Showing posts with label Sleep. Show all posts
Showing posts with label Sleep. Show all posts

Monday, March 16, 2009

Clinical trials: all in the name of science pays BIG BUCKS!

Seeking evidence of disability

I had some other topics I was planning to write about today but I caught something on the news tonight regarding another drug receiving FDA approval for the treatment of fibromyalgia so I thought I would concentrate on a timely subject by writing about my participation in two clinical trials.

Participating in clinical trials for new or existing drugs vying for FDA approval as a claimed treatment for a medical condition is most definitely a unique experience - but not necessarily easy to qualify for.

During the pre-qualification telephone interview, some participating clinics will reject you on the simple fact (and don't tell them) that you have filed for Social Security Disability for the illness that the trial is doing testing to treat. Their logic is, what if you get the active drug in the double-blind placebo study and you, not only show miraculous improvement (which might destroy your disability case), but leave knowing how to play the violin as well? Okay, that may be a stretch.

Besides
what business is it of theirs anyway? When I heard on the TV or the radio that a clinical research study was taking place to test a new drug for the treatment of fibromyalgia, the first thought in my mind was that hopefully it would work and maybe I could fully function again. There was also no guarantee that I would be getting the actual drug - I might get the placebo.

I have participated in two clinical trials for drugs seeking FDA approval for the treatment of fibromyalgia. Both drugs were already on the market as treatment for other medical conditions but were not "officially" FDA approved as a proven fibro-treatment drug. The doctors may have known it helped their patients and may have prescribed it for pain but they could not say it was a treatment for fibromyalgia . They could say they had fibro patients who were taking it for other conditions and reported it helped with their pain.

It's like this - take Avon's Skin-So-Soft bath oil for instance. Everyone has known (since what seems like Biblical times) that Skin-So-Soft repelled mosquitoes but, without spending millions of dollars in some government approved scientific lab for years of testing thus jacking up the price, Avon legally could not make the claim. Now they can.

Anyway, back to the subject of my clinical trial participation...

My first clinical trial was for FDA approval of Xyrem as a medication for the sleep disorder associated with fibromyalgia. The study period was 16 weeks and included four medical exams (of the tender points) by a rheumatologist and four overnight sleep studies.

I had to sign for the "drug" because Xyrem was considered a controlled substance. I also had to assure the clinician (in writing) that I would keep it secured to prevent theft in case my apartment was broken into. So now it was more than a medical problem I was trying to get help for - I could be faced with charges by the DEA for misuse, loss, etc. Clinical trials for drugs are always a federal matter.

As I said, there was no guarantee that I would be receiving the actual drug or placebo. This was a double-blind placebo vs actual drug trial. In a double-blind study, neither the clinician or patient know whether or not the "drug" is the placebo or the actual drug.

Also, there are two parts in the drug testing in the trial.

On your initial visit to the clinic - if you are accepted into the clinical trial you - are given a Palm Pilot. The Palm Pilot beeps indiscriminately signally you that it is time to answer the questionnaires. It can beep once a day or several times a day and you have to take it with you everywhere you go. In the evening you have to send the transmission of the questionnaires to the pharmaceutical company or clinic via the fax modem included with the Palm Pilot.

The "drug" comes sealed in a box with instructions but on plain unlabeled bottles. Each box and bottle have a serial number on them which the clinician records beside your name on your chart. Then you have to sign for the "drug" proving that you have received it. Each time you return to the clinic you are required to bring the "drug" with you in the box and bag you received it plus the Palm Pilot. The clinician checks the bottle to be sure you have followed all instructions and taken the required dosages. If it is the end of the first phase of the trial, you turn in the first package with "drug" and, after close inspection by the clinician, you are given another box with another bottle of the "drug". Still neither you or the clinician knows if it contains the placebo or actual drug. Each visit to the clinic includes a medical exam including blood tests, more questionnaires to fill out or interview with questions. Each visit to the clinic can last between one to two hours.

The four sleep studies included in the Xyrem clinical trial was the main reason I wanted to participate. It is a known fact that there is a sleep disorder associated with fibromyalgia, but due to the cost, most doctors feel that a sleep study is an unnecessary expense that undoubtedly can offer proof of disability. This was documentation I needed for my Social Security Disability claim.

Anyway, at the end of the clinical trial it was discovered that (both times) I was given the placebo. Of the participants who were given the placebo, I was the only one who showed no improvement in sleep. as documented in all four sleep studies. There is no way anyone can bluff their way during sleep monitoring.

The other participants who received the placebo showed improvement giving validation of the placebo effect claim of mind over matter.

I knew I had the placebo both times. Xyrem was used as one of the "date rape" drugs. It did not make me drowsy or disoriented. Many times, in the middle of the night, an hour after taking it, I would walk to CVS and shop. I'm sensitive to meds and haven't been able to drink alcohol in years.

And the results of the sleep study the night of May 18, 2004: Delta stage 3 sleep was 3.8% and stage 4 was 0.8%. Normal for each stage is 10% . I had 2 REM episodes for 18.5 minutes which was 20%, normal is 25%.

I had three other abnormal but worse sleep studies in this trial, all of which I submitted to Social Security in my initial filing for disability in August of 2004. Despite FOUR abnormal sleep studies, I received two denials by the Social Security Administration resulting in homelessness in 2005.

By the way, I was paid a total of $3500.00 for participation.

In 2006, I also had THREE abnormal sleep studies from Metro Hospital in Cleveland and a CPAP was ordered.

Also, in 2006, I participated in another double-blind placebo clinical trial for FDA approval of the drug Milnacipran. I had to leave this trial due to dizziness so severe that I ended up in the emergency room then the Cardiac Ward for three days. It is not known whether or not I had a reaction from the "drug" but I wasn't going to take any more chances. It was discovered by the facility where I was participating in the trial that I was receiving the actual drug. Milnacipran was approved for the treatment of fibromyalgia pain in 2009. Despite the scary side effect, it did relieve my pain. No sleep study was involved by the physical exam, monitoring of the drug and usage of the Palm Pilot to monitor my progress was part of the study. Payment for participation wasn't very lucrative. I received $150.00 for the time I was in the 12 week program.

I was awarded SSDI in August 2007 by an administrative law judge for the myriad of symptoms associated with fibromyalgia - sleep disorder, pain, anxiety, depression; chronic fatigue immune dysfunction syndrome (CFIDS), degenerative discs in my spine, osteoarthritis, etc.

Today on the news there was a segment of another drug approved by the FDA for the treatment of fibromyalgia pain symptoms. I used my "cool camera" to video the segment. I apologize for the sound quality midway and to the end. I must have had my thumb over the mic.

Sunday, March 15, 2009

My CFIDS/Fibromyalgia weekend

Living with the pain & fatigue

Damn I'm exhausted; sore (burning and throbbing sore) and those ETs must have visited me while I was asleep in the recliner for 6 hours - the mind is mush. So here I am slumped over my desk - staring vacantly at the monitor, the key board, the wall, my cigarettes. hand eye coordination is awful.

Thoughts coming to mind - click, change the channel; another thought-click change the channel. Staying focused is problematic but I've had more severe bouts with Fibrofog like the year or so when I couldn't read.

Plenty about that in another post - later.

Another thought just came to mind - whatever mind I still have left. I forgot to eat supper Saturday. I guess I'll fix peanut butter toast and a tall glass of chocolate milk - sounds real good!

I feel bruised; beaten. I have a certificate for a free 40 minute massage from a local massotherapist. Finally I found someone to go to here. I haven't had a deep tissue massage in a year since I moved and I miss going to my massotherapist in North Royalton . Massage did far more for pain relief than the drugs.

This week and all the stressors have taken a toll on my anxiety level leading to all the pain.

Did anyone get the number of the bus that hit me? Oops, forgot; not in Cleveland anymore. Back in my hometown of Toronto, Ohio - there has been no public transportation here since 1972.

I have a truck tho'. Gary bought it when we were living in East Cleveland - got it for $500.00. We got more than our very limited money's spent worth out of it so...

Need $600 + to fix it - Transmission! The walking is killing me. I can't believe - dare I say it? - I miss RTA (urine stained cloth seats, having to stand because of kids sitting in the disability seats, etc).

Despite having a disability RTA ID and bus pass, I'm surprised I was able to get a disability seat.
Heading eastbound on the #6 Euclid. Photo by Cindy Miller - 2007


It's been a rough two days - 2 hours of rest for every 15 minutes of housework. I managed to change the bed linen tho'; took me an hour because I stuck with it! I also had to go upstairs to the apartment and get it ready for the new tenant. The timing - despite that I feel like crap - couldn't have been better. We need the cash!

Just standing to wash the dishes is nearly impossible. My feet are a mess from all the walking I had to do just to get around downtown Cleveland before the state approved my disability cash assistance. I have nerve damage too in my legs.

Once my Medicare is straightened out and I am able to find a competent doctor here, I'm requesting assistance to help with the housework - at least three days a week.

I've managed to keep the house in relative good order. I kicked Gary out of the living room and he is spending most of his time in bed. He was trashing the living room and really breaking down my new couch. He can barely walk and besides, the bedroom is closer to the bathroom for him. I don't care if the bedroom gets trashed from all of his meds all over the place.

People ask me how I managed dealing with my illness while homeless.

I had my safe places to go when I left the shelter every morning. Voinovich Park behind the Rock Hall was one place - no one questioned anyone laying down there. Since I had a food stamp card, I could belly up to the salad bar at the market inside of Reserve Square for one salad, pasta, fruit platter to go. I spent the entire day resting along the shore of Lake Erie.
Voinovich Park, Cleveland. This guy is relaxing in my old spot.
Yep, I took this photo and the one below it - 2007


Another safe place that I spent a great deal of my time was at the Northeast Ohio Coalition for the Homeless where I volunteered.

I researched, wrote for "The Homeless Grapevine Newspaper" -when my mind worked
but they had a couch and there were certainly plenty of times when I had to nap during the day.

Usually I was beat when I got there. The walk wasn't far from Community Women's Shelter on Payne but sometimes that short walk from E. 22nd Street to 3631 Payne Avenue could take me an hour on a bad fatigue day.

I met Gary while homeless. He and four other guys and one of the guy's girlfriend were all living in a camp near I-90. Another place for me to lie down if needed.

For obvious reasons, thank God those days are behind me now. Despite having a big house and property to maintain, at least I don't have a schedule to deal with. It's nice to be able to lie down whenever I please.

And I most definitely will be making an appointment for my free 40 minute massage Monday morning - even if I have to pay for a cab ride to get there.

In the meantime, I am going to drag myself back
(with a heating pad and Tylenol) to my recliner. Time to go back to sleep.

I'll just post this and edit it later when I have more energy and far less pain.




Wednesday, March 4, 2009

Visits by extraterrestrials...

...if you're asleep, is there still that sucking noise?

My sleep has been totally screwed up my entire life. That's why I chose to work midnight shift - I had great difficulty functioning at a day job.

I struggled to sleep at night; fell asleep a lot in class in high school (although I was never caught). I can no longer enjoy going to a movie theater because I fall asleep, staying awake at meetings, lectures, etc. is virtually impossible. Baseball games? I'm walking around at the top of the innings; watching the game in my paid seating at the bottom of the inning when the Indians come to bat.

I fell asleep at work a lot at my last job; standing, while cutting film with X-acto knife or razor blade in hand. Happened after they had moved me to day shift. That's when the 'fit hit the shan'!

I suffer from short term memory loss. I remember a lot of things from when I was 6 months old - being baptized, the taking of the group picture at the Miller Family Reunion in 1956. I remember being potty trained, watching the first-run televised original "Mickey Mouse Club" from my playpen (how in love I was with Cubby O'Brien), the day my dad tried to sneak it out of the house to throw it away (how I carried on!).

I remember events in my friends lives that they don't remember.

But don't come up to me on the street or at a class reunion and say, "Cindy, do you remember me?"

Just give me a few minutes (or twenty) until the electrical transmitters in my brain spark. The circuitry doesn't work too well - sometimes it shorts out.

Often, mentally focusing on any task is problematic whether it be housework, writing a check, talking on the telephone, reading, comprehending, concentrating. If the phone rings while I am cooking it disrupts my thinking.

Something shorts out in my frontal lobe. It's as if someone has a remote in hand, changing the channels but it's all going on in my brain; not the TV. And that humming noise is such a distraction.

Something strange was going on one night while at work in Michigan. A very simple task I had to do that's too technical to explain to anyone who doesn't know prepress. An apprentice could have done it without any problem; for me, a journeyman, it was cake. But let's say I made a major mistake while compositing two films into one film. I checked it, saw the mistake I made and tried to correct it. All I had to do is combine 16 films into 8 films. I wasted 16 pieces of film and 5 hours on what should have taken me two hours at the most. I saw the mistake, knew what I did wrong but my brain and actions were like a broken record; skipping, repeating.

Years later, I lost my ability to read, to distinguish color, became dyslexic, lost my hand-eye coordination - yadda, yadda, yadda.

Some days I can wake up and feel fully rested and capable of thinking. Some days I do nothing,; talk to no one other than Goldie or Gary.

Fibromyalgia and Chronic Fatigue syndromes are what I have and both conditions have no clear test marker (just adnormalities) making both conditions difficult to diagnose or to even prove, especially when winning a claim for disability. I have seven abnormal sleep studies. In some, I never hit REM sleep; in others I was in REM stage for less than 15 seconds.

So keeping in mind that there is no cell (like cancer) or any other defined marker has caused me to wonder if possibly(?), sometime in the middle of the night, I am being visited by Greys, Nordics, Reptilians or any number of interplanetary beings. After all there are many well documented encounters-some sightings by law enforcement, some by airline pilots, some by astronauts.

I even saw a triangle in the sky hovering over a corn field near Columbiana, Ohio in 1978, back in the day when Ohio state Rt. 11 was a hot bed for UFO activity from Columbiana all the way to Astabula.

There was even a multiple witness sighting of a craft between my hometown of Toronto and Stratton in October of 2008! Could they possibly know I left Cuyahoga County? Are they looking for me?

The Vatican even believes in ET while many in the medical community dispute the existence of Fibromyalgia or Chronic Fatigue Syndrome (because of the complexity of both conditions, they don't want to acknowledge what they don't know about both -a cop out).

I had an MRI at the Cleveland Clinic. The neurologist said there was something unusual on the MRI.

So, the next time you see me and I seem disoriented - in a fog - unable to concentrate, ask me if my ear hurts. I think that's where they insert the straw. Could that MRI possibly offer validation?



http://upload.wikimedia.org/wikipedia/en/7/74/Toserveman.jpghttp://alien-ufo-research.com/betty_and_barney_hill/Betty_Barney_Hill.gif
Top photo: HEY THERE! HI THERE! HO THERE!- It's Cubby O'Brien. WHY? Because I like him!
Second photo: IT'S WHAT'S FOR DINNER
- Scene from Twilight Zone
episode "To Serve Man".
Third photo: PROBED FOR TENDERNESS - Abductees Barney and Betty Hill

Sometimes ya just have to make light of your own situation!