Medical Un-Professionals

I’m in awe of how fast 2014 slipped away.  I feel like that Days of Our Lives opening sequence with the hourglass and the narrator saying, “Like sands through the hourglass, so are the days of our lives.”  That was the show to watch back in my high school and college days.  I had to record it on VHS and watch it later, which makes me feel old because that has now been replaced by DVR.  I no longer watch Days.  I had to quit that show when Marlena was possessed because the storyline was too ridiculous.  (I guess I didn’t think it was too ridiculous for Kayla to be buried alive by Vivian with a supply of oxygen in her casket and some sort of communication system so she could taunt Kayla, but Marlena being possessed was.  Please don’t question my teenage logic.)

2014 was an event-filled year.  We spent time at a family reunion at TeBri Vineyards in Monroe, Oregon.  Time spent with family is always a treat, but made even more special because several relatives from Norway made the trek over.  I spent many hours during the spring and summer working with shelter dogs, which was good medicine for my soul.  Working with a homeless dog to earn their trust can be challenging at times, but spending time with them to make them more adoptable makes my heart happy.  Breaking a dog of a bad habit such as car chasing, or patiently working with a scared dog to get them to come out of their shell, is quite rewarding.

 
The biggest bit of excitement came late last summer when my husband and I moved from our small town filled with family and friends to a bustling city.  The hubs was offered a career opportunity that he couldn’t pass up and I was fortunate to be granted a transfer with the government agency for which I was already working.  The biggest change for me work-wise was instead of working glorious part-time hours, I am back to a full-time schedule.

We bid adieu to our cute little home on an acreage nestled next to a river that we could enjoy from the privacy of our back deck and moved into an apartment.  We said goodbye to all the deer, turkeys, coyotes, and other critters along the creek and said hello to traffic lights, thin apartment walls, and noisy neighbors.  We moved from our panoramic view of Mount Adams and Mount Hood, to the view of a sandy hill that is technically a mountain, but looks more like an overgrown anthill.

Mountain views back home.

"Mountain view" at our new place.

 
It is a treat to have civilization (AKA restaurants, movie theaters, grocery, concerts, hockey and department stores) nearby, but I often find myself homesick for that quiet little house on the river.  Now, instead of having a doggie door that my pooches could use to come and go as they please, we have to take potty break walks up and down a flight of stairs several times a day.  That is fine, except for the days that my 13 year old lab is sore from playing too much Frisbee at the dog park earlier in the day and she cannot navigate the stairs to our second story abode.  Her 60 pound frame isn’t too heavy to hoist up on my bed at night, but it is a different story lugging her up a flight of stairs.

Pee o'Clock is between the hours of 1:30 - 4:30 a.m.

Settling in to city life has been an adjustment, as I knew it would be.  The chaos of moving, saying goodbyes to all of my extended family, co-workers (most of whom feel more like family member than co-worker), and friends (including my beloved shelter pups), leaving my support system and my comfort zone, packing, unpacking, changing our address, meeting new co-workers, learning some new job duties, doubling my work hours, and adding a short commute, culminated into stress, and triggered many a migraine headache.  Sometimes life feels like a constant struggle to live a normal existence.  During the bad days, my frustration reigns supreme and I feel like a salmon swimming against the current.  I wish I didn’t have to battle just get through the mundane tasks of life on such a regular basis.  I try to celebrate my good health days, but there is a cloud of apprehension following me.  Even on my good days, a migraine will usually start creeping into my head at some point.  I am terrified of the days the migraine gets out of hand and I end up having to call in sick or leave work early.  Thankfully, I am still receiving Botox migraine treatment.  Even though I’m experiencing regular migraines, I suspect they would rate higher on the pain scale if I didn’t have Botox on board.

Medical Unprofessional

December was lousy.  I had 30 out of 31 days with migraine pain.  I was able to get Christmas dinner on the table, but by the time dinner was ready, I was too sick to sit down and enjoy the meal with the family.  Bah humbug!  When the pain is out of control and I am in a lousy mood, I try to remind myself what I am thankful for.  I am particularly grateful for the support of my family and friends who help me deal with chronic migraine.  My parents are always more than willing to help in any way they can.  My husband will pick up the slack on housework when I’m down for the count.  He will also bring me medications, water, or whatever I need at the drop of a hat when I’m under the weather.  Then there are my crazy dogs who keep me feeling a little less isolated.  When it seems life is passing me by while I’m stuck in bed in the middle of the day with a sleep mask on to hide my light sensitive eyes from the evil rays of sunlight, I am comforted by their company.  The rhythmic sound of their deep breathing next to me, and the weight of one of their heads, heavy with sleep, on my feet makes me feel a little less isolated.  These are some of what I call my “medical un-professionals” who are just as important, but in a different way, than my medical professionals.

I don’t have much more to share right now, except to tell you that I have started a new migraine treatment recently approved by the FDA.  I plan to post all about it soon, after I’ve had a chance to see what kind of results I get.  Fingers crossed that I’ll have some good news to share.

You'll Never Know If You Don't Try

I have tried a boatload (by boatload I'm talking about a barge sized vessel, not a tug boat sized vessel) of both over-the-counter and prescription medications to treat my migraines  I've also tried treating the migraines without medication.  Over the years I have read about and heard many different suggestions that might alleviate my migraine headaches.  Today I'm going to focus on some of the more natural remedies I've tried.

Aromatherapy is something that people commonly recommend, particularly lavender and peppermint essential oils.  I jumped right on that...I love peppermint.  My Mom and I invested heavily in peppermint products.  Peppermint candles, peppermint candies, peppermint hot chocolate, peppermint mochas, and peppermint essential oil. I even discovered that Paul Mitchell makes a Tea Tree Lavender and Mint moisturizing shampoo and conditioner that smell heavenly.  While the aromatherapy was soothing, it did not do much to reduce my migraines.  I think the best luck I had with an aromatherapy product is Origins Peace of Mind, which is a minty lotion that I gently massage into my temples and the base of my neck when I'm not feeling well and it will help some.  When all else fails sometimes I may mix up some hot cocoa with a shot (or two) of peppermint schnapps, a peppermint swizzle stick, and some mini-marshmallows.  It might not do a damn thing for my migraine, but a nightcap will usually relax me a bit and maybe, just maybe, the peppermint in the schnapps will provide some migraine relief.  I used to keep York peppermint patties around occasionally nibble on them during a migraine, until one unfortunate day when I got a whopper migraine with nausea and I puked up a peppermint patty.  Now I can't see a York peppermint patty without that memory haunting me and my tummy turning queasy. 

Then there are pillows.  I have spent a small fortune on pillows over the years.  I thought a proper pillow that provides good neck support might help out my migraine situation since the majority of my migraines are accompanied with neck pain and muscle spasms.  I have spent over $100 a pop on many a pillow that provided negligible migraine relief.  My bed is cluttered with mass quantities of pillows now.  And let me just note that memory foam pillows are outlawed for pillow fight use at our house.  Somebody might suffer a concussion if smacked upside the head with one of those suckers.

Here's a fun suggestion for potential migraine relief that I have heard about.  Pinch your left nostril closed so you are only breathing out of the right side.  I tried it.  When no one was looking.  It didn't provide any migraine relief for me.  I had heard it years ago, but it apparently made a resurgence in the news recently because it was suggested to me twice in the past few months.

And there's caffeine, which I view as a double-edged sword.  It can alleviate migraine pain, but if you drink it too often it can trigger migraines.  I have to proceed with caution in this department.  If I'm at work and a migraine begins I can sometimes grab a soda or mocha and the jolt of caffeine will quash the migraine.  I find it best to order a small caffeinated beverage because if I drink too much caffeine the migraine will come back with ferocity when the caffeine wears off in my body.

It was once suggested to me that my migraines could be connected to my sinuses and maybe I should try using a neti pot.  I didn't know what a neti pot was so I Googled it.  Oh my God!  Gross.  I talked myself into trying it because what it if rid me of my migraine headaches?  I would never know until I tried.  I had a heck of a time mustering the courage to actually go through with using it and it took me several days after buying the neti pot to actually try it.  When I finally attempted the neti pot, it was an epic failure.  I thought I was going to drown and my husband laughed as I choked on the water instead of irrigating my sinuses.  I likened it to being waterboarded, to which my husband pointed out was a gross exaggeration, especially since I had never experienced waterboarding (thank goodness!).  I didn't care if he thought I was being a drama queen.  It was a traumatic experience and I decided the neti pot likely originated as a form of corporal punishment.  For a moment I imagined myself in Gitmo instead of standing in front of my bathroom sink.  It took a couple of months to gather the courage to attempt the neti pot again.  Lo and behold I got it figured out, but it didn't seem to do anything for me.  I tried it daily for several weeks to see if it would eventually give me any sort of relief.  I kept up with it until "the incident."

"The incident" started out innocently enough.  I had a cold and my nose was all stuffy.  I decided to use some nasal spray to open my sinuses before using the neti pot .  Several minutes after using the nasal spray, when I felt like I could breathe easily, I broke out the neti pot.  The neti pot flushed any remaining nasal spray far into my sinuses.  It was accompanied by a horrible burning sensation and I teared up and yelped in pain.  Just thinking about the "the incident" makes my eyes water.  That intense burning sensation wouldn't subside for the longest time.  (I liken it to having a deep paper cut.  Not the kind of paper cut you get from a normal piece of paper, more the kind you get from a file folder.  Then take that paper cut and place it into a glass of freshly squeezed grapefruit juice for about 30 minutes.  I think that is probably a fair comparison.)  The neti pot has been stashed in the deepest, darkest corner of the bathroom cabinet since "the incident" and will likely never been seen again.

Let me reiterate that these are just my opinions and experiences with different treatments that I've tried over the years.  These aren't all of the things I've tried, just some I thought I'd share.  I'll write more about some positive pain management treatments and techniques in a future blog post.

Dear Diary

When I was a wee lass, my big sister received a diary for Christmas.  She was five years older than I and she didn't particularly enjoy having a little sister constantly pestering her.  I was intrigued by this strange book of blank pages secured from prying eyes by lock and key.  I also got the word diary confused with the word diarrhea.  Whenever I asked her what she wrote in her diarrhea, she just got mad at me.  Her anger made me even more curious.  I believe I attempted to open it when she wasn't around, but was never successful.  I'll never know what secrets were secured in her diary.

I got a diary of my own when I was older.  I tried to use it, but never got into it because it seemed like a homework assignment.  That's how I feel about the migraine diary.  It's a homework assignment.  Not only is it homework, but it's on a subject (migraines) that I hate.  Am I the only one out there who despises that stupid migraine diary? I have been so bad about keeping it updated in the past.  I only do it when a doctor is adamant that I keep it updated.  I've been disciplined and have kept my migraine diary for seven straight months this year.  (Granted, I have only done it because I was properly motivated...my doctor needed it to include it in the paperwork for treatment pre-authorization to my insurance company.)

Several months ago I promised my doctor that I would be vigilant and keep detailed records.  I created a beautiful migraine diary form in Microsoft Excel.  I presented several months worth of diary forms to him recently and he perused them for a few minutes before saying, "You're borderline obsessive compulsive, am I right?"  If by "obsessive compulsive" he was referring to how I record my pain level as experienced at four intervals each day, along with a section to mark the migraine symptoms experienced, and another section to mark down any medication taken; then taking said information and printing out a one page report for each month that is centered both vertically and horizontally on the page, then I guess the answer is yes.  I could also take the data and make a beautiful graph of my pain levels if he'd like, but I didn't bring that to his attention because I didn't want to come off even more OCD than he already thought I was.  And for the record, I prefer to think of myself as detail-oriented, not obsessive compulsive.

My form is a work of art.  Besides, what was he expecting to see?  A diary like I had in junior high school where I dotted each i with a heart?  Maybe something like this:

Dear Diary,

Today I had a hellacious migraine.  One of my co-workers turned on the fluorescent lights at work.  Don't they understand how bad the lights hurt my eyes when I have an effing migraine?  I put on my sunglasses to shield my eyes from the evil light, and now I'm certain that my co-workers think I put my shades on because I was nursing a hangover from the night before.  Great.  To make matters worse, my migraine intensified by noon and I had to leave work early.

Crankily Yours,

Katie

Isn't it easier to mark down that my migraine was a pain level 5 in the morning and a pain level 7 at noon, then mark a box that my migraine was accompanied by light-sensitivity and another box that indicates an inability to work?

I know my doctor liked my form and I think it's funny that he thought I was obsessive compulsive.  Little does he know that I have worked a number of years in jobs where presentation of presented material has become my forte.

When the doctor asked if I was borderline obsessive compulsive I laughed and said, "Maybe."  My hubby happened to be at this appointment with me.  He laughed at the same time and said, matter-of-factly, "Yes."  I gave him serious stink eye over his response.

Mountaineering

When I was in about five years old, my kindergarten teacher asked me what I wanted to do when I grew up.  My response to her query was, "I'm gonna be a mountain climber."  I have no idea why I said I wanted to be a climber.  Maybe it sounded adventurous.  Or, maybe I was having some sort of ESP as a child and I saw the word "mountaineer" in my future, when really it was "migraineur."  :-)  What I do know is that climbing a mountain is the last thing I'd want to attempt as a migraine sufferer.  My teacher, who is a very nice lady, responded with something along the lines of, "No, you can't be a mountain climber.  You need to pick a different profession."  I remember standing there in a daze.  My hopes had been dashed.  I accepted that I couldn't be a mountain climber as a fact because my teacher said so, and started thinking about a different line of work.  Apparently I was an agreeable child.

As an adult I've often laughed about that memory.  I thought teachers weren't supposed to quash the dreams of innocent children.  As it turns out, my teacher was right.  Maybe I should send her a thank you note for setting me straight when I was young, because mountain climber would never have worked out for me.  That kind of physical activity paired with migraines would have made me a lousy climber.  I picture climbing to Mt. Everest base camp, then having to be carried back down by a Sherpa when I am rendered useless with a migraine. 

I had a killer migraine last week.  It stuck around for two very long days.  I had a ton of things to do around the house.   I could barely load the dishes in the dishwasher before having to lay down for 30 minutes before tackling the next simple chore on my list, which would be followed by more down time.  Progress on my task list was moving slower than molasses in January and my frustration was increasing exponentially with each passing hour.  As I lay on the couch my mind wandered back to my kindergarten memory of my teacher killing my dream of being a mountain climber.  Right now running the Swiffer across my kitchen floor sounds about as daunting as climbing Mt. Kilimanjaro.

The Guilt Trip

zip line fun

Who doesn't love a good vacation?  I know I do.  With each vacation I take there is a dark cloud looming...inevitably I will get a migraine at some point during the trip.  I've come to learn that air travel is a migraine trigger for me and that whenever I fly somewhere I am more likely than not to have a migraine when we land at our destination.  The same is true for when we return home.  I prepare as best as I can and carry medication close at hand.  Then there are other times I get one, for example when we went zip lining over Fremont Street in Las Vegas last fall.   At the end of the zip line there was a big spring that catches your zip line to stop you.  When my zip line hit the spring there was a little whiplash action and my neck instantly began to ache, and a migraine manifested shortly thereafter.  (Note to self:  Save the zip line for the last day of vacation rather than the first.  Lesson learned.)

A number of years ago, I'm thinking 2004, my ex-husband and I went on a vacation to Switzerland.  It was a once in a lifetime, dream vacation.  We started our trek in Portland, Oregon with a plane change at Chicago O'Hare.  By the time we had made it to Chicago, I was dealing with the onset of a migraine and feeling frazzled.  After the hours long flight to Zurich, Switzerland I had a full blown, monster migraine.  I just needed to lay down, but our journey wasn't over.  We had to retrieve our luggage, load into a double-decker tour bus, and and embark on an approximately two-hour journey to Interlaken, Switzerland. 

Interlaken

We sat on the top deck of the bus in the first row of seats with windows completely surrounding us.  We were treated to gorgeous views and sunshine as the bus meandered through the Swiss countryside.  I tried to enjoy the scenery, but I just wanted to crawl up into a tiny ball.  The bright sun was killing my eyes through my sunglasses.  The voices of excited travelers filled up the small space and the noise was deafening to my overly sensitive ears.  To top it off, we were traveling with a large group of my ex's co-workers and their spouses, many of whom I had been looking forward to catching up with.  I was trying my best to hold it together and be friendly, but my version of friendly during a migraine probably comes across as aloof.  I hate for people to see me when I'm having a migraine because I don't feel like myself.  It's embarrassing.

Interlaken

I remember letting out a sigh of relief when we got to Interlaken.  Interlaken is a quaint and clean town nestled in the in between two lakes with phenomenal views of Jungfrau (the third largest Alp in the Bernese Alps, the summit is 13,642 ft).  The architecture in Interlaken is old and beautiful.

Hooters in Interlaken

Oddly enough there was a Hooter's restaurant there that totally didn't fit in with the historic feel of the quaint town.  If you were to play one of those games where you search a picture to find the thing that doesn't belong, that Hooter's would probably be the thing in a picture of Interlaken.  (Of course we stopped in to get some wings while we were there.)

Migraine Hangover?

When we made it to the hotel not all of the rooms were ready for check-in.  Some people in our group were fortunate to get rooms, but ours was not ready.  I remember sitting down in the lobby of that beautiful hotel and tears started streaming down my face.  I wasn't sobbing, I was just so tired and in such pain that my eyes were tearing up and that's when my ex lost it and yelled at the hotel staff to get us a room straight away.  The poor staff, they hustled to get a room ready.  As soon as we entered the room I flopped onto the most comfortable bed I have ever slept in and had an injection of Imitrex.  Sweet relief, but I still had to sleep off the migraine hangover the rest of the day.



I'm still a tiny bit bitter that I had a migraine during that trip.  It was a fabulous adventure tainted by yet another migraine.  I remember feeling guilty because not only did it affect my trip, but it also affected my ex-husband's trip.  Instead of exploring Interlaken that first day we were holed up in our room waiting for me to feel better.  I also wish that my friends didn't have to see me so sick and watch my ex yell at the hotel staff.  Embarrassing.

The $500 U.A.

I'm fired up.  Not only does visiting a pain specialist cost an arm and a leg, they also feel it necessary to test my urine for drugs.  Do they assume the worst and figure that if someone is coming to see them that there is a chance they are not in pain, but making it up to seek narcotics?  I suppose that scenario does play out on occasion.

The pain clinic I now go to has a drug testing policy.  There is a mandatory urinalysis (UA) on your first visit, and they can randomly select you for UAs at future visits.  So I go along with their policy and submit a specimen to them on my first visit.  It's not a big deal to me at the time.  It turns into a big deal when I get a statement from my insurance showing that the urinalysis cost $500.00.  No, that was not a typo.  Apparently a pee test there costs $500.00!  Are you kidding me?  Holy cow.  I've had to take pre-employment drug tests in the past and I know those only cost approximately $50.00.

I called the clinic and inquired if they had made a typo, maybe keyed in an extra zero in their figure when they billed my insurance.  They informed me that they had not.  They said that they ran ten different tests on my sample and each test costs $50.00.  Wow. 

Here's my beef with the situation...I'm not seeking any heavy duty painkillers or narcotics of any sort.  I'm simply seeking therapeutic Botox treatment.  Even the doctor agreed that there isn't anything else left to try at this point.  I also made it clear to him that I'm not agreeable to any sort of narcotic pain medication because I just don't want to go down that road.

No wonder insurance is so expensive.  $500 pee tests are just one tiny example of exorbitant costs.

Botox: Take 2

I went in for my second Botox treatment the other day.  I felt like whomever has that voodoo doll of me was relentlessly stabbing pins all over its head.

I must say that the injections hurt less this time, but the after effects were worse.  I awoke at 2:00 a.m. the next morning and couldn't sleep much after that because of throbbing pain at the 20+ injection sites.  Ice packs helped some with the pain and less than 24 hours later I was feeling much better.

I have a ton of little red spots on my forehead from the injections and some of them are accompanied by tiny bruises.  It could certainly be worse.  Last time I had one big goose egg and bruise on the center of my forehead for several weeks.  Eventually the bruise turned a lovely yellow color so at least it was less noticeable than the deep blue/purple color it began with.  To me it felt like I had a unicorn horn sticking out of my head, but I doubt it was that noticeable to everyone else.

I felt I looked like this with my goose egg/bruise.

My doctor is pretty cool.  He and his nurse let my husband take pictures of the treatment to use on this blog.  (Thanks doc!)  The procedure doesn't take long at all.  Here's a couple of before shots:

Syringes of Botox and whatnot

Me being over dramatic about the injections.

Here are some pictures of the procedure:

We've got a bleeder!

My doctor was asking questions and making me laugh during the procedure.  Not cool.  I was trying to go to my happy place where I can be completely still, a technique I've learned from living with chronic pain, giving myself injections of medication, and getting several tattoos.  (Sorry about the tattoos Mom, I know you're not a fan and are probably rolling your eyes as you read this.)

I think the temple is the most painful injection.
The doctor was making me laugh in this pic, but I was trying to be still.

Am I the only one who is kind of freaked out about pregnancy ultrasound pictures some people post on social media?  I wish people would just make the announcement that they are expecting without the visual aid of an ultrasound photo.  Seriously, it feels like a flashback to biology class or that scene in Spaceballs where the alien pops out of the guy's stomach.

Scene from Spaceballs

Well, the doctor suggested taking pictures of the ultrasound when they put the Botox injections in my neck, so here it is.  I guess it shows the needle going into my neck muscles, but it just looks like a bunch of wavy lines to me.  At least there's no freaky alien looking thing in my ultrasound picture.  You're welcome.

They only used the ultrasound on the neck injections because they have to insert the needle deeper and need to make sure they get it in the right spot.  I've heard that if they get it in the wrong spot there is an outside chance that it can mess with muscles associated with respiration.  YIKES!  What would happen in that situation?  Would I have to live in an iron lung until the Botox wore off?  That's a few months!  I snap back to reality and decide to push the thought into a dark corner in the back of my mind.  The thought will probably creep up again and my subconscious will produce an associated nightmare in the next couple of months.

I'm in and out of the clinic in about 30 minutes.  I walk out looking like my forehead was attacked by a small swarm of angry bees.  The procedure is non-invasive and I could drive myself home, but not this day since I've got my chauffeur/husband with me.  (I drove the hour to the clinic so he will drive the hour home.)  The worst side effect I have after these treatments is muscle weakness in my neck that starts about two days after the procedure.  I experienced it last time and it lasted approximately two to three weeks.  It is painful muscle strain sort of feeling and I feel like a bobble-head.  I am most comfortable sitting in a high back chair where I can let my neck rest against the back of the chair and I don't have to hold it up.  When nobody is around I sometimes put on a cervical collar to allow my neck muscles to relax.  The muscle weakness also makes doing yoga a bit more challenging, but I can get through it with some slight modifications.

The Botox is helping.  I still get migraines, but my pain level is less intense.  I will go back for another treatment in three months.