Side Effects Bring On The Sweats

Co-existing conditions alongside fibromyalgia can cause difficulties for lots of us. As I’ve said here before I have a long list of other diagnoses and they each bring along a specific medication. This requires very careful management as it can cause serious problems if any negative drug interactions occur.

When I was first diagnosed with fibromyalgia my rheumatologist wanted to prescribe me Lyrica and Amitryptyline. This is a fairly standard practice with fibromyalgia but these drugs can have very different results in people. Some people will swear by their effectiveness while others may have very negative side effects from them both.

Because of this, I didn’t start taking them both simultaneously. I began with the Amitryptyline alone to see if I encountered any changes. These could have been positive and have an impact on my symptoms, I may have had no change at all and the changes could have negatively impacted my symptoms. But by trialling a drug individually, everyone would know that any changes could only have been brought about by that drug alone.

This same system of slow introduction has been used to monitor any changes made to my on-going medication regime. New medications, increased or decreased dosages or removing drugs have all been implemented in this way. This ensured that only one change has happened at a time.

The only change recently has been the introduction of methotrexate for my arthritis. As a result, the side effects I’ve experienced this week can, in my opinion, only have been caused by this drug.

Most people go to warmer climates and will sweat a little as the body regulates your temperature. Similarly, people may sweat after eating a very spicy meal. But what about sweating profusely after eating the equivalent of a cucumber sandwich in an air-conditioned room?

Last weekend I attended the Arthritis Ireland national volunteer meeting. I got there nice and early and had a relaxing hour or so in the pool and hydrotherapy suite. I then had a long cool shower in my room and dressed for dinner. I hadn’t taken my hands down from putting on my shirt when the sweats started.   

I was leaking and leaking badly. My forehead glistened and I could feel the rivulets of sweat down my back, down my chest and down my legs. I didn’t even sweat like this playing a cup final on a sweltering summers’ afternoon. I tried to enjoy the meal and discreetly rub my forehead to mop up some sweat but I was fooling no one and I was incredibly embarrassed.

Now a few drops of sweat on a warm night and after a meal isn’t remarkable, but this sweating was intense and has continued all week, day and night. I’ve struggled to sleep due to being soaked in sweat and I’ve been lying on the couch in shorts and a t-shirt and started sweating profusely. Methotrexate must be the culprit.

I’m presuming this because it’s not the only negative side-effect I’ve experienced this week. Fatigue is constant with fibro, for many people extreme fatigue and lack of energy can be the very first symptoms to show up. I was no different and I know what fibro fatigue feels like. So you can imagine my surprise when I started crashing out for naps this week. I’ve barely been able to get out of bed each day and on Monday, Tuesday and Wednesday I had some long naps around 6pm. Then on Thursday, I managed to get up at my normal time but I was fast asleep on the couch by 11am and was only woken by a phone call at half twelve. Yesterday was no different.

I’ve felt completely wiped out and this has led to reduced concentration and even dizziness and blurred vision which I haven’t had for ages. As I said, the only change is methotrexate so I can only presume that it is doing this. I could probably deal with this if my pain was reducing but if anything I’m in more pain now and extra joints have gone from bearable to really painful in the last few weeks.

I’m back with the rheumatologist next Thursday to assess where I am and we’ll discuss my options moving forward. Methotrexate can take time to begin being effective so I may need to ride out the sweats for a bit longer. But we’ll also discuss if these side effects mean we’ve to try a different course of treatment. The important thing is I’ve the utmost respect for, and trust in, my new rheumatologist and I know we can have an open chat with all options on the table. Therefore by the time the appointment is finished my mind will be at ease and my treatment will be planned out.

Thursday can’t come around quick enough.

Doctor, Doctor

Doctor, doctor, I think I’m invisible”

“Next please!”

Anyone else remember at least one doctor’s appointment that felt like this? With the wide variety of symptoms and the time it takes to get a diagnosis I think a fibro fighter is lucky to have only had one appointment like this.

My appointment like this happened just over a year ago. I already had my fibromyalgia diagnosis but the terrible migraines, the confusion and the dizziness called for a visit to another neurologist. I saved up an absolute fortune so I could afford to visit a neurologist who came highly recommended and with a list of accomplishments and letters after his name.

€320 it cost me to visit that specialist. €320 to be told that all I needed to do to fully recover was to re-join a football team for exercise and camaraderie and talk to a cognitive behavioural therapist. The fact I hadn’t been able to stand for 20 minutes to watch my brother’s match the day before didn’t even register with him.

As I say this was the worst experience I had and everybody will probably have a similar story to tell but how can this still be happening? Awareness and understanding of fibromyalgia is improving day by day but there is still a group of people who don’t believe our symptoms are real and are prepared to dismiss us as hypochondriacs and whiners.

Before a diagnosis is made, we all undergo tests that come back negative and because of the wide variety of possible symptoms, these tests are often ordered by many different specialties. Therefore it can be hard to stand by the courage of your convictions and continue searching for an answer when the evidence and often the opinions of your doctors are firmly against you.

The major reason for this fight comes from deep within us. We’ve all been sick, broken a limb or suffered injury before we begin to experience the symptoms of fibromyalgia. So we all know that when the fibro starts, this pain and fatigue is different to anything we’ve experienced before and we need to find out what it is. GP’s, consultants, friends and family may all try to explain it away and say it couldn’t be as bad as we describe but stand by yourself and your beliefs and you’ll be vindicated in the end.

It is a pity that there is still a mind-set among many people that fibro is all in our heads and they will struggle to listen to us or even try to understand what we are going through. There are, however, things we can all do that will help us out and begin to break down the walls of disbelief we encounter.

A very important acronym to remember when you are interacting with medical professionals is to take PART. It took time before I adopted this attitude for all appointments but once I saw the benefits of it, it became second nature to me.

So what does PART stand for?

1. Prepare

It is important to be thinking of your next appointment long before you get near the waiting room. In between times keep track of your symptoms, list 3 or 4 things that recur or any patterns you see developing. Then be ready to report back to the doctor on these most important items.

2. Ask

Ask questions about your diagnosis, any new medications or tests that are recommended.

3. Repeat

Repeat any points that have been made during the consultation so there is no confusion or miscommunication. It can also help to have a second person beside you to ask any questions that you may forget or to jot down the important points for you.

4. Take action

Follow the advice and treatment plan you are given and if, for any reason, you can’t do this then report back to the professional honestly. Once you leave the surgery the doctor will presume you will take medications as prescribed or follow other advice unless you tell them otherwise.



PS: I am always open to suggestions about blog posts and this one follows up a comment from my fellow blogger, Bambie H in Australia, which I was chuffed to receive. If anyone else has questions or ideas for topics feel free to let me know.