Cancer Lesson #39: Sleepless Nights
I’ve never been one to stay up all night, even in college, when it was considered de rigueur to pull at least one all-nighter. But a week after my first chemo treatment, I couldn’t sleep.
I’d experienced a similar wakefulness at the onset of menopause, when characters set up housekeeping in my head and began keeping me awake. Their slamming doors and raised voices made me want to call the landlord. When I realized the landlord was me, I got out of bed, began writing, and never looked back. Though hormonal hot flashes continued to interrupt my sleep, I always managed to get enough rest to function.
Cancer treatment, it seemed, was different. I struggled for hours, trying to relax enough to drift off. My thoughts chased each other around and around in my head in a frenetic game of tag that left me exhausted, but wide-awake.
The first time this happened, I got up at one and wrote a blog post. That took until two-thirty. Then I got the brilliant idea to switch my writing focus completely and began a proposal for a non-fiction book about cancer. Of course, composing that document took until morning, when I greeted the dawn with a bleary-eyed squint, wondering how I’d make it through the day.
I was convinced this problem was somehow drug-related, but the only reference to sleeplessness in my drug information sheets was on the one about the steroids I took the day before, day of, and day after chemo. Could this side-effect have kicked in a week late? It didn’t seem likely.
The second night, I tried progressive relaxation. My toes are relaxed. The arch of my foot is relaxed. My ankle is relaxed… By the time I reached my forehead and eyebrows, I was completely relaxed. Relaxed, but, alas, still awake.
So I tried visualization. I’m on a beach. A beautiful beach. The water is azure, and the sun warm on my cheek. I feel the gentle breeze, hear the waves lapping against the sand… The lovely vision merely succeeded in making me want a vacation. And the bathroom.
Shattered by my sleeplessness, I finally began falling asleep. But as soon I began to dream, I’d wake up.
The dreams were telling: I am dressing to go somewhere – pulling on clothes and then taking them off because they aren’t right for the occasion. Still unsure I’m ready, I bend to pull on my boots. My mom strokes my head, as if I am a kitten, and her hand comes away with handful of hair.
Well, as we used to say in fourth grad, duh! Not ready to lose my hair. It didn’t take a genius to figure that one out.
Casting my mind back further, I remembered an earlier dream set in an antique store. Walking around with my mother and father, I knock something on the counter. The owner insists I must clean not just the counter, but the entire case. I don’t have time. Antiques plus my deceased father plus my mother at an earlier age equals the past. No time to clean up the past.
Wow, I think, this is easy. My subconscious is reminding me to focus on the present.
And, finally, I remember the last dream. There’s an accident involving lots of teenagers (probably underlying worry about my daughter during the season of graduation parties), and the sheriffs are trying to get them routed to hospitals. They need people to illuminate the accident scene with their car headlights in order to move more quickly. Mom and I are trying to get there, passing dozens of cars full of people, uncaring or unaware of the emergency, as they watch a movie at drive-in theater.
Trying to get to a place where I can help people. Was this a nudge to move forward with the book idea?
My relief at deciphering these dreams led me to believe the restless nights were due to psychological truths I’d been avoiding, and I went to bed on the third night fully expecting to sleep.
I didn’t. If anything, it was worse. My mind raced, jumping from one thought to the next. I would lose it if I didn’t get some sleep soon.
Since The Engineer had to work the next day, I didn’t want to keep him awake with my movements. I crept out of bed, and went downstairs to review the drug literature again.
Suddenly, I remembered the Levaquin (Levofloxacin) – a powerful antibiotic sometimes used to treat Anthrax. Dr. H had prescribed it only days before to prevent infection due to my low blood counts. It had slipped my mind because it never occurred to me that an antibiotic could have such severe side-effects.
Realizing the information sheet on Levaquin was in the bedroom with my sleeping husband, I sat down on the landing outside our bedroom and waited for morning. When The Engineer got up, I found the leaflet and read it once more. There, on the ninth page, under “Central Nervous System Effects” were the reactions I’d been experiencing. Restlessness, anxiousness, trouble sleeping, nightmares – it was all there.
I called the doctor’s office and left a message telling them I couldn’t take any more; I had to get off this drug. Dr. H was out of the office, but his colleague told me to come in so they could check my blood counts.
If the levels had improved enough, I could go off the Levaquin. If the numbers were still low, they’d give me something to help me sleep.
After a blood draw showed my numbers were still dangerously low, I ended up with a prescription for Ambien.
I whined. I didn’t want to take sleeping pills. The nurse’s response was just what I needed to hear.
“Well,” she said, “you can stay on the Levaquin and take Ambien. Or you can end up on the hospital with an infection.”
That night, I took the Ambien and slept.