One pill makes you larger / And one pill makes you small…
— Jefferson Airplane, White Rabbit
I finally gave in (to myself) and asked for a prescription for tolterodine. I started taking it a few weeks ago and have been grudgingly, reluctantly satisfied with its effect on my bladder. But as with any new med, I fret.
This now brings my current chemical regimen to five: glatiramer acetate by injection, tolterodine, simvastatin, bupropion and sertraline in tablet form.
Digression: using the generic names pleases me and is purposefully catty. Not using their brand names somehow belittles them. Wait, can drugs be belittled?
When I first went to my therapist, I was adamant that I didn’t want “head meds.” I guess that’s a common request. But I felt hopeless and couldn’t stop crying. Months later she broached the possibility of medication again. She insisted that my quality of life should be important to me.
Now, with a little tinkering, we’ve settled on a mix of bupropion and sertraline for me. I’ve subsequently learned that the incidence of depression is way higher in people with MS than even for others with different chronic diseases. The thinking now is that it may be a result of the plaques forming in that part of the brain. So that’s numbers one and two.
Furthermore, I am genetically susceptible to high cholesterol. That is the excuse I gave my GP when I wanted a simvastatin prescription. In reality, I was urged by another person with MS to take it, that he had experienced an almost complete remission after artificially raising his cholesterol to get it prescribed.
For me, I didn’t see the harm in starting to address the high-ish cholesterol, but I haven’t noticed any changes in my MS symptoms. That’s number three.
In years past, I’ve performed the interferon beta-1a (Copaxone) injections but developed a severe liver toxicity known as toxic hepatitis. I was yellow and had to go on short-term disability to stay home for two months and get my liver enzyme count back down. I went for blood tests every two weeks and it rendered me ineligible for all other MS approved interferons.
But the consensus of the medical community is that because there is no MS cure yet and also there is no definitive way to determine the severity of the progress of the disease, I should be on any of the currently approved drugs “likely to reduce future disease activity and improve quality of life” for people with MS. So in 2003, that left glatiramer acetate for me and that is number four.
In addition, a few years ago I sat for an IV course of methylprednisolone (steroids!).
Another time I sat for an IV of natalizumab on a Friday and was horrified when it was pulled off the market the following Monday for health concerns. It is now back on the market but it didn’t show significant changes to my MRI so my neurologist and I have decided to hold off on resuming it.
Oh, and I had a six-month round of the chemotherapy drug cyclophosphamide, also administered by IV.
So I guess I just talked myself down. From the moment I decided to start the interferon beta-1a injections, I was admitting to myself that I was willing to accept medication “on board” in my adult life.