In the past, I have made lists of things I want to accomplish over the weekend or vacation. I actually finish 50% of them.

These last few months I haven’t even made lists. I’ve been in my room, reading, watching mindless things on YouTube, but mostly too tired to do anything but stare at the ceiling. The weekend ticks past, wasted.

And now I’m on this new medicine. Did it lift the fatigue? Of course it did. It really did. This weekend I made a to-do list of 12 things and did ten of them. And some of the things were exhausting, like gardening.

Placebo effect? Maybe. I was livelier on Saturday than on Sunday. I did sack out all of Sunday morning. And to be fair, Gary put some of the groceries away Saturday because I was overly tired. But, 10 things done out of 12 opposed to 0 out of 0: that’s statistically significant.

Plus, this is supposed to improve my concentration, too. Perhaps I’ll just kill it at work on Monday. That would be nice.

I love knowing how drugs work. For example, MS eats myelin, the outer layer of your nerves, so one of my MS meds was a syringe of decoy myelin. I mean, I have no idea how they made it, maybe it was hamster myelin, but whatever. I know the general plan of attack.

This Modafinil/Provigil stimulant does not have one general plan. It has four little plans to keep you awake and alert. I feel like a committee had four wakefulness drug proposals, couldn’t decide, figured make the drug out of all of it. So this drug is a hodge-podge of the four schemes below. Just a hint of each. Not getting addicted.

1. It is the opposite of an antihistamine. Antihistamine makes you stop swelling or itching, but makes you sleepy. So this is a prohistamine. Maybe it’s a mirror molecule of Benadryl.
2. It’s the opposite of Gabapentin, which slows the synapses of seizure-having people. (More proof that Gary’s brain is too fast and my brain is too slow. Zombie Goldilocks would give the brains in our house a poor review.)
3. It tickles particular nerves in the hypothalamus that keep people awake. It’s astonishing to me that they mapped the brain enough that they know the tiny spot where the “awake” switch is.
4. It regulates your dopamine so you feel a slow but steady supply of the hormone that answers the question, “Why bother?”

I don’t know which of the four mechanisms is working or if it’s just the placebo effect, but I’ve got small plans for this weekend and big plans for cooking and gardening on Easter break.

We cut my MS medication in half a few months ago because my immune system was plummeting. It held steady at 0.20 for … what … almost 20 years on the immunosuppressants? And then 0.18, 0.16 … and you can’t have that.

So with that medication tweak, the house of cards started slipping and an MS symptom crept in. I felt fatigue.

It wasn’t the overwhelming fatigue where you lie on the floor with your hands turned up because it takes too much effort to have your hands face down. But I did spend entire weekends in bed, and you can’t have that either.

So I started Provigil/modafinil, even though the new insurance refused to pay for it. (An aside, it costs $1,000 a month, but if you get a coupon off the Internet it costs $30? Is our economy built on that nonsense? Concerning.) Anyway, I was out in the garden a week later. I don’t know how it works. Not caffiene, not uppers, so what is it? What is the mechanism?

There will be other effects of cutting the MS meds in half, I’m sure. I blew past .20 lymphocytes and went up to .26 (normal is .80).

I’m getting my Covid booster shot soon. I wonder if I’ll feel those post-vaccine symptoms normal people do. I certainly don’t want to catch the new “Cicada” variant. (And when did we start giving scary names to variants? Concerning.)

I would worry about new lesions, but I have an MRI scheduled for August, so we’ll catch them then. That is if we still have MRIs, evidently the war in Iran is affecting the helium that MRIs need to function. Again, say it with me, concerning.