By far, one of my greatest challenges is keeping my med toxicity at bay. I take varied doses four times a day, and the ones in the morning and evening are doozies. The one first thing in the a.m. (300 mg of carbamazepine and 200 mg of lamotrigine) is especially tough to tame, and it can literally leave me flat on my back for two to three hours. Needless to say, excuses for being late to appointments in the morning can wear thin!
Over time, I’ve found five tactics to lessen the toxicity and keep me alert. They’re not rocket science, but maybe one or two of them will help you:
Ø Caveat: I hope this goes without saying, but, on the off chance it isn’t obvious, make sure your doctor is bought into this idea before you do it. Do not do it on your own. If you haven’t evaluated your meds and/or titrated your doses with your doctor for a long time, it might be a good place to start. When I was pregnant and had gained serious weight, we had upped my daily doses pretty darn high. After having my son, of course I lost weight, but I didn’t go back to where I was before. Now, 15 years later, I’ve gone back to my original weight. Feeling that living mornings toxic isn’t necessary for someone with controlled epilepsy, my doctor cut back on my morning dose of lamotrigine, and it’s made a world of difference. I’m now in a position to do a few other things to cut back on the toxicity.
Ø Eat a fibrous breakfast, making sure you get some bread or other grains in. At least for me, it provides a buffer in my stomach. I find that oatmeal without all the sugary fruits and syrup is best.
Ø If you’re a coffee hound, as am I, cut back on it or make it weaker. You also could put more milk proportionally in it. As you can imagine, caffeine tends to make blood race just a little faster… and it can throw the meds into your bloodstream and up to your head at a rate your brain is not ready to assimilate. Bam! Wooziness.
Ø Similarly, don’t bend from your waist to pick up things, letting your head follow the action down. The gravity pushing on your head also will do a number on the blood rushing to your brain.
Ø Here’s one that’s counterintuitive: Don’t lie down. While it feels good, I’ve found that sitting up keeps the blood pumping at a normal rate in the morning. Lying down, while not making the blood rush, makes it a lot easier – and, thus, faster – to get to your brain.
So, for me, the takeaways are to make sure you don’t do anything that will encourage your blood to rush to your head for a good while (for me, an hour), buffer your stomach with a decent breakfast, and stay seated. And, of course, I’m grateful to my doctor for giving me a green light to reduce my lamotrigine, even ever so slightly. It made a big difference.