This past weekend has been spent wrestling in some degree of agony with some recalcitrant legs that refuse to sit demurely as they were designed, and instead proceed to nag away making me most uncomfortable. Added to that I’ve had an extremely sore lower back and DOMS, and I was not a happy camper.
Since I’ve been worried about my increasing use of tramadol, particularly having to take it during the day for restless legs, last Friday I resolved to get back to only using it at night for RLS. In conjunction with this decision I’ve started up again recording all the meds I take, so that I can monitor my med consumption and see what patterns emerge. Tracking all the details of my med taking is something I do every couple of months or so, just so that I have a good set of data to see where I’m headed.
Well last Friday I managed to hold out all morning, and succumbed to having a tramadol just after lunch (1.36 pm) to some unbearable RLS. When I’m being vigilant I try to hold out by using other meds such as acetaminophen and ibuprofen, and only if it gets really bad do I use a tramadol. The problem with this approach is knowing when to have the tramadol. If the terrible feelings from RLS are just going to get worse (despite acetaminophen), then I should take a tramadol as early as possible, as it takes at least 45 minutes to kick in. 45 minutes when one is sleep deprived and yet cannot fall asleep (due to the RLS irritation) can be excruciating, and it takes a lot of will power to turn away from taking another tramadol and instead just be patient and wait for the first one to work. I won’t lie, waiting 45 minutes for some medication to kick in when one is feeling so tired and terrible, is a horrible way to be. During the day I can distract myself to some extent as well as use other methods, however at night when lying in bed in a darkened room so that the senses are dulled, the agony of the RLS is intensified.
On Friday I managed to only need one further tramadol when I hit the sack, and so total count was just two, with one of those coming in the evening. A good start.
Then on Saturday I was feeling pretty much recovered from my cold, so I hit the gym and decided to go light on some leg work. Well, that is always the plan, and as per my usual stupidity I ended up going too heavy. When I go back to the gym after a lay off I tend to “go light” by using what I usually use to warm up when I’m at my normal level. However I always forget that this is still too heavy. So history repeats. It felt light at the time, however come Sunday and a really bad case of DOMS starts kicking in. Anyway, I’m getting ahead of myself.
I finish the workout and am managing to keep the RLS at bay. One of the methods which I find useful is to wear some socks that cover my calves and keep them warm. For some reason my calves always feel really cold – which seems to bring on the RLS. I’ve got a pair of woolly socks (how do you spell wooly? Both woolly and wooly are ok according to my spell check) which I cut the feet out of and which I use to keep my calves warm (I should clarify that ‘calves’ are my calf muscles, not baby cows in a field!). A hot water bottle also has some benefit for me at night. I take a tramadol at 5.15pm for what I record as “moderate to severe RLS”. Then at 8.35 pm I take another one for mild RLS. I took it then as I didn’t want the RLS to get worse (and it was already mild), and also hoped that it would settle enough in about 1.5 hours so I could sleep. My legs had other ideas. At 10.05 pm I still had RLS and being frustrated, took another tramadol. It didn’t help. I tossed and turned for another 2 hours. Now if you have done it before you’ll know that tossing and turning for 2 hours is a LONG time. It really sucks. By 12.35am I was really fed up. I pushed all caution to the wind and took another tramadol. That seemed to do the trick and I finally had some relief in my legs, and I could sleep.
Sunday hit and as I mentioned above, the DOMS started to kick in. Added to that I have been getting pretty bad lower back pain. This lower back pain isn’t muscular, but joint pain. My remicade isn’t due for another 3-4 weeks yet so I am concerned that I have such bad pain in my back. Anyway, I get into the acetaminophen again as I’m determined to keep the tramadol away during the day. I manage to hold out again until 8:15pm, which I thought was pretty good. However by 9:15pm I still have restless legs and take one more tramadol. I have work in the morning so I want to get a good sleep – especially since I had a poor sleep the night before. My boss has SMS’d me that we have an important meeting in the morning too. Well, another two hours of tossing and turning and sleep doesn’t come and the RLS although not severe, is bad enough that it is keeping me awake. I hate you RLS! For some reason my heart was also racing, which prevented me from relaxing. I don’t know what was up with that. My wife wakes up and gives my calves a massage, which help a lot and I finally fall asleep – although I have some weird dreams.
With all this trouble with RLS I’m determined to conquer it without the use of tramadol. I found a couple of articles online which showed that in a small study of people with RLS, compression really helped. You can read the articles here and here. That second link discusses use of a compression device which they found totally eliminated RLS in 1 out of 3 patients who used it. So armed with this info. I’ve been searching for compression devices online. It appears that compression socks are the cheapest option, I found some through Amazon for about $22 – you can see a selection of prices here. Then with a bit more research I found that the socks come not only in a variety of sizes (of course), but also a variety of different pressures. It seems that the range starts with light pressure of 10-20 Mmhg, then 20-30 Mmhg, and finally 30-40 Mmhg. I was going to order the 10-20 Mmgh and then I discovered a shop right next to where I work has these in my size. The price was also the same, which saves me from having to ship them from the US. So I bought a pair and have been wearing them today. My legs do seem better. I’ll get another couple of pairs tomorrow and wear them for a few days to see if it could be a solution. My fingers are crossed.
I also came across this beast in Amazon for $657. I’m actually contemplating getting it if the socks don’t work and my RLS doesn’t get better. You can’t put a price on good sleep.