So, I had my recheck with the neurologist/sleep doc today. We talked about the fact that I was doing really well on the Nuvigil (250mg once daily) and a scheduled nap halfway through my 8-hour shift, back when I first got diagnosed. And we talked about the fact that, after work changed me to a 12-hour shift, everything went to hell. The naps were no longer helping; they were, in fact, making things worse! The 12-hour shift means 2 naps, and when I did manage to fall asleep, I'd wake up feeling worse, and I'd have more sleep attacks later in the shift, instead of fewer.
Doctor says, "Easy way to fix that. Stop taking the naps!"
I told him I'd done just that a couple weeks ago, but I was still having 2-3 sleep attacks a night--usually only a few minutes each time. We talked about the fact that, when I first got diagnosed and started taking the Nuvigil, I was on an 8-hour shift and I wasn't having sleep attacks once I started the medication. So, I came away with a letter from the doctor declaring it medically necessary for me to return to 8-hour shifts. Now, I just have to get it through at work. Of coruse, until then I'll still be on the 12-hour shifts. I'm sending an email to my HR rep to arrange a meeting, but it might not be until Thursday morning, since my next scheduled work night is Wednesday night. I am, however, offering to come in just to met with her earlier in the week.
I also got a bit of a surprise. My diagnosis was narcolepsy "without significant cataplexy," so I read that as narcolepsy w/o cataplexy. However, in the letter the doctor wrote today, he said he's treating me for narcolepsy with cataplexy! So, I guess "without significant cataplexy" just means I have very, very mild cataplexy.
Of course, that may be just because I have a tendency to ... not react emotionally to situations. I've been thinking about this alot, lately. Because of other issues, I have always preferred to spend time alone--usually reading a book--or with only a few other people around. I'll enjoy myself, certainly, but I just don't experience strong emotions of any kind--happy, sad, angry, whatever. Instead, I just ... shut down. I think perhaps it's a defense mechanism I developed at a young enough age that I just didn't notice it anymore until I really sat down to think about it. I mean, there are only two experiences I've ever had that I can positively attribute to cataplexy, and the first of those was way back in 5th grade!
Anyway, now I get to push the required shift change through work. I dropped off the FMLA paperwork (Thank you, ZombiePrincess!!) at the doctor's office, and I'm not sure if he'll but the schedule requirements on that paperwork. There is a space for it, though, so I'm hoping he does. And I do have the letter from his office. I hope it's going to be relatively easy and painless, but I'm ready to fight if I have to.
Wish me luck!