I unfortunately don't really have the option of upping my amitriptyline dose. The dose I'm on, 25 mg, is apparently the ideal dose for me for preventing migraines. At one point my GI tried upping my dose, but even at 40 mg the migraines were back within a week or so. The primary reason I'm on ami is because of the migraines - it helping me sleep is lovely but is secondary to that. So I'm pretty much stuck at 25 mg because I'm more miserable with migraines than I am with lack of sleep.
The good news is, I zonked out to sleep last night in spite of the steroid suppository. Slept like a log and feel pretty good today. Guts feel more settled and no blood in the stool so far today (although usually that's been happening in the evenings and it's 4:45 PM here right now so I may still have blood in my stool at some point this evening). So far so good, I'm feeling better today than I have in a bit. I think the steroids are helping.
My GI specifically mentioned enemas when he said we might do a flexi-sig - he didn't even say enema, he said "we'll have you do some enemas" as in plural, so I guess that means I'll have to do several enemas beforehand if I go that route. And honestly, with the bleeding lately I have been having some anal pain (getting the suppository in last night was quite painful, I nearly cried out loud as I was putting it in). So I am expecting the flexi sig to be painful, but it's not like I haven't had things in my backside (colonoscopy scopes, suppositories, an anuscope) in the past and I'm not super anxious about it. Not looking forward to the prospect of it, but not losing sleep over the thought of it either. And hey, a bowel test where I don't have to do prep or drink contrast is a winner in my book!
Oh, and yeah, I honestly am a bit concerned about weight gain on the suppositories. I was only ever on pred for very short periods of time (like 5 days at a time) so I never gained weight from that. Entocort I tend to just gain a little extra weight, I think I ended up with about 6 extra lbs total from being on it for 8ish months. But these hydrocortisone suppositories, the one other time I was on them I didn't change my eating habits and I kept exercising the whole time, but even so I gained 1 lb each week I was on it (6 lbs in 6 weeks). True, that weight did come off rather easily and probably was just fluid retention, but still, it seemed extreme compared to gaining less than 1 lb per month on Entocort. I don't want to head down that 1 lb per week road again so I'm being a bit pre-emptive and trying to cut a few calories just to be sure. I actually still haven't lost that extra bit of Entocort weight from when I was on it in 2014, so I have a few pairs of pants that fit a bit tight already and I don't want that situation to get worse. (I was on Entocort from Feb thru Oct 2014 and gained 2 lbs during that time, and I actually gained about 4 lbs right after coming off of Entocort, I was exercising and trying to get back to my usual weight, but then I got the flu at xmas and couldn't exercise for awhile due to the respiratory symptoms, and now the bleeding is largely preventing me from exercising, so weight loss right now is tough with just exercise so I'm seeing a need to cut a few calories.)
I guess I should give an exercise update. I haven't done any.
On any days where I'm having bleeding and/or just not feeling great, I'm opting to rest. So far that's been every day this week, although today I'm doing fairly well. I told myself that if I have a good day with no blood, then I should make the most of it. So I'm thinking I'm going to do some gentle exercise tonight - I'm leaning towards yoga. I have a 30 minute yoga program set up in my Wii Fit, it's just the right balance of being a bit challenging but not being crazy or anything. It shouldn't make things worse at any rate. It's things like the sun salutation, the warrior pose, etc - nothing that contorts me into a pretzel (not that I could anyway, I'm ridiculously un-flexible). So I think I'll do some yoga tonight, and assess how I'm feeling tomorrow and go from there. If tomorrow I'm still feeling okay, then I might just sneak to the gym for some weights (I'll avoid the abdominals machine so that hopefully my guts don't get angry).