufen can make a difference as long as you take them regularly and are careful not to take too many.
My very best wishes to you and thank you for your lovely compliment. It sounds like you've really been through the wringer and you certainly deserve a better time of it!
Meg
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Oh Sharon thank you so much for that excellent advice. I hope you are feeling well again and that life continues to improve for you. I know it takes more than a book to treat depression but I would like to recommend 'The Happiness Trap' by Russ Harris as friends with depression tell me it has been a huge help to them in managing their condition.
Meg
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l hope you are feeling a bit better Meg.
l am traveling ok at the moment, still have a few low days, but l will have a look at this book, l am happy to read anything that will help.
Thanks Sharon
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