Friday, September 9, 2011

Yesterday, or, a time when records were set, new friends were met, but no long term answers, yet...



Eden actually pointed out a simply brilliant post from a webcomic called "Hyperbole and a half", recently, which highlights the plain inadequacy of the traditional pain scale used in doctor's offices these days. Unfortunately, I had entirely too much of a valid reason to use the proposed new scale, yesterday.

As it turns out, my respite from pain was a lot briefer than I had been hoping as of last post. Migraines, chest pain, and vomiting all made intermittent appearances over the last few days, culminating in the mother of all horrible experiences yesterday. I still don't know exactly what was going on, but I woke up in absolute agony shortly after midnight, with immense pressure and a sensation of fluid shifting around in my head - every change of angle for any reason whatsoever kicked the already nearly unbearable pain into extra high gear. Being absolutely exhausted, and frankly unable to face the thought of the movement involved in getting up and finding something to take the edge off the pain (not to mention not having the slightest idea what medication would be appropriate, as this felt so different from my normal modes), I spent the next few hours drifting between lying awake and getting just far enough into sleep to have absolutely terrifying dreams - somehow sleeping while in pain always seems to be about the only thing that produces dreams that I remember, and they're always just scary as hell; perhaps my normal sleep cycle just runs right past REM on the way to deep sleep in a desperate attempt to make up the many hours of sleep I tend to miss.

In any case, one of the dream cycles I landed in was just profoundly disturbing (this among dreams of being fired from working at Costco and being trapped in an underground apartment). For some reason, I ended up in a sequence that essentially had me convinced that my little brother, a man whom I've known, loved, and respected for approximately 28 years now, was a figment of my imagination. Now, I know that this sounds odd and unbelievable, but you have to understand, my normal memory is absolutely shattered at this point, most especially the memories from my childhood and early adulthood. Often, when my thoughts turn to my first wife, Jessie, for whatever reason, it's hard to feel that those years were real, given how little of our life together that I can recall. Kind of tragic, really, and not a fact that I care for, but I use it now as a comparison, because the dream had me feeling exactly the same way, that maybe the experiences I recalled with him were really all in my head. Regardless, I woke back up, still in horrible pain, and spent the better part of an hour and a half recounting the experiences I'd shared with him, and trying to convince myself that Tim actually existed. Perhaps this will give you some idea of how tenuous my hold on reality is at times, especially when I'm hurting for sleep.

The remainder of the night flowed by in much the same way, with dreams becoming less and less logical and pain continuing to get worse. I'm afraid that by the time Eden woke up, and eventually talked me into going in to the ER (I had myself quite convinced that they wouldn't be able to help me, that they would commit me for being suicidal, and that I wouldn't survive the trip to the ER due to the movement required), I had scared her quite a bit. Normally I'm a pretty stoic fellow, as I don't see the point of crying in most cases, and really don't have access to much emotion most of the time (left overs from the military and various traumatic periods, I think). This time, however, I managed to get myself into a hell of a state, somewhere between screaming and sobbing (Scrobbing?), as crying only made the pain that much worse, and of course, once started, it was awfully hard to calm down enough to stop. Surely unfairly scary to those around me, and I'm sorry for having exposed them to such a thing.

In the end, Eden did get me to the ER, with me holding on desperately to the seat and handle the whole way, trying valiantly to minimize movement from the most miniscule of bumps, with my eyes hidden behind both sunglasses and a wet washcloth. As I told the intake nurse, my pain was holding at a 10 ("the worst pain you've ever experienced" - prior to this point anyway) without movement, and was simply making up brand new numbers with any aggravating movement, crying, or the wondrously unpleasant experience of vomiting, which I'm afraid I had to dash away for twice while waiting for a bed to open up in the ER.

Of course they threw blood tests at me, and even took a CAT scan to be sure that there weren't any suspicious blobs showing up in my head to explain the nastiness, but in the end, they weren't able to come up with an explanation, other than possibly meningitis. Given that my temperature and other stats were in a normalish range, and that my pain was eventually managed, we decided to hold off on the spinal tap required to test for that against the symptoms returning in the next few days. Of course, to get my pain under control, they ended up piping in some Dilaudid, a morphine derivative that I hadn't been introduced to previously, along with a varied witches brew of anti-inflammatories and anti-histamines in my IV. Let me tell you, that's some pretty powerful stuff - quite unpleasant waves of sensation when first given, but insofar as A. covering pain, and B. making the remaining pain unimportant, that stuff is amazing. I went from pain quite literally off the scale to perhaps a 4 or a 5 in a matter of hours. Granted, I surely would have preferred some kind of answer for why things hurt so dang much, and I'm more than a little scared that it will return, but failing that, I'll take it. They even sent home two pills of it just in case, along with a few other meds, which I'm given to understand is quite unusual for that level of narcotic. The pain hasn't returned bad enough to make me resort to it yet, thankfully.

Actually, today hasn't been half bad - I woke up with very low static pain, but extremely high photophobia this morning, and so didn't accompany the girls to the swimming hole today, but even that faded for the most part in the afternoon after a dose of the anti-inflamitories and anti-histamines that the ER gave me to hold out until I can see my new doctor.

In point of fact, I don't have a new doctor - while the VA approved me leaving my previous nurse practitioner, they've simply assigned me to another one, as I mentioned last post. Oh well; I did get set up for an intake interview with her next Tuesday, so we'll see how that goes. I still do have some hope for the results of the MRI that my neurologist ordered - it should show much more soft tissue definition than the CAT scan, and thus may show different results. I have, however, given up on the elimination diet - it seems clear that dropping the major allergen possibilities from my diet had no significant impact over the week or so I was on it, although technically I suppose I could still have some environmental factors kicking in as allergens, so I'll still be asking for a test for that kind of thing.

So yes, that's where I'm at now - quite impressively horrible over the last few days, but at least today wasn't too bad at all. As Eden said, it's awfully nice to see me smile and laugh again (and it's awfully nice to have the attention span to do so - the fact that Ed Byrne is brilliantly funny helped too - we spent the evening watching some of his standup.)

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