Those of you who are faithful reader of Mike’s blog already know that our flight from LA to London on Virgin (a day and a lot of headache and hassle later than planned) went pretty smoothly. After cooling our heels for an extra 24 hours at the Hilton LAX, I enjoyed a couple of glasses of champagne in the Virgin lounge before boarding and we headed to the plane, where I enjoyed a couple of three more glasses in my comfy seat with my feet propped up for take off.
I decided to treat myself to one of Virgin’s front of the plane perks: the in-flight head and neck aromatherapy massage. Mike and I enjoyed our dinner across the table at my seat–with more wine–and then we settled into our respective duvet-lined beds for the night, he to listen to Michel Thomas’ Italian lessons on his iPod and I to watch Amazing Grace on the in-seat movie.
Afloat on a sea of bubbly, I needed no encouragement to fall asleep after the movie ended, but wishing to guarantee a full night’s sleep, Mike took an Ambien and slept soundly.
In fact, he slept so soundly that when the lovely flight attendant came to gently wake him for breakfast (which he’d ordered) she couldn’t wake him. When she woke me, I asked just for coffee, juice, and water (feeling a little dehydrated from my previous night of liquid refreshment) and saw that he was still sacked out. He continued to be sacked out as the cabin became the normal beehive of activity that landing soon occasions.
When the Captain came on to announce he’d be turning on the seat belt sign in 5 minutes and Mike was still sacked out, I gently shook him. He did not rouse. I shook harder and called his name. He did not stir. I could see him breathing, but he didn’t respond.
I shook more firmly still and slapped (gently) at his face and got nothing. And this began to worry me.
I stepped around to his berth and got him by the arm and pulled, exhorting him that it was time to get up, that we were landing soon.
Finally he opened his eyes and looked rather blankly at me. I kept repeating that he had to get up, that we had to get his bedding straightened up, so that we could convert the bed to a seat again. He stood up and seemed not to know what to do.
This, of course, is a very competent person, usually pretty quick on the uptake, but he just stood there looking like he didn’t know what planet he was from as I sort of elbowed him out of the way and straightened up his bedding.
When I told him to push the button to convert the bed to a seat again–the one right beside his thumb–he sort of touched it and let go and then didn’t understand that he needed to keep pushing it to raise the seat back…even after I told him two or three times. I raised the seat back and he sat down.
The flight attendant came by and he asked about breakfast–something I’d already told him a couple of times that he’d missed. She told him that she’d tried twice to wake him, but couldn’t and that breakfast was over. She offered him a quick cup of coffee, which he sat up and began to drink, with a blank, dull look on his face. The same look he turned on her each time she came back to ask if he was finished, so that she could clear the cup. She talked, he looked blank, didn’t respond, and she left…twice.
This behavior began to seriously worry me; I thought something awful must be wrong. Mike teases, cajoles, cracks jokes, laughs at all hours of the day and night; never does he sit, mute and confused.
Throughout the disembarkation process, I had to shepherd him along as I would imagine one would have to do with an elderly person suffering from dementia, constantly turning back to find him falling farther behind, having to almost pull him along the concourse, watching him list and weave and fumble and stare blankly when I spoke to him.
The lights were on and absolutely no one was home for several hours after we disembarked.
We dropped back to the back of the hoard of people making their way toward customs. Usually we’re sprinting ahead of everybody to get out and get on our way. Somehow, we made it through Passport control and Customs, but he now tells me he doesn’t remember any of it, including signing his declaration voucher (that I had to fill out for him).
I bought our tickets on the Heathrow Express train (something he usually does) and we slowly made our way into the bowels of the airport complex, down to the train platform, and onto the train into town.
We were under a tight time bind (or at least we’d put ourselves under one) trying to make it into London in time to grab lunch at Ye Olde Cheshire Cheese, before it closed at 2:30. It’s a pub around the corner from Samuel Johnson’s (of Dictionary fame) house and, in fact, the very establishment at which he and Boswell (not to mention even Charles Dickens) took many meals. The place has been there, as a dining establishment, since about 1538. It burned down in the great London Fire and was rebuilt on the same site (in about 1666-7). Our last trip there, he’d had a Steak and Kidney Pudding, glass of hard cider, and a bowl of Spotted Dick (a rich bread pudding speckled with raisins or currants and not in any way low carb, but delicious all the same) and I had ordered a stuffed pork tenderloin and veggies. Mine had been quite tasty, but the Steak and Kidney Pudding had been so memorable that I’d eaten half of his and foisted off half of my pork onto him. We wanted another round that we needn’t share and had been looking forward to going there to enjoy it on this trip.
All the more curious that I couldn’t seem to get him to move, talk, go. His was a one-act play: stand and stare.
We went straight to the hotel and checked in. He fell into bed and slept another three or four hours, then waked and was more like himself, but still sort of sluggish and dull.
My medical brain was spinning with differential diagnoses of what might be going on throughout the evening and after we returned to the hotel late and hit the sack: toxin? poison? stroke? He had no lateralizing neurologic signs, so I didn’t think it could be a stroke, but I must say the possibility of a TIA or RIND in the frontal, executive regions of the brain had me worried.
In the middle of the night, I awoke like a shot and knew what it had been. The Ambien (plus the copious booze) had caused a somnambulistic amnesia in him, just as it had done in those people splashed on the media who had taken the drug and suffered binge eating episodes in their sleep, walked about town, and even driven cars.
He had sleep-walked his way off the plane, through the concourse, through passport control, through Heathrow, onto the train, into a cab, to the hotel, and up to our room. He’d occasionally spoken, but most often, just looked blankly when asked a question.
I can see a little humor in it, now that I know he’s okay, but I can tell you that at the time, it was spooky and quite disturbing. And I’m…as my darling husband always reminds me…a medical man! By training and experience, I’m equipped to deal with such an episode. I cannot imagine how frightening a similar event would have been for someone without the knowledge and experience or worse yet, for someone traveling alone. Whether it was just a bad reaction to Ambien or specific to the situation of taking Ambien after drinking and being awakened instead of awakening when the drug wore off we may never know.
But for my money, I’m writing in my book of medical lore that Ambein and booze don’t mix! I can say, categorically, they’ll never get mixed again in the bloodstream of anyone I know.
Wow, that is really scary. And at least he had you with him. My first thought was how nasty the situation could have been if he had been traveling alone.
I’m glad that you both finally made it to Italy ok despite all the flying woes!
COMMENT from MD EADES: Thanks. Looking back is better for sure ;D
Wow! I would have been terrified!!
Wellbutrin and booze don’t mix either. Several hours lost for me the 1 time I did it. I was never told to not drink on it. Does the ambien have any warnings on the package?
COMMENT from MD EADES: I think it does, since most of the sedative hypnotics, anxiolytics, antidepressants, and muscle relaxants do.
Imagine how well the Ambein zombies are driving their cars.
COMMENT from MD EADES: And there’s little doubt that some of them are out there.
I’ve been on Welbutrin, taken in the am for several months and have never noticed a problem when I have had a glass of red with my dinner, 3-4 times a week.
COMMENT from MD EADES: Wellbutrin probably also carries a warning label about alcohol, since it’s chemically related to the benzodiazapines, I seem to remember. And, as with Mike, one glass of red wine probably wouldn’t have mattered, but several glasses of champagne and a couple of glasses of red wine might. At least it seemed to with him.
Ambien (at least when I took it) did have a warning about mixing with alcohol. As it was the drug didn’t need any help in making me behave strangely, as in “I carried on a twenty-minute conversation with my husband and I don’t even remember going downstairs” strangely.
COMMENT from MD EADES: I feel sure it does contain such a warning, but then just about every medication for sleep or anxiety or muscle relaxation does as well. He’s taken it before without incident, so I do feel that the amount of alcohol he’d had in the airport lounge, boarding the plane, and during dinner played a role in his untoward response. To be on the safe side, though, I think I will ban Ambien from his apothecary kit.
My brother had episodes of sleep-eating with Ambien. One time he made himself a sandwich laced with some medication he was taking, enough that if, had he eaten it, he would have probably died! After that I think he gave up the Ambien.
I’m glad you got through the ambien incident without doing any long term damage!
I actually wanted to comment on your passing reference to having had a bowl of “spotted dick.” You described it as a bread pudding – usually it’s a suet pudding – like the steak pudding that apparently preceded it. I have a great weakness for suet pastry – and only recently discovered that fresh suet is amazingly different from the packet stuff. The difference is as big as between butter and margarine. I indulge it on the rare occasions when I can get my butcher to save me some fresh beef suet. If it’s a birthday, I might make a steak pudding, but if it’s a lesser occasion, I’ll go for suet dumplings, in a beef stew, so I can have a little treat, but keep a lid on the carb count. I have sometimes made the sweet suet puddings, but I really prefer the savoury ones.
Since when does alcohol and any kind of drug mix?
Reminds me of that simpsons episode about “Nappien.” There really aught to be better warnings on the commercials.
Comment from MD Eades: In fact, on almost all of the product inserts for sedative hypnotic drugs–and I feel sure for Ambien, as well–it states not to drink, operate machinery, etc. Whether the product would have caused a problem for him in this instance without having had the champagne, who can say. Likely not, but who knows.