Monday, January 20, 2014

Treatments and Needles

Doctors. They don't know everything.

I just came across this little article, and it was quite interesting, but not at all surprising to me: Headache Docs List Top 5 Tests and Treatments to Avoid. The list goes:

1- Don't perform neuroimaging studies in patients with stable headaches that meet criteria for migraine;

2- Don't perform computed tomography imaging for headache when magnetic resonance imaging is available, except in emergency settings;

3- Don't recommend surgical deactivation of migraine trigger points outside of a clinical trial;

4- Don't prescribe opioids like oxycodone and drugs containing butalbita like Fioricet – for patients who get headaches often;

5- Don't recommend prolonged or frequent use of over-the-counter pain medications for headache.

Those last two are what made me think I was going crazy for the first two years of this adventure. The first place I went for treatment, Kaiser, pushed Motrin on me like they were candy, told me it was a stress headache and I needed to relax. The Motrin didn't do a thing, unsurprisingly to anyone who has ever had a migraine, but when I went back and asked for another solution, they'd just refilled the prescription and sent me on my way. Then, my insurance changed and I saw a doctor who prescribed all the drugs, including every painkiller ever, but while I was drugged into a semi-compliant stupor, I saw no positive effects in my head. When I remembered I even had a head, that is.

Western medicine has failed me thus far, I've seen some truly terrible doctors and have been recommended some truly terrible treatments.

HOWEVER, I recently had an appointment with a new PCP, and she's fantastic. She seems kind and sensitive and supportive and inquisitive. She's made some suggestions that I'm trying to follow through on, and she even got me to get a flu shot.

Which I'm going to talk about now, so needle-phobes, you might want to skip the next five paragraphs.

I've been slowly developing a needle problem; every time I've gotten a shot or had blood drawn in the past several years, it's ended up being a bit of an ordeal, and I think it's getting worse.

The first instance was years and years ago, pre-migraines even. I went in for dental work and they came at me with the needle and I jumped out of the chair and yelled profanities that my mind has graciously allowed me to forget. They did their drilling sans novocaine that day, and I was fine, but for the future, I noted that I really need to not look at the needle that will be going into my mouth.

I've told that story several times over the years and I always laugh, it was so long ago that the visceral terror I felt when I saw the needle coming at my face has faded to a strong unease in my memory. I've had blood drawn over the years and a few shots; I was never comfortable but I'd take deep breaths and be largely ok. The last time I got bloodwork done was kind of traumatic, but I wouldn't expect to have such a bad experience again any time soon.

So, when I agreed to get the flu shot, I thought it would be no big deal. The nurse approached me, I was fine. I pulled down the neck of my shirt so she could get at my shoulder, I was fine. She started fiddling with her equipment, swiped me with the alcohol and I suddenly got so nervous, I was quite unprepared for it, and I asked my boyfriend to hold my hand. He came to my side and the nurse asked him to hold my shirt down over my shoulder, since my own hand would be occupied. So, he's on my right, holding my right hand, and then he puts his arm around me expose my left shoulder and I FUH-REAK. I start thrashing and wriggling away from the nurse, and I tell my boyfriend not to hold me down. He sounds surprised when he says that he wasn't, and I know in my brain that he wasn't, but my body went into total fight-or-flight mode, and his arms around me plus needle approaching were a terrifying combination in the moment.

I took a moment to recompose myself and my boyfriend intentionally held me very loosely to help me relax. The nurse was a pro and as soon as she had consent, the shot was done and she was cheerfully out of there. The tears never quite flowed, but my eyes were wet and I could hear the quaver in my voice, I was relieved that the scary thing was over, and super unnerved that a simple vaccination should be such a scary thing. I really don't need a needle phobia.

I'll be getting more bloodwork done soon, hopefully, and I'm really interested to see how it comes out. Last time, I had high cholesterol, low Vitamin D, and a high ESR. I'm willing to bet that my cholesterol is better now, since I was eating eggs and dairy daily back then and wasn't exercising much at all, and I'm really hoping it's some amazingly perfect number that I can brag to everyone about, because that's always fun.

I'm also interested in seeing the cholesterol results because I discovered another effect of changing my diet, and it was unexpected. Since at least my early twenties, I've had a sort of yellowish stripe in my eyes. It wasn't really obvious, but I first noticed it when I used to wear eye-makeup, and I never knew what it was attributed to. I originally thought it was from smoking, but it didn't go away when I quit smoking. I mentioned it to a doctor once, but he pretty much shrugged and said it was nothing to worry about. Okay, then. I realized the yellow stripe was inexplicably gone about a month after I changed my diet, so I googled it again -- previous googling of yellow-eyed symptoms returned lots of jaundice hits, which is not what it was, surely I would have noticed the liver failure by now -- and when I combined low-oil into the terms, suddenly I had my answer: dirty sclera. The internet tells me that it can be caused by (among other things) high cholesterol, and because my sclera cleared up so suddenly after changing my diet, it felt like the first real evidence that going vegan and low-oil was the right choice for me. You know, besides the higher stamina, more regular poops, and near-immediate weight-loss. It's been a win-win-win-win!

A few days ago, my boyfriend and I were talking about my experiences with medical professionals and he noted that I haven't really made any progress on that front in years. I agreed, but then pointed out that while I've been a rather non-compliant patient, I've made HUGE strides in my physical fitness, in learning how to better medicate with marijuana and extracts, and I've made so many positive changes for my health that no doctor had ever suggested to me, I could hardly be considered stagnating. I would like to try again with western medicine, but the past few years have proved to me that my intuition is to be trusted just as much, if not more, than any doctors' I see.


Anonymous said...

i'd love to know what recommendations your PCP made and also the changes you have made to improve your health. i always appreciate learning what people do to help improve their health and living with chronic illness/migraine. i am sorry you experience with doctors has been so horrid. i have had migraines for half my life; for 30 plus years and have seen too many crappy unhelpful doctors. but, the few good ones i had were amazing/superstars and i remember helpful suggestions from each-those golden tidbits of things to do that help. your bog posts are so helpful and your writing is so good. (@infiniteknot) are you on twitter?

steph said...

You're so sweet, thank you so much for your kind words. <3

I am on twitter and I requested to follow you! I'm @stucktomyshoe