Hey everyone I need help desperately. I am looking for answers or solutions every where I can. It is such a general symptom, it is hard to find any useful info. For almost three months now, I have been dealing with extreme fatigue. When it started, I was on the same meds I had been on for years (fentanyl and percocet). I get so tired and I mean it is so bad that I have to find a place to lay down or I will fall over. It comes over me very suddenly. When it starts, I often sleep for 15 or more hours straight through. No one can wake me. I sometimes hear them, but cannot budge no matter how important it is for me to get up. I have gone for a couple days in a row - sleeping 16-17 hours and only being awake 7-8. I feel like I have been run over by a truck. Then I will feel normal for a few days and wham, it hits me again. Not only is it frustrating, but it is starting to scare me. I went to the doctor about 2 months ago. I was severely depressed - partly because of the chronic pain and frustration with conflicting diagnosis and opinions, but partly because of the fatigue. He figured the fatigue was actually a symptom caused by the depression and put me on anti d's. He put me on Effexor because he said it is somewhat stimulating, not sedating because I definetely didn't need to be sedated anymore. Well, my mood is better now and I don't feel as depressed, but this fatigue thing has not improved. Besides my pain meds, I take prilosec for a hiatal hernia, Super B Complex, B2, and Calcium regularly. I have a problem with no appetite and I don't eat properly (actually I never have). I make good food choices, I just don't eat often (usually once a day) or eat very much. I tried supplementing with nutritional drinks and that didn't seem to help. I am scheduled to see my PC again on the 12th. Anyone have any ideas what would cause this extreme fatigue or what I can do to help it? Please help.

Have you been checked for fibromyalgia or chronic fatigue syndrome? You might have luck talking with a Rheumatologist about those two.

Ditto on Jim's comment -- and a close look at viral or bacterial infection may be prudent. But be forwarned: all blood labs are not alike in terms of their reliability and diagnostic capability! We can chat whenever you like.

That's all the medication you're taking? The reason I ask is that I was on Neurontin and was experiencing the same thing. My doctor INCREASED my dose and the sleepiness went away alot. I needed to "breakthrough" my threshold. Once I did that I wasn't so tired. I'm currently on between 1800 - 2100mg.

Severe pain makes me want to take my Oxycontin and go to sleep.
My sleep dose for Oxycontin is 100mg.
My work dose for Oxycontin is 60mg (chewing 20mg for quick action)

I am hypoglycemic and I have this problem when my blood sugar is low. I have also experienced extreme fatigue if I use some artificial sweeteners. I know these may sound like simple solutions, but I thought they were worth mentioning. Have you ever been checked for hypoglycemia?

I would be very happy to take some of that sleep off your hands, would you like to swap for my insomnia?
Seriously though,you really need to have a full blood workup done, lots of things could cause excessive drowsiness/tiredness such as the ones already mentioned. It's a worry that you're so out of it you have so much dificulty being woken up, even after many hours of sleep.
I was on Effexor for 4 months, stopped it 2 weeks ago. It caused me to be hyperactive and one of the reasons I stopped it is because I couldn't go to sleep and am waking 4-5 x per night. I'm hoping that will improve once it's out of my system.
B.T.W. the Effexor also decresed my appetite for the first 2 months, how long have you been on it and at what dose?
Best of luck with finding an answer.
Cathy

Tisury:
Depression can cause hypersomnia but not to the degree you are describing--and usually when there is hypersomnia, there is also overeating, not loss of appetite. Your doctor took an easy but incorrect route. Now it's time for him to take you seriously and give you a very thorough evaluation. Please let us know how it goes.

You need a complete physical and lab profile by a qualified Internal Medicine doctor. If your Family doctor is also Internal Medicine, tell him you feel you need a complete workup as that's what should be done for your symptoms to r/o the most common medical probs that would cause extreme fatigue of that nature.

You can be refered out if need be to other services that might better work with whatever diagnosis is derived based on a real good THOROUGH history, physical and lab work up.

Tisury,

Yes, I agree with the complete workup. Also consider an evaluation by a sleep lab. Your symptoms sound severe.

In addition to the conventional medicine route (which is what I would do first if it were me), you may eventually want to talk with a naturopath. I understand that some of their testing is different.

Good luck.

Thanks to everyone for your concern and helpful ideas. I saw a rheumatologist, but that was 4 years ago when my back problems first started. He did a lot of blood tests then, but that was a long time ago. I really haven't seen any doctors for much of anything except for the backpain. I also had bloodwork done 2 years ago before my ADR surgery, but I am sure that was just a general nonspecific work up.

Can they test for fibromyalgia or chronic fatigue syndrome? I thought these were simply diagnosed after ruling out other possible causes. Although I do recall something about trigger points with fibro.

Eddie - Years ago i had tried neurontin, but I didn't like the side effects. This is all the medicine I am taking right now, except that when my pain is especially bad, I add Bromelain to the mix for it's anti inflammatory properties. The fentanyl patch is 100mg every other day switching which side I change - i leave one old patch on. The percocet varies greatly from 1 or 2 a day, to 6 or 7 - depending on the pain levels. My pain is not managed very well, but that is partly my doing. Being able to think clearly and function is very important to me and alot of medicines knock me on my "a _ _". I continue to work from home doing accounting and tax preparation and I can't do that if my mind is all in a fog, so I won't take anything that messes with my head too much. Sometimes I wonder if the sacrafice is worth it or not, but.....I need to earn money if I am going to consider going to Germany and I am just a type A person - not happy unless I am busy.

Cathy - I have been on 75mg Effexor for a little over 2 months now. The doctor chose that one for it's stimulating properties, but it definetely isn't stimulating me. Right now I would swap you for some of that insomina so I could manage to get something done, but I'm sure I would be looking to swap back then. There is only one thing worse than sleeping all the time and not not being able to wake up and that's not being able to go to sleep for a long time.

I had no appetite before being put on the Effexor. When I saw the doctor 2 months ago for the depression, I had lost 10 lbs in 2 weeks. Not that I couldn't' stand to lose a couple pounds, but I go days sometimes without eating and that's not good. I have to force myself to eat and I don't feel good after I do. This has been going on for a long time - I think the pain meds and decreased activity - but not to the extreme of losing 10lbs. in 2 weeks.

As I said, I am scheduled to see my PC on the 12th as a follow up on the Effexor and the depresssion - if I can last that long. This is so frustrating and depressing to me. I will definetely be pushing for a complete work up now that I have talked to all of you. Thanks to all of you.

Oh, and another symptom I didn't mention - upon first getting up, I feel light headed and dizzy for awhile. Figured that was just cause my blood had to get circulating again after being down so long.

I just hope the cause of this is easier to pin point than the cause of all my back pain.