I had several errands to run this weekend. Luckily, I was generally feeling okay with a dull headache during much of the day. However, by nightfall, the headache is usually at its worse. Last night was no different. I was watching TV and realized I needed to put together a post for today, but my head was aching so badly that I gave up trying to say anything of substance. I hope all of you had a good weekend.
Category Archives: Health
Lately, I have been breaking a cardinal southern rule. My mama raised me that when someone asked you, “How are you doing?” you should always answer with one of the following phrases: I’m good, I’m okay, I can’t complain, etc. The problem is, I’m not doing good. I am in near-constant pain with periods of more intense pain. The Botox treatments for my headaches were working, but for some reason, they haven’t been able to handle the current painful headaches I’ve been having. For a month or so, I have compromised with saying, “I’ve been better.” Yesterday, a coworker asked if I was feeling better; I simply responded, “No.” I’m tired of trying to put on a brave face and say that all is okay. It is not. I haven’t gone so far as to be brutally honest and say, “I feel like shit, and I am always in pain.” I’m getting close, though.
My mental and physical state is declining. I am tired. I am depressed. I am at my wit’s end. I need some answers. Maybe I will be able to get some after my MRI next Tuesday. I talked to the nurse at the Headache Clinic, and she had talked to my neurologist about which MRI I needed to have: the closed or open MRI. She recommended that I get the closed MRI because the images are better, and if there is something small, the closed MRI is more likely to catch it, whereas the open MRI might not. I made the earliest available appointment: Tuesday night at 7:30 pm. So, next Tuesday, I will drive down to New Hampshire and have the MRI. I’ve never been fond of driving long distances at night by myself, but I have done it before, and I can do it now. I didn’t want to have to wait even longer for the MRI.
Luckily, I got a notice from my insurance yesterday that they have approved the MRI, and they did not specify which one they would allow me to have. The letter just said that Cigna approved me for an MRI with and without contrast. Cigna’s Informed Choice Team has not tried to call me again to attempt to convince me to have the cheaper MRI, and I’d refuse if they did. Cigna’s Informed Choice Team told me the first time that it was my choice. Yesterday, I got an email from Cigna with the subject “Tell us about your Cigna service experience.” They should not have asked me that because I rated my experience very low, and I told them exactly why it was such a terrible experience. I know they will dismiss my criticism, but they need to know that they cost me a week in getting a test that could be essential in diagnosing the problem and possibly saving my life if the MRI shows something terrible. I pray that there is nothing deadly found, but I want to know what they might be able to find out.
When doctors in the past have ordered CT scans, x-rays, or other tests because they could not diagnose what was wrong with me, it has each time turned out to be something. Once, it was pneumonia. Another time it was epiploic appendagitis, an uncommon, benign, self-limiting inflammatory process of the epiploic appendices. Luckily, that time it was not appendicitis. The most recent time I had an x-ray, they found bursitis and arthritis. Luckily, none (other than the pneumonia diagnosis) was anything horrible, but it did provide peace of mind. Mysterious pain can cause all sorts of psychological issues when doctors have a hard time diagnosing the cause of the pain. For me, at least, I begin to wonder if my pain is even real, though I know that I feel the pain. The worry and depression can cause further health issues.
While I talk about my pain and health on this blog, I only talk about health issues with those closest to me in real life. Susan hears all about it and is always helpful in alleviating my worst fears. My mother hears about it when she will actually listen. But most of the people in my life, I rarely tell them about issues I am having. I don’t want to be seen as a complainer, and I don’t want their pity. I want people to understand, but I do not want pity. I talk about my health on this blog because someone could have the same health issues, and it helps to know that you are not alone. I want to help others if I can, and I would like to know that I am not alone.
If you work for a health insurance company, I am not directing this post at you, but at the healthcare industry in general, especially how health insurance companies treat us. I also blame my university’s human resources department for not providing better healthcare insurance for its employees. I have had costly health issues before, but my current headache treatments have been the worst so far in dealing with my insurance company.
It began when my neurologist prescribed me Emgality and Migranal for my headaches. These are expensive drugs, and my insurance company, Cigna, denied both. My doctor appealed the decision, and they approved it. They denied Emgality because I had not tried Aimovig or Botox first. When Emglaity proved not to be effective enough, my neurologist prescribed Aimovig, but Cigna rejected that too. Again, we went through the appeal process. Aimovig did nothing, so we moved on to Botox. Also denied, again appealed. The Botox has been the most successful, but whatever the cause of my current headache is, the Botox can’t handle it, just as the nerve block and steroids did not help.
I have been struggling to get an MRI scheduled to rule out a tumor or other brain disorder for the past week. My doctor scheduled my MRI at the hospital, but my insurance company called and said that it would cost me over $2600 out of pocket, and I should schedule it for a place called Open MRI because that would only cost about $700. They did not explain that open MRIs are inferior images, but that’s not the worst of it. Cigna canceled my MRI at the hospital, but they screwed up rescheduling the MRI at the other place. Cigna mishandled it so badly; I ended up calling my neurologist and asking for help straightening this out. My neurologist’s nurse explained that I might need a more sensitive MRI if the problem happens to be very small. It might not show up on an open MRI image. The nurse will talk to my neurologist first thing this morning and decide if I need the regular MRI or the open MRI.
The insurance company’s issue isn’t really about saving me money, but about saving them money. If I have the MRI at the hospital, it will cost Cigna around $2000, but if I have it at Open MRI, it will cost Cigna just $210. Yes, they may be slightly motivated by helping me, but they are pushing me to have an inferior diagnostic test because it will save money. We shouldn’t have to worry so much about the cost of healthcare. Stress has such a detrimental effect on our health, and to have to worry about the costs of healthcare and can we afford the treatment we need is very stressful. It is so shameful that we are one of the most industrialized and wealthy nations, and we cannot provide affordable healthcare for our citizens. I hate that so many Americans are afraid someone will get more of something than they will. Human greed is a major problem, and people don’t want to give up something, no matter how small, so someone else can live a slightly better life.
I don’t get why insurance companies have the power to choose what treatment we can and cannot have for conditions, especially chronic diseases such as my migraines. The United States needs serious healthcare reform. We need to have doctors be able to prescribe treatment and have those treatments be affordable. Millions of Americans go into massive debt over healthcare costs. Nearly twenty years ago, when I worked for a bankruptcy lawyer, we had many clients who had lost their job because of health issues, and their healthcare costs had become unbearable. I would see broken people come in all the time under the weight of medical debt. We would help them file bankruptcy, back before bankruptcy “reforms” made filing much more difficult. We would see a significant difference in them before their hearing because their creditors had been under court order to cease collection attempts. If we had the chance to see them after their bankruptcy had been discharged, they were completely different people. Without the stress of debt, their health was able to improve.
I will never understand why people oppose healthcare reform. I’m not necessarily talking about socialized medicine, though I think it is needed. I just mean that doctors should not charge patients without insurance more than they charge patients with insurance because doctors negotiate with insurance companies. Many things need to be reformed if we are not going to move to universal healthcare. The state of the United States’ healthcare is dire, and too many people just can’t afford the healthcare they need.
Yesterday was an emotional day for me. I woke up once again with more head and neck pain. My neurologist sent me a message asking, “How are you doing? Has the pain improved?” I messaged her back to tell her that I had seen improvement through much of Saturday, but the pain began to return by Saturday evening and has continued to worsen since then. She ordered an MRI, which I will have done next week. I pray that if they find something, it won’t be anything terrible. Honestly, it scares me that they are having such a difficult time controlling this headache. The pain of the last week and a half has caused me to be depressed. I have had headaches worse than this years ago, but I have never had one that was this intense for this long. I went years with a constant headache, but it came in waves. While I was never without pain during those years, I had days when the pain was not all encompassing, followed by periods of debilitating pain. This current headache has been close to being debilitating all the time. It has hindered my ability to concentrate. So, the pain is making me very emotional.
Also, I watched the impeachment trial. The video that the House managers played was very disturbing and upsetting. I cannot see how anyone could not be moved by it. I believe that the video’s editing could have been better because I think it would have been more effective with time stamps throughout, as much as possible, to show a better timeline of events. That aside, I think it was very effective. On MSNBC, Claire McCaskill reported that friends of hers in the Senate chamber saw some of the Republican Senators (Rubio, Cruz, Cotton, and others) refusing to watch the video and busied themselves with papers on their desks. She also said that some Democratic Senators turned away because they could not watch the videos and relive that day all over again. It was a brutal video to watch, but I think that no matter what political party you belong to, you should be paying close attention during the trial. Seeing Rep. Jamie Raskin choke up talking about his family being in the Capitol that day was also difficult to watch. It’s upsetting that it is unlikely that enough Republicans will vote to convict the former president of inciting an insurrection, but I know that most Republicans want to put their heads in the sand and ignore what happened. The former president’s lawyers made rambling and ridiculous arguments that contradicted each other. Nothing they said was convincing or based on reality. Castor did admit that the former president lost the election, but that’s been clear to most of us for months. Schoen just looked like a raging nutcase, but considering his client list, I expected no less.
Hopefully, today will be a more mentally stable day for me today, and there will be less pain physically.
The headache I have been suffering from for over a week seemed to improve on Saturday, with little pain throughout the day, but the pain was back on Sunday. When I woke this morning, the pain was as bad as before I saw the neurologist. It is evident that the nerve block was a complete failure, and the steroids don’t seem to be helping a lot either.
I have to work this morning to answer some urgent emails, send some information to program presenters, and work on some promotional material for another virtual program. If I can get all of this done this morning and I don’t feel better this afternoon, I will have to take the afternoon as sick leave. I hate to continue to take sick leave, but I find it increasingly hard to concentrate.
I spent most of the weekend mindlessly watching television, in particular, old Star Trek episodes from the various series: Deep Space Nine, Enterprise, and Discovery. Star Trek has a way of calming me down and letting me forget my troubles for a little while. I did watch the Super Bowl last night, but I found it profoundly disappointing. The Bucs seemed to walk all over the Chiefs, the commercials were mediocre at best, and the halftime show was horrible.
I had never even heard of The Weekend. I can’t remember the last Super Bowl halftime show where I had no idea who the performer was. I had to look him up. Apparently, he’s a Canadian singer, songwriter, and record producer. If they wanted a Canadian, there are so many outstanding Canadian acts. If they’d gotten Shawn Mendes, at least we would have had eye candy. Honestly, I don’t care much for Shawn’s music, but he is awfully damn cute and sexy.
Anyway, that’s all for now, but here’s a bonus of Shawn in his Calvin Klein underwear.
I saw my neurologist yesterday at the Headache Clinic. She asked me a lot of questions about my pain and did an exam. She said that she did not believe it was shingles but was inflammation of my occipital nerve. These are nerves that run up the back of your head and are one of the primary nerves involved with migraines. She believes that when I had the abscessed tooth a couple of months ago and the subsequent root canal, it aggravated my occipital nerve causing a trigger migraine.
She told me that this could take months to clear up, but there were things they could do to improve the condition. She began by prescribing to me a six-day course of a Medrol Dosepak (methylprednisolone). I’ve taken this before. It’s not a pleasant treatment because it causes me to shake uncontrollably, but it is usually effective. However, I could not start the first dose until this morning before I eat breakfast.
In the meantime, she gave me an occipital nerve block, i.e., injections of lidocaine in the back of my head. Almost immediately, the back of my head was numb. She told me that this should stop the pain for about four days giving the steroids time to work. Sadly, the pain came back within a few hours.
I sent her a message through their online portal to let her know that the pain was back. She told me that nerve blocks are not always successful and to put ice on it for twenty minutes every hour. She also said not to give up on the nerve block just yet; it could still provide some relief. The ice pack did help some and eased the pain for a time. If the nerve block does eventually help, then she can give me another one in two weeks, then once a month until this clears up. I’ll be going on March 8 for my next Botox injections, so that might also help.
I am praying that the Medrol Dosepak helps, even if I have to suffer through the shakes. The treatment for this whole thing is not pleasant, so I hope it works. The administration of the nerve block was very painful, and we shall see how my body reacts to the steroids this time. Hopefully, it won’t be as bad as the last time I had this treatment. I don’t usually say this, but please keep me in your prayers. This pain is not only wearing on me physically but mentally as well. I feel like it will never end, and I am destined for chronic pain for the rest of my life.
The nurse practitioner I saw on Monday discussed my condition with my regular doctor. They decided that because there were only a few bumps, that it probably wasn’t a rash like shingles would cause. My doctor believed it is an atypical migraine and told me to call my neurologist. They also lowered one of my diabetic medicines to help with the hypoglycemia.
I called my neurologist and was able to talk to one of the nurses eventually. I described what was going on, and she made me an appointment to see the headache clinic’s nurse practitioner today at 10:30 am. The nurse suggested that they may need to do a procedure to inject lidocaine into the back of my head, neck, and shoulders.
I hope it will help. I’m sure she will also check again for shingles, but unless more of a rash shows up, it is unlikely to be shingles. What I know at this point is that it’s the worst migraine/headache that I have had in years. When I was teaching, I’d have headaches that would make me cry myself to sleep; the pain was so severe. The only medicine I had that would help was a combination of a potent muscle relaxer (Flexeril) and a strong opioid (Lortab or Percocet). Lortab helped the most, but FDA took it off the market. Those medicines only helped because they put me to sleep and allowed the pain to subside eventually.
The worst headache I ever had was when I had one of these bad ones and took an Imitrex prescribed to me. Instead of helping, the Imitrex intensified the pain dramatically. I remember it being so bad I dropped to my knees, and all I could do was curl up in a ball and cry. I probably should have gone to the emergency room because I’ve never had pain that intense before, but I did not have any insurance at the time, so I just suffered through it.
The good thing about the Headache Clinic is that they understand just how painful and debilitating a migraine can be. Not all doctors understand the intensity of the pain associated with migraines. I’m appreciative that my regular doctor understood that I was in constant pain and could get me into the Headache Clinic. I pray they can help me today.
Since Friday, I have had a burning pain on the right side of the back of my head. The pain is accompanied by periods of intense shooting pain. It does not appear to be one of my typical migraines, though I’ve had an accompanying migraine on the right side of my face since this pain began. First thing Monday morning, I called to get an appointment with my doctor. Sadly, my doctor was out on Monday, so I had his nurse give me a call. I was also having some issues with hypoglycemia (low blood sugar), so I needed to see someone on Monday and not wait for my doctor to be back in the office. I describe my issues to the nurse, and she thought I should come in and see one of the nurse practitioners. She also suggested their PA, but I find that woman to be an idiot and refuse to ever see her again. So, I made an appointment with the nurse practitioner.
I told the nurse practitioner my issues, and she suggested that the head pain could be shingles, temporal arteritis (though unlikely), occipital neuralgia, or nothing more than an atypical migraine. She looked closely at my scalp and examined my shoulders, neck, and head. She didn’t see a rash to indicate shingles but told me that a rash from shingles could take up to five days to appear after the onset of the pain. She drew blood to run some tests and check for inflammation caused by temporal arteritis or occipital neuralgia and told me to check the area in 24 hours to see if a rash appeared. She also tested my A1C to see if my diabetes medications need to be changed because of the hypoglycemia.
Yesterday, I had my downstairs neighbor check my head for a rash. She did see a single bump, but we could not decide if it constituted the beginnings of a rash. Since she checked yesterday morning, a few more spots have appeared that I can feel but not see, and the pain continues. My neighbor will check for a rash again this morning. The nurse practitioner I saw was supposed to call me yesterday to discuss my lab results, but she never called. I’m not sure why she didn’t call, but I guess it could have been because of the snowstorm. However, we only got 3.5″ of snow the night before and only an additional 1-2″ during the day yesterday. I called the clinic towards the end of the day, but I never got an answer and had to leave a message, which she did not return before the end of the day. I’ll try calling back first thing this morning.
Whatever this pain in the back of my head is, I hope it ends soon. It is affecting my ability to work, and if the pain doesn’t improve, I’m going to have to take some sick leave. If I knew what it was, I’d feel a little better, even if it was shingles. At least shingles can be treated. I hate having medical mysteries. I seem to always have mysteries when it comes to health issues, and the tests they have to run can get expensive. I just want to be healthy or, at the very least, have some answers.
I have an eye doctor’s appointment today. This is only my second time going to this eye care place. I had to find a new one because the one I had been using since moving up here quit taking my insurance. I also needed a place that gave diabetic eye exams. At this new place, I saw a female optometrist the last time I went, but she has left the practice and so they called and asked me if I was okay seeing another one of their optometrists. I had no attachment to the one I originally saw, so I let them change my appointment to this new guy.
I doubt much has changed. At my last appointment, they changed the type of contacts that I wear but not my prescription. I was wearing Acuvue 2 contacts, and I was told that no one still wore them, and I needed to change to Oasys contacts, which are also made by Acuvue. I can’t tell a difference in the feel of the contacts in my eyes between the Acuvue 2 and the Oasys, but I have noticed that I don’t always see as well when I am reading. This only started after I got these new contacts. When I called my eye doctor about it, I was told that it was most likely due to age, and I needed to get a pair of low prescription reading glasses. The reading glasses do make reading a lot easier. My old eye doctor had told me that I’d likely need bifocals at some point in the future.
The good news is that my prescriptions for my glasses and my contacts (they are two different strengths) have not changed in the past several years. Hopefully, my contacts won’t change as I still have several pairs from my current prescription, and I like my current glasses, though I rarely wear them. So, we shall see what I get told today.
In other news, we have gotten nearly a foot of snow over the weekend. It started in the early hours of Saturday morning before I woke up and when I went to bed last night, it had not stopped. The heaviest snowfall was Saturday morning when we got more than half of the snow that fell over the weekend. Since I moved to Vermont just over five years ago, we have only gotten 3-6″ of snow at a time. This winter has been different. In the snowstorm we got just after Christmas, we got 9″ which at the time was the most snowfall I had seen at one time since I moved here. That snow was dry fluffy snow and was easy to brush off my car and patio. The snowfall over the weekend has been heavy wet snow that was difficult to clean off my car. Luckily, I did not have to clean off my patio because my neighbor and her kids came yesterday morning and cleaned off the patio and stairs for me.
I was feeling a bit off last night, and I just didn’t feel like writing anything. I had a very low-grade fever and an irritated throat (not sore, just some sinus drainage), and that always makes me feel like crap. I plan to write more tomorrow since it will be my final post of 2020.