Yes, yes, I can be practical. Recall that I wrote in The Reboot of feeling aimless and desirous of doing nothing. Well, this does not fit my personality. I tend to be much more machine-like in disposition. Sometimes even bordering on hypomanic. I make plans! I get it done dammit!
That has not been the case for me lately. I just want to lie around like a giant vegetable. I failed to include one very important variable in my assessment. Chronic pain. I don’t know if any of you live with chronic pain, but it’s a bitch. I have Chronic Migraine Disease along with some other weird diagnoses that I like to pretend I don’t have. The migraines though? There is no getting away from those. I have tried everything short of acupuncture. That may be next on my list. I was hit by a drunk driver and sustained a serious neck injury. Thus my “disease” was born.
What is my point?
Medication cocktails can also cause feelings of aimlessness, melancholy, and feeling like a giant mushpile, and doctors, as much as we need them, are not necessarily experts in pharmacology. In fact, unless your doctor is a pharmacologist, assume that they know little to nothing about the drugs you take and how they behave in your body when you combine them. To prove this point, I’ll tell you this. I once had a neurologist tell me that she preferred to consult with a pharmacologist before prescribing any kind of medication to any patient because medical school and subsequent training provided her with little to no training on pharmacology. This was why she did no prescribing herself. Her practice staffed a pharmacologist. The neurologist diagnosed. The pharmacologist prescribed. Isn’t that a fantastic way to practice medicine? In fact, this is often how it’s done in oncology particularly in pediatric oncology.
In my case, I take many medications daily to manage migraine headaches. Without those medications, I would be plagued with about twenty migraines a month. And, I don’t mean the kind of headache where I can pop an Advil, lie in the dark, and call it good. I’ve never had a “migraine” like that. I mean the kind that leaves scars on one’s brain and shows up on an MRI as a T2 lesion. Emergency Room visit migraines. Trepanation migraines. “I think I’m stroking out” migraines. I know other people who suffer like this, too. You live in fear of having one. They are a special kind of suffering. So, you take your meds because the meds bring down the intensity when you have a breakthrough event.
And, what happens when you fall into a migraine or cluster headache cycle because that happens? This is when you must pay attention to that “cocktail” effect. Triptans (i.e. Imitrex, Zomig), which are migraine abortives, are very effective most of the time, but they can cause depressive side effects. No one tells you this. I will randomly cry after taking a triptan. I’ll feel not quite right, but I won’t be in pain. I’ll feel like a zombie. A neurologist might tell you that it’s the aftermath of the migraine because a migraine is a neurological event–not a headache. It’s like the post-ictal feelings after having a seizure. You just feel weird. I have a seizure disorder. I’m down with that explanation. When you are, however, stuck in a migraine or cluster headache cycle, you usually have to add other medications to your regimen in order to halt the progression in addition to all the other medications you might be taking. An NSAID like naproxen is often recommended. Naproxen can mess with your nervous system causing symptoms of depressed mood and feelings of fogginess. This is well-documented. If the pain is still a problem and your doctor has given you narcotics to fill in the gap when all else has failed, as mine has, then you may add something like Vicodin. Narcotics are known depressants. So, there you are, days into a neurological event, managing your pain, waiting for it to stop, taking three depressants in addition to your other medications, and wondering why you feel aimless, ambivalent, foggy-headed, and somewhat tamped down.
Sometimes when we are so accustomed to living with certain realities, we fail to see the one thing staring directly at us. I am so used to living with chronic pain management that I failed to even consider that this could be why I have felt so “off”. In part, I think I was looking too hard in other places. Also, it’s discouraging. I don’t know what else I can do to improve myself so that these migraines get better. Alas, one keeps moving forward.
All this is to say, sometimes the answer you’re looking for is right in front of you. It isn’t complicated. It’s easy. It might not be the answer you want, but it is nonetheless ever present.
Sort of like looking for your lost glasses. You look everywhere, up and down, side to side, inside and out, when all the while, they were sitting atop your head.
That’s practical, right?