Hamarana

[This post has been re-dated to twelve months from the original, since its still generating comment: I have comments set to autoclose at about a year]

You might wonder what the change of direction is about, here.. Modafinil? WTF?

Here’s the story: Some months ago, my friend Chris told me that he had been prescribed this new drug, Modafinil, and that it was making a huge difference to his life. He was able to get on and do what he must, he joined a gym and started a weightloss program which turned out very successfully, and he was trying to persuade me to give it a shot as well. I was reluctant until I thought it through.. Chris and I both suffer from OSA (Obstructive Sleep Apnea) and so we are unable to obtain Modafinil on the PBS, because its only prescribed for provable narcolepsy here in Australia (unlike the US where both of us would be eligible, because of OSA). Instead, we have to pay $120 or thereabouts per month, in order to stay awake long enough to do what we need to. (I’ve gone with getting it from overseas)

For various reasons I was looking at the Medicare Site today (actually contemplating getting credentialled and getting a Provider Number and going to work for a GP instead of doing what I currently do) and noticed the PBS link. So I looked in there and saw the link to Modafinil. Followed the link and found out just how hard it is to get prescribed, even if you do have Narcolepsy. I found it really hard to believe what I was reading: even if you are a narcoleptic, you can’t get Modafinil if dexamphetamine will do. Here’s a quote from the site

Authority required
Initial treatment

Initial treatment, by a qualified sleep medicine practitioner or a qualified neurologist, of patients with narcolepsy where:

1. therapy with dexamphetamine sulfate poses an unacceptable medical risk or
2. intolerance to dexamphetamine sulfate of a severity necessitating permanent treatment withdrawal develops

WHAT THE….? The Australian Government prefers that you take amphetamines than a drug which is a) not addictive, b) wont give you a high and c) can be withdrawn immediately with no side effects. You just have to wonder who runs the PBS Authority show down there in Canberra.

It seems that the NSW government is going to employ “specialist nurses” to work in emergency depts in Newcastle and Sydney because of the escalating nature of binge drinking. The words “stable door” and “horse” spring to mind.

The advertising campaigns have failed. The school education programs have failed. Here’s the solution…

SHUT THE DAMN PUBS AT A DECENT HOUR AND DONT LET THEM OPEN SO EARLY! (oh wait… thats no good… state revenue will fall through the floor)

Also… how about preventing the manufacture of alcoholic beverages which are designed to get young girls and boys on the booze… if it tastes like softdrink its a short bloody run to a binge drinker. (Oh gosh… if the kids arent on the booze, and bingeing, who’s going to pay…)

Jeez… Aussie goverments… get real… just for once. And for gods sake the money you make out of the booze is NOT worth the bodies, minds and lives of these kids.

Do something constructive, and meaningful, and stop with the bullshit solutions that will do SFA to solve the problem. I, for one, am sick to death of one government after another making itself look good by offering up a solution that those of us on the ground know is going to fail.

Anyone who has known me for any length of time is aware that I struggle with weight problems. A single look confirms it. As I have gotten older, it has become more and more difficult to deal with: and then, a few years ago, it seemed to spiral totally out of control. Along with that came PCOS (complete with skyrocketing insulin levels and a savage hunger), sleep apnea (try losing weight when all you do, all the time, is work, sleep, eat), diabetes, high blood pressure (although my GP and I are in a constant argument about what constitutes high blood pressure. I’m happy with a 130/80 and occasional spikes, she is not!) and high cholesterol levels. I never thought I would end up as I have, and it scares me.

I’ve tried Herbalife. Yes, it works, no doubt about it, and you do feel really fantastic when you use the products. But you have to stay on it for the rest of your life, and its bloody expensive. I’ve tried calorie controlled diets, but I can never stick to them, ditto weight watchers stuff. I’ve tried various fad diets over the years, but none have long term weightloss as a result. I like the idea of a low GI diet, and the kickstart diet that Channel 7 promoted last year was pretty effective, initially, but geez I got sick of vegie soup after 2 weeks of nothing but. However, I can live with a low GI diet as a lifelong thing, one really isn’t missing much at all.

Why don’t I exercise, I hear you ask… Well… I used to. I was a tennis player, and a tenpin bowler. In my youth I was a pretty decent swimmer as well, and did the usual lifesaving certificates up to Bronze Medallion level. I quit swimming after that and the weight began piling on. It was kept in check from time to time by my level of activity. I sustained a back injury at age 15 and now that is coming back to bite me, so walking any distance is out of the question, its just too painful. I even have a disability parking permit now and that is a real PITA: a kind of a slap in the face. I can, and do, get on an exercise bike (which I love because it also affords me the time to listen to audiobooks on my computer or iPod… its amazing how much you miss when reading the words… and how much more you get when listening to someone else read them. I guess I read too fast). And then my knees give out. But I keep getting on and having a go.

Where I am at today is commencing on the Optifast regime. Its pretty savage, reducing your caloric intake to <800 a day. I’m not sure I can stick to it completely, but given the rubbish I have been into in the last few years, its going to be an improvement anyway. I bought the chocolate shake mix yesterday and had my first this morning. Its not bad, but its something I know I am going to struggle with, so I wandered out about mid-morning and also acquired a supply of Vanilla shake, chicken soup and berry bars. I had a berry bar at lunchtime and I really didnt like it much. I don’t think I’ll buy any more when the current supply is done.

With a great deal of relief, I also noticed that even though you are replacing three meals for the first 12 weeks, you can still have two cups of low starch vegies, so I hit the local fruit and veg market on the way home and now have a truckload of green leafies in the fridge, all ready to go for tea, after the chicken soup.

How will I go with this? No idea. Its never been easy for me to lose weight, even when savagely curtailing my intake… but for some reason I am expecting success. I certainly hope for it. I have an appointment with the surgeon in two weeks time for assessment for gastric banding and I rather think I may be excluded because of age and and excess of antibodies… and in truth, I remain unsure of whether I want to have the anaesthetic in any case. I’ve already arranged to continue seeing the dietician in any case, regardless of his decision.

I like the Optifast program, it seems much saner than many meal replacement programs and does not look to keep you on the product forever, but rather gets you to a point where you eat less, and more healthily. Less, being really important. We all eat way too much, all the time, and I am constantly amazed at what I see people put away, that even I at my worst cannot manage.

This is all about getting my health back. I’m never going to be a sporting loon, nor am I ever going to be skinny, but I know I can do something about the blood pressure and the diabetes (and maybe the sleep apnea as well although theres some evidence to show it existed before the worst of this set in, and was simply untreated for around 14 years)…

I want to feel better, and I don’t want to be a drain on the health system.

Wish me luck.