Drugs

My mind is feeling ambitious this evening, despite the fact that it is Monday, not usually the most energetic collection of post meridian hours of my week. I want to wash my bird-crapped car, go for a walk and enjoy the long spring evening outdoors, maybe pull a few weeds in the garden before the daylight's completely gone.

But every time I stand up from the couch, my body says bllllaaaahhhh and all the blood rushes to my head and I sit back down again to watch another episode of the Weeds Season 6 boxed set from the library.

It's the Maxalt -- while effective at halting a budding migraine in its tracks (as long as I take it soon enough) side effects include devastating fatigue, heaviness of the limbs and a slightly underwater feeling. But most of the day I fought a slight headache. I doubted it would achieve the status of the Real Deal, the Big M that most horrible of horrors, *migraine* (that is) mainly because I just had a two day killer-diller last week, and USUALLY that means I'm safe for at least a couple of weeks, for some reason. But because lately they've had a way of sneaking up on me, I finally caved in and took drugs just to be safe. I really don't think I could take another two days of blinding pain just yet.

I know I've mentioned my Christian Science upbringing, besides which having, in my middle age, become rather boringly puritanical about drugs and liquor and whores and such (just kidding -- I'm still into whores. No, REALLY kidding, I'm not actually into whores anymore -- I think it's the drugs talking) ANYWAY, what I am TRYING to say and having such a difficult time getting around to is my ambivalence about The Drugs.

Funny thing about that, too. Last year when I had this procedure they gave me a prescription for hydrocodone. I didn't really need it for the post surgical pain, which was kid stuff. Coupla ibuprophen do the trick for that. But I was happy to have it for those occasions upon which I didn't take the Maxalt fast enough and got nailed. The first few times I took it, it almost seemed miraculous, the way it dissolved the pain and sent me into a deep restfull sleep. In fact, it made me a little nervous. As I think I've said here before, strong narcotics and chronic pain seem like an inherently unstable combination.

As it's turned out, however, my aspiring addiction seems to have been squashed in the bud. Probably for the best, but I still have the whole horrible days of debilitating miserable pain thing to deal with, so I'm splitting the difference and calling it an ambiguous blessing.

So here's the deal. Although, as I said, the first few times it worked beautifully, very quickly I seemed to develop a tolerance -- at least insofar as the pain-killing properties of the stuff are concerned. When it came to the nausea, well that's a whole nother story (as we say here in Southeast Texas)!

The time before last when I waited to long to take Maxalt and resorted to hydrocodone in a futile attempt to outwit the migraine, after three hours in which it had yet to do much to blunt the pain, I suddenly was overcome by nausea and puked my guts out. So that was pretty much that for the narcotic pain relief and off I went into two days in migraine land. So this time, although I thought it was possibly a waste of perfectly good drugs, afraid of the pain and hoping for the best, I popped a pill anyway.

This time it was a rather large mistake. Oh, it killed the pain initially, okay. And I slid off into a grateful narcotically-induced blissful slumber. But when I woke up 10 hours later, the migraine was back -- and the nausea was waaaaay beyond anything I'd experienced before. I have NEVER puked so much in my life, and I know it was the hydrocodone and not the migraine, because the pain that first day wasn't even that bad. It was much worse the second day and I only threw up a couple of times. I'm pretty sure I puked 14 times the first day, and the only reason I'm able to make an estimate at all is because it seemed like I was on an hourly upchuck schedule -- and the puke-fest went from approximately 8 a.m. 'til 10 p.m.

So, I'm pretty much at "never again" with the hydrocodone.

Although, I have to admit -- I still didn't go so far as to throw the bottle in the trash. I compromised and tossed it into the back of a bathroom drawer. What can I say? Fear of pain is a powerful thing.

The procedure, part II

I think I started this more than a month ago so I really ought to finish it...

When we last saw our plucky heroine, she was awaiting surgery for a neurostimulator implant at Humble Surgical Hospital in Texas, with great trepidation.

It was strange coming out of the anesthetic.

Before I reached consciousness I remember saying over and over in my mind -- at least I think it was only in my mind -- "I believe. I believe. I believe..." Just what I believed then was a mystery to me when I finally came to completely. God? Modern medicine? Ghosts? Who knows?

My throat hurt and I desperately wanted water, but all I could do was croak "hurt," to which a nurse said she would give me more pain meds -- I said "No, no!" because the last thing I wanted at the moment was more drugs -- I was totally fucked up on dilaudid. They told me about a button I could press for more drugs. I wondered what was to stop patients from overdosing.

It seemed like it was hours before they finally gave me water.

Throughout the night they continued to wake me up at intervals, and each time I remember thinking, "Oh God, I did it. I actually did it." And not in a good way, either.

The next day was beyond awful, but I guess it doesn't materially explain anything about what it's like having this device implanted in my body, so I'll skip it. Suffice it to say I had a bad reaction to the dilaudid and the surgery was probably about twice as difficult to recover from as I'd expected -- the doc told me they could do it as an outpatient procedure, they just recommended the overnight stay "for the patient's comfort." I actually think I'd have been better off at home without the intravenous pain meds, but then, that's that perfect hindsight vision.

In any case, a technician came and programed the device for the first time before I was discharged. I was given a handheld device that controlled the programs, of which I was given four at first. The programs controlled the intensity and the frequency (I guess that's what it is, anyway) of the stimulation, and I could control each of the four leads separately, if I wished to.

Once I got up and around, I found the wires in my head much more painful than I had realized they would be. It felt something like wearing a tight, rather heavy wire mesh cap on my head.

The pain from the incision in my butt wasn't that bad -- in fact, I barely took the pain killers they prescribed for after the surgery. I took half of one maybe 3-4 times. Mostly the dilaudid had made me so sick I wasn't really in the mood for more medication.

It seemed to be helping at first. I don't recall having any major migraines the first couple of months -- but I think it was a fluke. I think I was just in one of my good phases, which I do have from time to time, happily. But I liked to think that the device was actually stopping them before they even started. So I was prepared to make peace with the infinite weirdness it was sharing my body with a foreign device.

The stimulation itself feels a little odd as well. In some ways reminiscent of the pins and needle tingling of a limb that's fallen asleep. At low levels it's somewhat pleasant, but when turned way up (which I do when a headache starts) it can get a bit uncomfortable.

This might be the moment to say I was raised in the Christian Science faith, and although my family wasn't fanatical about it -- we went to doctors and took medicine for colds and such -- there was a certain underlying mindset that health was a more or less spiritual condition, mind over matter, that sort of thing. Sorry I'm not explaining it better, but I'm not sure how much a theological discussion will add to this already lengthy blog post...

Anyway, I just wanted to explain how extreme and intrusive this all seemed to me. I have crazy scars on my scalp (which are covered by my hair, but they still feel really weird) and you can actually feel the wires under my skin and even see them faintly in my forehead. I wear bangs to cover it up. There are also ugly scars in the middle of my back and of course on my butt, which doesn't thrill me.

However, as time went on and the wires and device healed into place, it became slightly less uncomfortable. Full recovery from the surgery took at least a couple of months and going back to work the week after it was a mistake. Taking two weeks off probably wouldn't have been excessive. I didn't really feel the doctor adequately prepared me for what to expect, but I don't know if my experience was typical. Knowing me, it probably wasn't.

I hadn't had the thing very long when all of a sudden the two front leads stopped working. The programs with those leads wouldn't load, for some reason. A couple of programs controlling only the back two leads worked, but pretty soon (by September --I had the procedure in June) I started having migraines again. I went in once and the tech was able to get all four leads up and running, but it wasn't long before the front two conked out again.

When I went back, she couldn't get them going again, and she told me I'd have to have a revision -- basically go back in for surgery, which I dreaded.

Fortunately, the revision was an out patient surgery and they didn't have to mess with the wires in my head -- only the incisions in my back and butt were reopened.

So we did that, got them working again, did more programing -- and by the next month I was back to the same old routine. After the first surgery the tech had told me it might take a few months to tinker with the programming to get it working for me, so I tried not to get too discouraged.

But I've gone back for programming a couple of times since then, and it pretty much seems like I'm taking about the same amount of medicine and spending about the same amount of time in agony as I ever did.

I'm going to go back again for more programming (I've been putting it off because a.)I don't have much hope it's really going to help and b.) I haven't felt like driving over to The Woodlands, which is where Dr. Chapman's office is. But if I still don't see some substantial results, I'm going to look into having it taken out -- which I am also putting off because hello, surgery, not fun!

There are a few more details and odds and ends, but I'll leave that for another post.

Adios, fellow migraineurs -- may you stay one step ahead of your migraine demons, or something like that.