Yesterday, I had my first COVID vaccine shot (Pfizer, if you’re wondering—I have faith in the Pfizer vaccine. They made Viagra after all. If they can raise the dead…they can save the living. 🤣). I got my vaccine at Kinney Drugs here in Vermont. It was so incredibly disorganized. I had been in a CVS the other day, which is also giving the vaccine. CVS was much more organized with a table just as you walk in to check people in and then a little cordoned-off place to give the shot. At Kinney Drugs, I had to ask someone where to go, and they directed me to the pharmacy counter. Once I made my way to the counter, I then stood in line forever, although there were only two people in front of me, and one of them was only transferring a prescription from Walgreens. Once I finally got to the front of the line, they took down again all the information I had filled out to get the appointment in the first place. My appointment was at 11:30, and it took about 20 minutes just to get checked in. I spent another 20 minutes waiting to be called back for the vaccine. Once I got the vaccine, I was given a 15 minute time to sit and wait to see if any side effects appeared. Once the timer went off, I was free to leave.

The vaccine shot was a bit more painful than a flu vaccine, but probably not as bad as the pneumonia vaccine. It was nowhere near as painful as the Emgality shots I used to take for my migraines. I did feel a bit flushed afterward for a few minutes. My face felt hot, and so did my arm, but it only lasted a few minutes. So far, I have experienced no other side effects. My arm wasn’t even sore last night unless I pressed on it. I am scheduled to take my second shot on April 15 and will be considered fully vaccinated two weeks later, on April 29. At least I know what to expect next time. I know this process was much better than the hours my parents sat in their car waiting in line for four or five hours to get their shots.

I also had to get my weekly COVID test for my university, which has become a pretty routine thing at this point. We just walk in and register, which involved giving our name and showing that we have the all-clear email from the university’s daily screening system. We then walk to a table where we are told to remove our masks and blow our nose. Then we put our masks back on, sanitize our hands, and move to the next available testing table. We are given a vial with our name and information on it and a cotton swab. We then move to the end of the table, take off our mask, swirl the swab around each nostril five times, and put it in the vial. Then we put our masks back on and once again sanitize our hands before leaving. I should receive my results sometime tomorrow.

It was a busy day, not just because I got the COVID vaccine and test. Wednesday night, the tooth that I had the root canal began to hurt worse than it had been hurting. It’s always been sensitive since the root canal, but it had started to be painful in the last several days, in addition to being sensitive. I called my dentist’s office, and at first, they just prescribed an antibiotic and set up an appointment for April 1. Luckily, they called back because they had a cancellation and could get me in at 3:15. I took the appointment right away. He took an x-ray and tapped around on my teeth and did some bite tests. He believes a crack in that tooth that would not show up in an x-ray is causing a recurring infection there. I discussed with him my trigeminal neuralgia diagnosis from my neurologist and what prescriptions I am on for that. He believes the tooth is aggravating my trigeminal nerve and that I don’t have full-blown trigeminal neuralgia. He said that if there is improvement after taking the antibiotic, he believes the tooth may be a significant part, if not the primary cause, of the pain I’ve been experiencing on the right side of my head. He said if the pain lessens in the tooth, he wants to extract the tooth in hopes that it will relieve the pain. 

I messaged my neurologist with what my dentist said, and I am waiting to hear back from her. She and I had discussed the tooth being the cause of the trigeminal neuralgia and what started this pain in the first place. I hope that she and my dentist can get to the bottom of this nerve and tooth pain. I desperately need relief. I have seen very little relief from the medicine prescribed for the trigeminal neuralgia, and the pain has been pretty constant. Since this whole thing began back in November of last year, the pain has always felt different from migraine pain, but it all started at the same time this tooth became abscessed. Now, I have to wait for what my neurologist says and if the antibiotic causes any improvement.

Over the past year, most of the people I know have gained weight during this pandemic. In a poll of more than 1,000 WebMD readers, nearly half of the women and almost one-quarter of the men said they’d gained weight “due to COVID restrictions.” This trend is no surprise, as routines have been disrupted, stress has increased, and it’s mostly been unclear when things will ever return to normal. 

The restrictions that quarantine places on everyday life have interrupted many people’s daily routines. The rise in unstructured time, the closure of gyms and recreational centers, movement restrictions, and the enormous stress of the pandemic affected people’s sleeping patterns, eating habits, and levels of physical exercise. All of this contributed to weight gain. People struggled to focus on weight management due to increasing work demands, unforeseen hardships, and safety concerns.

Since I was young, I’ve always struggled with my weight. Until I was 6, I was considered too thin and given milkshakes to gain weight. Sadly, that worked too well, and I learned that I loved food. Stress has almost always caused me to gain weight. I had a workout partner for a while in graduate school, and I lost enough weight to get down to a healthy size. However, my workout partner moved on, and I fell back into old habits. The weight came back. Over the years, my weight has continuously fluctuated. I’ve gained weight, lost a few pounds, gained some back, and so on. 

Over the past year, I have been fortunate not to gain weight as many of my friends have. I have lost over 30 pounds, but I need to lose more. While many people have begun wearing pants with elastic in the waist, I’ve had to buy pants with a smaller waist. Wednesday, when I had to go to the museum, I put on my dress belt, which I have not worn much over the past year. It was too big. I tried to cinch it to the next hole but realized there wasn’t another hole to use. I realized I had to buy a new dress belt. I had already purchased a casual belt that fits better, but I thought my dress belt would be okay.

Some people might be like me and have lost weight. Others have gained weight during the pandemic. However, we have to realize that we will get back to normal eventually. If you have gained weight, you can get back into a routine to get you back to a healthier weight. I will have to work not to fall into bad habits and regain the weight I have lost. In a time when more than 530,000 Americans have died from COVID-19, and in the face of the devastation caused by this pandemic, the anxiety, and the sadness, it is important to remember that simply being alive and healthy is a blessing.

I had hoped to update everyone on my MRI results, but as I write this, I still do not have any definitive answers. The “After Visit Summary” for the MRI results gave a diagnosis of trigeminal neuralgia (TN), but I have not heard from my neurologist yet. I will send a message this morning asking when I will hear something. My neurologist and my doctor had not believed it was TN, which is a rare neurological condition. I suspect that my neurologist will also look at the MRI scans before she makes a definitive diagnosis. I am not going to say that it is TN at this time, but it seems like it might be more of a possibility than my doctors initially thought.

One thing I do know for sure is that I hope I never have to have another MRI. They told me that the table was uncomfortable, but this was more than just a little discomfort. The table was hard and flat, which caused lower back pain throughout the procedure. Furthermore, the tube I was in was very tight, and the way they had my head strapped in caused severe pain in my neck and shoulders. It was also hot inside the machine. They turned on a fan, but it did not do much, and I was sweating profusely. It finally got to the point that I had to ask to be taken out. The tech told me that if she let me move, they would have to stop the procedure and reschedule when they could give me some Advil for the pain. Knowing that Advil does little to relieve pain for me, I just said to continue. Thankfully, she turned the fan on high, and once I cooled down, the pain at least became bearable. 

When I was brought out to put in the contrast, I found out a new tech was there. She was much nicer and talked me through the procedure, and helped calm me down. Each time before the MRI started back up, she told me how long it would last, which the previous tech had not done. Knowing how much longer I would be in the machine helped. It just gave me a sense that it would eventually end sooner rather than later. I was so stiff when it was over from being in such an uncomfortable and painful position that the tech had to help lift me off the table so I could sit up. For me, this MRI was a nightmare and a bit torturous. It was not because I was claustrophobic; that did not bother me as much as the heat and painful position. I was so glad to get out of there and head back home.

If I hear more today, which I hope I will, I will give an update of the diagnosis as soon as I can. I appreciate all of the prayer and loving energy you have been sending my way. Thank you. It means so much to me.

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Because I was so stiff and sore from being in the MRI machine, I spent most of yesterday like the guy in the above picture. I mostly just laid on the couch and watched TV. I’m glad I had already planned to take yesterday off before I had the MRI. I took the day off because I knew it would be late when I got in Tuesday night.

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UPDATE:

I received a message from my neurologist this morning, and my brain MRI results are “reassuring and normal.” She is prescribing indomethacin as it can be very effective for the type of head pain I am having. She wants to try me on this medicine to see if we can get the pain under control. I pray that this works. The good news is that it does not actually appear to be TN as the initial diagnosis from the radiologist reported, and since the results were “reassuring and normal,” there are no signs of a tumor or multiple sclerosis. My neurologist believes it is more likely hemicrania continue (HC), which responds well to indomethacin.

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.

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.