Where is the dopamine?

It looks like I’m sliding into crying all the time again. Friday at work I started crying because of a work conference I had decided not to go to because I was scared I would get a migraine. I went down to the Parkade, thinking I would cry in the backseat of my car, but I forgot my car keys. By this time I was already crying hard, so I didn’t want to go back upstairs to get them. I called the employee assistance program, thinking that maybe there was an off chance that they would have an opening for a counselling appointment. They didn’t, but the gal who answered the phone thought that I sounded so upset that she patched me through to a social worker who was on crisis duty. He was very nice, and said that he could barely understand me between the echo of the Parkade and how hard I was crying. He recommended that I just give up and go home, and give work another try on Monday.

So Saturday I was OK. I did some laundry, and some dishes, and cleaned the bathroom, and I totally thought to myself that if I didn’t have a migraine on Sunday, I could wash my make up brushes and do a bunch of things that were sort of on my to do list but not really urgent. Of course I had a migraine on Sunday, so that was the end of that.

The migraine extended into yesterday, so I ended up not getting into work until 11 and then leaving at 4:30. That’s totally more like half a day then a day, but if I stay there I would’ve just been physically there but  unproductive. 

So that brings us to today, where I went to the hospital for ketamine. I started crying after the infusion had begun, and I can’t even really point to a specific reason. I just felt desolate, and kept thinking of poems like 

Come to me in my dreams, and then by day I shall be well again. 

For so the night will more than pay the hopeless longing of the day.

And then I got upset about thinking how the day was filled with hopeless longing. I guess about halfway through the infusion I started to feel better, in the sense that you read about ketamine being used for really acute depression, and then manage to have a bit of a nap afterwards. Then I headed to my psychiatrist, where I started crying basically right away and explained to him that it was one thing to not be able to go to a work conference, but that I didn’t even get to wash my make up brushes, boo-hoo hoo. 

So he increased my meds and gave me a prescription. I took the bus to the pharmacy to find out that they had to order one of the drugs in, so then I took an Uber home and had a shower, because by that time I was just feeling red-faced and wrung out. Then I headed into work, not getting there until 2:30 and leaving at 7 because a colossal thunderstorm started and I was worried that I was going to be having trouble driving if I waited much longer. 

So now here we are, I’m heading into the middle of the week and I don’t feel like I have any of my shit together at all. My skin is horrible, with huge fucking zits because I’ve been eating chocolate and cornflakes with sugar and not much else. I had bought some pierogies, and I think the sour cream I bought to go with them is expired. Because apparently boiling water to put perogies in is too much cooking for me to manage. So that’s pretty pathetic. I think that I should buy some bag salads or something, but I don’t feel like fucking bag salads. I feel like cinnamon toast with warm milk, and candy bars, and waffles with syrup, and always comforting high carb things.

Anyway, I’m not really feeling too hopeful at the moment. My brain has all kinds of drugs being thrown on it, and it just devoured them all and then shit kicks my neurotransmitters anyway. I’m still averaging 2/3 of my time with migraines, which is depressing in and of itself. At least I have a counselling appointment for this Friday, only two days away.

Fuck to the yes!!

I haven’t gotten a chance to post about my doctors appointment on Monday. It went fucking fantastic. When I was at my neurologist for Botox, I asked him about trying a different opioid. Not necessarily more, but something different. I’ve been on Percocet for 20 years, and I really don’t think it’s doing much in the painkilling department anymore. He said he didn’t really have any objection, but he’s never prescribed anything other than Percocet so he wasn’t really comfortable. He suggested I go to my family doc, and if my family doctor turned me down, to come back and he would do some research. Which is totally fair.

So I call my family doctor, to find out that he’s out of town on vacation and he has a locum covering for him. So I explain the situation to the receptionist, who’s known me for 15 years, and she suggested I go ahead and come in. So Monday afternoon, I went in. It took like 40 minutes before the actual appointment because they just moved to a new clinic space, and so they were taking everybody’s height and weight which was less than I thought, so that’s good, and entering everybody’s drugs into the computer. I didn’t know the dosage of most of the drugs I was on, and I offered to call the pharmacy and find out, but the nurse or nurses aide or whoever said it was fine and they would just reconcile it later.

Anyway, the locum was a young woman and I just explained exactly what I was hoping for. She offered me a stronger dose of OxyContin without the acetaminophen, and I said that I’d taken more Percocet than you are technically supposed to in the past, and I was interested in trying something new. Toradol does nothing for me, and Advil works really well, and they’re both NSAIDS. So it seems reasonable to me that a different drug in the same class might work better for me.

She said that I clearly had a long and refractory history and much as they like to not give opioids out, it seemed appropriate in my case. Then she offered me a referral to a pain clinic I’ve never heard of, where she did her residency, where I guess they do lidocaine and trigger point injections. So I left with a prescription for a summer’s worth of Dilaudid, and a pending referral.

I had a horrible migraine the next day, tied to the weather, so had a chance to try it and it’s amazing. The only problem is that it knocks me right out. Which is OK, I don’t really want to be conscious during a migraine, but it doesn’t mean that I won’t be able to work if I take it.

So I won’t have to buy sketchy drugs off the darknet after all, ha ha.

Two days in the life.

8 am – Leave to catch the bus.
9 am – Arrive at the hospital to get ketamine at nine.
12:15 pm – Allowed to leave (They want you to stay two hours after your treatment ends)
12:30 pm – Catch bus home
1:15-1:45 – Feed cat, and myself
1:45-2:15 – Nap for half an hour (feeling exhausted)
2:20 – Leave for neurologist appointment @2:45
3:10 – Leave neurologist with a face full of Botox
3:15 – drop triplicate prescription off at drugstore
3:20 – drive to work
3:45 – arrive at work
4:00-5:45 – Super important work meeting. Boss asks if I can get the work done by the end of the next day. I say of course.
5:45-5:55 – I had a migraine onset during the meeting, so I need to get on top of it now. Ransack my desk and purse and realize I don’t have any triptans (migraine specific drugs) with me. Shit! Take a Tylenol 3, a stiff shot of CBD extract and start drinking a Pepsi.
6:00 pm – Start working on stuff for Super Important Project Deadline from the meeting. Since I didn’t get to work until almost 4 o’clock, I’m going to have to stay here all night. Besides, the idea that I could wake up with a migraine tomorrow and not be able to make it into work is stressful, so I want to try and finish this tonight.
6:30 – Symptoms getting worse. Give myself a needle full of Gravol.
6:45 – So drowsy! I start drinking a Pepsi.
11:55 pm – I’m done my work, hallelujah!
12:15 am – Stop at pharmacy to pick up prescriptions.
12:30 am – Arrive home. Check email, get into bed and try to unwind.
1:30 am – Fall asleep

Wednesday:
10:00 am – finally manage to wake up after multiple alarms. Soooo tired.
10:45 am – I gotta have a shower.
11:25 am – Leave for 12:00 pm massage appointment.
12:00 pm – The Botox made a noticeable difference. My face and head are much more relaxed, but my neck shoulders and upper back are a crunchy mess. The massage is more painful than relaxing, but I know it will feel better later on.
1:30 pm – Arrive at work and stop for a flat white (2 shots espresso) on the way.
1:35 pm – Arrive at my desk. Take 2 Dexedrine and hope it will help me be alert.
2:35 pm – Call to reschedule my 4:00 pm doctor’s appointment. The idea of driving to it and it eating up work time is stressing me out.
6:00 pm – I should be working until 8:30 at least but I’m just tired and fried.
7:30 pm – Give up and go home. It’s just been “presenteeism” for the last couple of hours anyway.
8:00-9:00 pm – Pay bills, look up upcoming pay dates, update budget
9:00-9:51 pm – Organize and refill meds, so I have some in my purse, some for at work and some for at home.
9:51-10:15 pm – Eat something.

So… where is the time for fun? Or housecleaning? Or cooking and packing lunches? Or socializing? I thought maybe if I kept a diary I’d see where the time was going, but it sems like it is work, migraine, or doctor’s appointments 24/7. I think having chronic migraines in the summer is depressing in and of itself.

Some progress.

I saw my neurologist today and got my Botox injections (finally). I asked him what he thought about the steroids and he thought 50 mg was enough to use one time to knock a migraine out, that they didn’t have to be “stepped down” at 60/40/20 over a few days like I’d read. So he prescribed me some more prednisone. That’s fine.

Then I asked about a different opioid. He said Percocet was the strongest he prescribed and I said “not stronger necessarily, different” and he said that he actually never prescribed anything other than Percocet so he had no problem with my having Dilaudid (I mentioned they came in 1 mg which would be less than a single Percocet) but could I ask my family doctor for it, and if he (GP) said no he would do a little research.

So I called my GP’s clinic and found that my GP is actually away and there’s a “really good” doc covering for him. I told the receptionist, who has known me for 15 years now, that I needed a prescription that my neurologist had no problem with me having but wasn’t used to prescribing himself, and she didn’t think it would be a problem. So I’m going there tomorrow for that.

In the meanwhile once I got back to work I started having a truly massive headache and realized that I didn’t have ANY triptans with me or in my desk – not a Frova or a Zomig to be found anywhere – so took some CBD extract, an Advil, a Tylenol-3 and a needle full of Gravol. I could technically work from home but I’m afraid I’ll only sleep because my head hurts so much. Wish me luck.

Migraine & suicide risk.

Migraine.com article about suicide risk

After following the groups for two years, researchers discovered that participants with Migraine and severe, non-Migraine headaches had a 4 times greater risk of attempting suicide than the subjects without Migraine or headache. The level of pain played a role in attempted suicide as well – study subjects with a higher level of Migraine and non-Migraine pain were at greater risk for attempted suicide. In fact, each time the pain intensity scale went up by one point, the risk of attempted suicide went up by 17%.

My parents are visiting, and I hate it.

I hate it when they come. I hate feeling like a horrible person for not being able to just suck it up when they annoy the living crap out of me.

There is a sweet little hotel literally at the end of my block but they don’t like it because it’s not a chain (?!?), so they are staying like waaay on the outskirts of town. I saw a sign for “infill” and explained that is totally what I want to do when I buy a house, and then they went on and on about how they live in the suburbs in the middle of Big Box Land and they LOVE it, which is like the 7th circle of hell for me – we just have totally opposite values which I get and they just sort of don’t.

I tried to suggest to my dad that I not meet them for breakfast tomorrow morning because we were not getting along anyway, and they want to get an early start which means I have to leave to drive there an hour before I ever leave for work on a weekday, and but my dad was like “Oh no, so we’ll see you at 8:30, that’ll be good” because they want to pretend we actually get along I guess?

Ugh. I need to go to bed, I’m probably not even making sense anymore, but I could just cry because I have to go into work tomorrow, and for the next 6 days straight, and they stress me out. I don’t enjoy it. I don’t like it, I don’t think I like them, we have nothing in common, and then I feel even guiltier because I couldn’t just let it roll off my back and they play it like I just randomly “fly off the handle” and they are magnanimous enough to forgive me. Ugh. Awful.

Also, my fucking cutting scars.

Now that it’s short sleeve season I’m really feeling self-conscious about these fuckers. I don’t know if I can pass it off like I was trying to cut my cats claws and I got a swipe from his paw?

I’ve also spent considerable time and energy over the last couple of weeks investigating ways to cover this up. Cosmetically, I mean. Trying the entire gamut of concealers. Nothing is working. My arm is so pale that the vast majority of products make it look like I have a pink or peach or orange-ish patch on my arm, and then the few that I find a little more neutral just don’t stay on there. I guess I should buy a makeup setting spray.

Part of it is that it’s not just the color, it’s the texture, because I was just using shit on the ward and not like an actual blade, so it’s like I dug a little trenches into my arm that are sunken. I feel like I am going to need to get a tattoo to cover this up, because it makes me upset every time I look at them. Although I’m hard-pressed to think of a tattoo design that I’d want on the inside of my arm where the cuts are. I mean, I barely even scratched them. Honestly, like only enough for one drop of blood to fall off. Nowhere near even needing stitches. If I had known that like four months down the line I still have fucking scars, I might as well of gone to town. IMG_4760

So tired. Weary.

I missed work Monday because of a migraine then agreed to do a little side project yesterday (I’d like to have some spare dollars so I can get massage therapy and wait to be reimbursed in the insurance company’s sweet time) so that’s two days of work to make up over the weekend. It’s just this horrible cycle of always playing catch-up, and then I’m not balanced and not relaxed, which just makes it harder.

It takes so much time to go to the doctor/ RMT/ therapist/ neurologist/ psychiatrist/ hospital/ pharmacy and work and have migraines. I just don’t see myself as able to keep up a full-time job for much longer because I’m weary on a soul level.

Wednesday I went to work, booked a doctor appointment with my GP for 5:15 to try and get a referral to a dermatologist because my acne is worse than it was when I was a teen. I had to wait around for a half an hour which I spent washing my make up off so he could see the severity of the situation. When he came into the room, he said he was so sorry to hear that I was having such trouble with my depression. It totally dis-combobulated me. I was all ready to play the part of his patient who hadn’t seen him in months, and was coming in for a referral for my hormonal skin, no big deal. I don’t know if he looks up people’s electronic medical records before he sees them or if the receptionist does that as part of the chart or what. And I get that it makes sense, but it just totally changed the tone of things.

So he basically diagnosed me with bad skin due to stress. I’m breaking out on my face, and on my cheeks and joy line instead of my t-zone where I used to. Then I have huge patches of itchy dry eczema of the come and go on my hands and chest. So he prescribed me some kind of antibacterial cream from my face and a stronger steroid for the eczema, and I didn’t really have the presence of mind to push for referrals so I asked him to write me a prescription for migraine drugs, while he was at it, and said I would be back if it didn’t work. Then I went to the drugstore. And waited half an hour for it to be filled. Then the pharmacist said my total was 120 something dollars, and I just about had a heart attack because I just given them my new health benefits information with the card that I just got that day, which was supposed to give me 100% coverage. So the pharmacist figured that the plan wanted me to get generics, and they didn’t have two of the medications so I’m gonna have to go back to get them tomorrow, and so it was like 8 o’clock by the time I got home so I microwaved a bowl of peas and checked my email and went to bed.

Yesterday was the side job, so I had to get up super early so that I could catch the bus to go downtown to be on time, and I did, and I worked all day, and then I tried to finish all the paperwork at the end of the day but I was too burnt out. So I stopped working at 6:30, and went and caught a bus, but the transfer I needed was only running once an hour so I ended up walking most of the way home and didn’t get home until eight, just like the night before.

Today my skin just looks fucking awful, because I put Differin and the antibiotic cream on it which was obviously not a good idea, so I still have the bad complexion I had before, as well as a couple of dry red patches of skin that makeup just wouldn’t stick to. It was just sliding off and pilling and making my face looks super patchy. It’s like the worst make up day I’ve ever had. So then I started getting anxious that I couldn’t get my face into any kind of shape to go to work, which just made me get shaky and sweaty. So I went to work, stopped at the parking office to be told that it was too late to make any changes for this month, and didn’t actually arrive to the office until 10:30.

I had an appointment to see the hospital chaplain at 1, so I only got a couple of hours of work in before I had to leave. I wept at him for an hour and a half. I didn’t think I was that sad, but I started crying practically as soon as I saw it down. I guess it just takes so much energy to hold everything in and put on a good show at work that I’m not really in touch with stuff during the day.

So it was 3 o’clock by the time I got back to work, and I still had five hours to put in. It was just so shitty. I was totally unproductive and I felt just bleary and puffy and teary-eyed and tired. I managed to get a second wind a little bit toward the end, but I didn’t really put in a full days work. So I got home it shortly after 8, opened a can of tuna, and that brings us to now. I’ve been out of the house for basically 12 hours a day for one reason or another, and by the time I drag myself home i’m tired. There’s nothing in the fridge, except ketchup, so I have to go to the bank, then grocery shopping and back to the pharmacy, and I need gas, and I’m going to have to do some laundry before next week, and meanwhile I have to work two days out of this weekend, and probably have a migraine as well. It’s just so fucking exhausting, doing it all myself, and the cried out, wrung out, puffy eyed feeling doesn’t go away with a cup of coffee or even a Dexedrine.

I know in my head that most people that have this level of migraine consistently aren’t holding down a job at all, let alone working full-time, and I know how much time it takes for me to try and manage having a physical and mental illness, but still have this vague feeling that I ought to be able to pull things together somehow, there’s no point just stumbling through the days like this.