Sometimes, I'm not the sharpest knife in the drawer. Sometimes fairly obvious things escape me.
I am, often, a total dumbass.
I've been feeling really, really bad lately. General achiness all over, fatigue, extra-bad pain in my already crippled up arthritic hip. The hip is getting replaced next month because it had already reached the point of "dear baby Jeebus let's put in the bionic parts," so it just made sense that all the pain was because of basic hip degeneration.
Except that it started getting bad in my upper arms, too-- an old rotator cuff injury flared up again. And my elbows started hurting.
Ah, well, I figured.
I've been doing a lot of chocolate work and typing. But then my legs started to ache, bad, all the time. My sleep became affected, as I couldn't get comfortable and I kept twitching, kicking and moving around all night, trying to find a position that didn't hurt.
Vicodin, for which I have an ongoing prescription for when the arthritis gets the better of me, became my best friend. I went through my monthly allotment a week early. I begged drugs from a friend, cut out simple carbs for a few days, took hot baths ... all helpful in the short term, but overall, it kept getting worse. I was also increasingly moody and irritable, partly from pain and lack of sleep, but also because my brain chemistry felt kind of fucked.
Then the holiday weekend arrived and I found that I could barely walk. I was stiff, in pain all over, and exhausted.
You're hot, Patrick said, after sitting next to me on the couch for a few minutes. He put his hand on my forehead.
You have a fever.
Maybe I have Lyme disease, I said. It was a joke, but I finally reached the point where my tiny stupid brain allowed that SOMETHING IS ACTUALLY WRONG HERE.
Finally, today, it occurred to me what's different in my life since this started. My doctor put me on simvastatin (the generic of Zocor) for cholesterol. And then I vaguely remembered that two-second conversation with the pharmacist during which she muttered something about "call your doctor if you have muscle pain."
So I hit the internet:
Statins work by blocking the action of an enzyme (called HMG-CoA reductase) that is part of the early stages of production of cholesterol.
The problem is that the substance formed by this enzyme is also required as the starting material for Coenzyme Q10; this matters because Coenzyme Q10 is absolutely required for the production of energy from food using oxygen. This in turn means that the muscles have to use the rather inefficient method of glycolysis to create energy - this is the method normally used when the muscles are working really hard, as in weightlifting or a sprint. This causes lactic acid buildup and that is what causes the aching. Lack of Coenzyme Q10 can also cause congestive heart failure, because the heart doesn't have enough energy to pump properly.
Muscle aches are well known as a side effect of statins. Unfortunately, if this problem is not addressed fairly quickly the muscles can become damaged, and in extreme cases the muscle cells die, break down and their contents are released into the bloodstream - a problem called rhabdomyolysis which can severely damage the kidneys as well. Side effects this severe are rare, however.
Some experts estimate that roughly 20 percent of patients who take statins
experience muscle pain, and it could indicate a serious problem. Perhaps more, because many don't report it to their doctor (the pharmaceutical companies will only own up to about 1.5 percent). Hell, it took me over a week to make the connection, mainly because I'm used to being in pain most of the time, so I figured this had to be related. In Germany, doctors prescribe CoQ10 to patients to counter the effects -- here in the U.S.? They just keep switching patients to different cholesterol meds.
So on Monday, I'll call my doctor. And I'm going to tell her that I intend to make changes in my diet and
start taking niacin, and that perhaps we'll see how the blood test looks in six weeks after I do that. According to the piece at that link, niacin works best for
lowering raising** HDL when taken with statins. But honestly? Right now I'd like to dump the Zocor entirely. With extreme prejudice.
** Like I know the difference.