I wasn’t feeling great last night. I was just feeling kind of yucky. I had been working hard all day on a presentation I will be giving, and I was a bit worn out with a bit of a headache. I think I may be having some sinus trouble, as I have noticed some of the signs of sinus issues. I hope that’s all it was, but it just means that this post will be short today. I hope all of you are doing well.
I am not feeling well mentally or physically today. The disappointment over my dental ordeal (see yesterday’s blog post and comments) has me feeling depressed and in physical pain. Thankfully, I am off work today. I have some time that I have to either take or lose by the end of our fiscal year, so I am taking off every Friday from now until the end of May. I need a break today; I need some time for myself and not have to deal with anything today.
My dental appointment is today. My dentist will reevaluate this problem tooth and decide if it should be pulled. I don’t believe there is any other course of action that can be done. While I would prefer to keep all of my natural teeth, with this tooth becoming abscessed at least three separate times, I do not believe it is going to improve. If there is a crack in the tooth like he believes, then it cannot be fixed at this point and will have to be pulled. I dread this ordeal, but I hope it will cause these headaches to either cease or improve considerably.
These non-migraine/different headache pains started when this tooth trouble started back in November. For nearly six months, no treatment has helped. My dentist and my neurologist believe that it is likely this tooth is aggravating my trigeminal nerve and causing all of this pain. All of this began six weeks into my first Botox treatment. The Botox should have lasted twelve weeks, but this tooth became abscessed, and I have been unable to get rid of the pain since then. I hope that once this tooth is gone and the pressure on the trigeminal nerve is relieved, these headaches will go away, and the Botox will continue to be an effective treatment against my migraines.
Have you ever hit your funny bone (the ulnar nerve in your elbow)? If you have, then you know how painful it is, and it is unlike any other pain. Well, there is an equivalent. The headaches I have been experiencing, when at their worst, feel very similar to the pain that comes from hitting your funny bone, except that it doesn’t radiate from my elbow through my arm but radiates throughout the right side of my face, which can last hours or days. These headaches are not always that painful. Sometimes, it just a dull ache or throbbing sensation; those days are my good days. Pain medicine almost never helps, so I am ready for this ordeal to be over and done.
Just pull the damn tooth. If he does, then I will probably either spend the day on the couch or in my bed watching Star Trek. If I’m still recovering on Friday, I may just laze around and watch the original Star Wars trilogy. I have a feeling this is going to be a sci-fi weekend since that is often what helps soothe me.
UPDATE: Apparently, it’s not “like pulling teeth,” at least not today. My dentist can’t pull the tooth because of all the work done on the tooth. The visible part of the tooth is basically filling at this point, and it would likely break off leaving the roots. He said that the roots themselves are very long, and one is even curved, which adds further complications. He basically said that if he pulled the tooth, it would likely be a long, difficult, and painful procedure, but an oral surgeon will have no problem. I have to call this afternoon to get an appointment with an oral surgeon. He said it is unlikely I will get an appointment next week, and it will probably be a few weeks. He is calling in another prescription of doxycycline for me so I will have it on hand if the infection flares up again. He said he did not want me in pain over a weekend and not be able to do anything. Because the tooth wasn’t pulled, I am going to work today from home. There is no point in taking a sick day today because I will need it for the oral surgery. I am very disappointed. I wanted this tooth gone today; I am so tired of this pain. However, I understand his reasoning. He showed me the x-ray of the tooth and explained exactly what the problems were. I guess it will just be a few more weeks of pain caused by this tooth.
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 am very fortunate to have a primary care physician who is such a wonderful and caring person. He is very good at listening to me and discussing every aspect of my health with me. While these are characteristics of any good doctor, I have had doctors who did not care as much for their patients. For those doctors, a patient was just a job. However, my current healthcare team is very different. They seem to genuinely care about what is best for my health.
I am also exceedingly happy that my doctor referred me to the Headache Clinic at Dartmouth, and that I have received such wonderful care there. It has been a journey to get the right medicine to deal with my migraines, but Botox seems to be working well. The indomethacin prescribed for my hemicrania continua seems to also be working very well. While the first two doses provided some relief, with the exception of when I first woke up yesterday morning, I was headache-free throughout the day. This is basically the first time in about four months that I have been without head pain. I pray that this improvement will continue, and the indomethacin and Botox will continue to be effective.
So, my moment of Zen today is having caring and competent doctors who know the correct medicine to prescribe to allow me to feel normal again. I am very happy to have a great relationship with my doctor. Even when I have had to see another provider at his clinic, he has the other providers consult with him about my care. I am also very appreciative of his nurse, who I find to be very sweet, and I have often talked to her on the phone to provide updates on my health. I feel that I have a great healthcare team.
P.S. My physical therapist is also fantastic and deserves a mention. The things she can do with her hands to relieve one of my headaches is enough to make me want to marry her. I wish I could see her every time I have a headache because she knows how to manipulate my head in a way to relieve the pain like no medicine has ever been able to do. Sadly, I can’t just go see her every time I have a headache, so I am glad that I have found medications that seem to work.
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.
_____________________
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.
_____________________
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.
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.
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.