All This Up One Hill and Down Another Makes Me a Little Queasy

Whew, today was a long one. And I'm pooped so I'm just updating in point form rather than going on like I usually do.

First, to the doctor.

Who tells me that if the Lyrica's not working by now, it ain't gonna, so I can stop taking it (yay, no more confusion!) Like when the doctor's office called the other day to set up my appointment for my PAP test in February and for a full 24 hours I couldn't figure out why they were calling three months in advance. God, it was like a terrifying full-clarity preview of my not-so-golden years.

My biceps reflex is hyper-reflexic and I guess this is an indication of something or other to do with my spine. No one had tested my reflexes before but I guess that's what happens when you see two locums at three different points in between seeing your own doctor - no continuity.

SO, next I'm heading off to a neurologist (well, in 2 months or so when I can get an appointment) and in the meantime, getting an MRI to help rule out the next possible diagnosis - cervical spine compression of the nerves that run down my arms.

According to my doctor's note to my unit, I'm unable to do any activity that requires physical exertion until at least after I'm re-assessed in three months.

Which means that I'll need to see a DND doctor to confirm that who'll put me on a medical category which will put me into a holding pattern. What that holding pattern means is that during that time I can't go on courses or be promoted.

I guess I'll be staying home this summer then and then everything else will be a year behind. Not that a summer at home is such a bad thing, though. :)

Then, the lawyer. Not too much detail here, sorry, just the basics.

It's no fun listening to your own 911 recording when you don't remember any of it. Trust me on that one.

However, one of the charges has been dropped due to some term I can't remember at the moment. AHHH, technicality.

We're hoping to plea bargain me down to something that doesn't involve a criminal record. Since that will be very bad for my security clearance and any future plans to deploy for the military.

Which, really, is the entire reason I'm going through all this.

Otherwise, I go to trial.

On the way home I noticed that I'd lost my bus pass. But the bus driver let me come home without it. Of course, I still haven't found it.

To top a day of good news and bad off, about an hour ago whilst trying to fix a necklace with my teeth, I chipped off a big chunker of my front tooth.

*sigh*

Tomorrow, however, is a new day and today wasn't actually all bad news. So, there's that to get me through the night.

And, since I've been vetting some new music on the MP3 player this week, let's throw in some lyrics here. Cheers.

i'm a slow motion accident
lost in coffee rings and fingerprints
i don't wanna feel anything but I do
and it all comes back to you

Your Brain on Jen

Here is my head.

This shows a tiny spark of life in the middle there somewhere (and no I don't know what it is, maybe it's the light at the end of the tunnel).



Next up, big eye sockets, pieces of plastic maybe - I don't know if they show on a scan - some space there for my brain to rattle around in.



And last, but not least, a view from the top...



If you'd like to see them even bigger, go on over to the 2007 gallery.

Next Up: Melodic

Today, I decided that it was okay for me to announce to the doctor that I would never, ever again allow an anti-inflammatory near my abnormally normal self again.

We decided, together, that an MRI probably wouldn't tell us much.

Also, since the lumbar puncture ruled out pretty much everything on the planet that the blood tests haven't already managed to, then it is safe to assume that I am done with any sort of needle sticking, invasive errrr, STUFF for some time.

So, since my arms still hurt, where do we go from here, you ask? Or, whatever, don't ask, I'm telling you anyways.

Lyrica.

Which is new - so new apparantly that there are no cheap knock-offs - oh, sorry, generic brands, so it is quite pricey. The internet tells me that it was designed for MY PAIN! Of course, that is only if MY pain comes predominantly from shingles or diabetic nerve pain.

On the other hand - it is specifically a 'nerve pain modulator' and since that's the current direction of the thinking, (ie: damaged nerves in my arms) well, then, Lyrica it is.

I haven't picked up the prescription yet - it's for 2 weeks only - not because they think it'll work (apparantly it takes longer than that) but for them to check to see if any of the side effects kill me.

heh.

This is what the internet tells me about side effects..

difficulty speaking, loss of coordination, mental/mood changes, muscle pain/tenderness/weakness (especially if your are tired or have a fever), stomach/abdominal pain, uncontrolled movements (e.g., tremor, twitching), unusual tiredness, vision changes.

Tell your doctor immediately if any of these rare but very serious side effects occur: unusual bleeding/bruising, slow or irregular heartbeat.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching, swelling, severe dizziness, trouble breathing.

(If you happen to see me waddling and weaving down the street, twitching involuntarily, scratching my ass and looking a bit sunburned, could you stop and point it out to me? I'm a little distracted these days.)

Other interesting quotes from the Lyrica site (because Pfizer cares and is committed to helping me fight MY kind of pain)....

LYRICA works by reducing the number of “extra” electrical signals that are sent out from damaged nerves in your body. By calming the extra electrical signals in your nerves, LYRICA can help you become more comfortable.

Ahh, extra ones. Who knew? And excitable little buggers to boot.

I gotta say though, there is one bit that I find kind of scary...

Though it is very unlikely to occur, this medication can also result in abnormal drug-seeking behavior (addiction/habit-forming). Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed. Properly stop the medication when so directed. This will lessen the chances of becoming addicted.

So when you pull over to tell me that I look like I'm having some side effects could you also scream....."TWICE A DAY, JEN, DON'T TAKE MORE THAN TWO PILLS A DAY! THAT'S EARTH DAYS! 24 HOURS! PUT THE BOTTLE ON THE GROUND IN FRONT OF YOU AND BACK SLOWLY AWAY!!! NOW, BITCH, BEFORE I RUN YOU OVER LIKE THE GARBAGE YOU ARE!!"

I know I can count on you guys.

OHHHHH, AAAARRRRGGGGGG

Remember how I thought I might be having a reaction to the diclofenac? And everyone kept saying it wasn't the drug?

I made the executive decision (since it's not helping a whole lot anyways AND all my blood tests indicate that there's no inflammation in my body so why am I on an anti-inflammatory?) to stop taking it.

Day Two sans little 24 hour release pilly. Still a little sore in the neck but the headache's reduced by about 80%.

I took a couple of ibuprofen about an hour ago and am hoping that this nebulous state of affairs will continue. I'm heading out for work (yay, working New Year's Eve) in a little bit but before I left I thought I'd recheck the side effects of diclofenac instead of just listening to everyone else.

Because if I've learned anything in my life (after Prozac in the early 90's made me one of the few people who got all homicidal) it's this - if there's a weird side effect, Jen's going to bloody well have it.

Tell your doctor immediately if any of these unlikely but serious side effects occur: stomach pain, difficult/painful swallowing, swelling of the hands/feet, sudden/unexplained weight gain, vision changes, hearing changes (e.g., ringing in the ears), mental/mood changes (e.g., depression), fast/pounding heartbeat, persistent/severe headache, fainting.

Tell your doctor immediately if any of these rare but very serious side effects occur: change in the amount of urine, easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat), unexplained stiff neck, seizures.

I rest my case.

Of course, it could be the headache isn't gone and is just tricking me. But, HELLO? If work is slow later I will come back and, as an end of the year thing, tell you why I am, on the whole, pretty damn happy with my life.

It's a shock, I know.

Absolutely Itis'd Out

6:45 am yesterday, back at the ER, different hospital, same doctor. In fact, I didn't even see the doctor for the first two hours, since they knew why I was there.

A male nurse tried a couple times to get an IV in. A female nurse wandered by to tell me they were doing a CT scan. I'm thinking, "hrm, they don't normally do CT scans on your head with any kind of IV contrast and no one actually used the words "lumbar puncture" the other night, that's just my interpretation. Whyfor then an IV?"

The doctor wandered by to tell me that they were doing the CT just cause I was there and it was there and apparantly they like to do one before a lumbar puncture and that the IV was for sedation.

Cause, yanno, I'm thinking "House" and "ER" and holyfuck those babies look like they hurt like a sonofabitch.

As I'm getting ready to go for a smoke the CT tech came to get me and expresses disgust that I'm going for a cigarette. I say, "Jay? They just told me that I'm having an LP. I think I deserve a damn smoke." Suprisingly - he agreed.

CT scans of the head are nothing really - about 10 seconds long. It is a little strange to be at 'my' hospital, on the other side of things and to know that the people I work with are worried about ME. I expected that a couple of them would be looking for the report on the scan and it's okay (well, for some of them) but it's still weird to know that they were.

So, yeah, the brain is there. It seems to be happy. In the words of the radiologist who reported it, there are "no abnormalities demonstrated".

On to the needle into the spine portion of the day.

Which I don't remember. They gave me Versed, which the internet tells me the patient typically does not actually lose consciousness, but may lose the ability to form memories.

This I can confirm. They hold you down - that's the same as it is on TV. And they had to do it twice although they didn't confirm if that's because I was freaking out or if it's because he had bad aim.

I think that the amnesia is a good thing.


*click to biggy*
Apart from the tests that take a bit longer to process (and I woke up with more bloodwork done so I missed that as well) - you'll be shocked to know - I AM ABNORMALLY NORMAL. My spinal fluid is as clear as mountain spring water. It had ONE lonely blood cell in it - 5 to 8 is the norm.

What can they do but send you home? I mean, the ER is for people who are deathly ill and although I may be ill, I am not deathly.

I have a stiff neck and a headache that nothing can touch. Whether that's a part of whatever's going on with my arms/joints/muscles or the other way around is what they have to figure out but it seems that on their own they are not an indication of any disease anyone can think of.

We agreed that narcotics are stupid since we know they won't make my headache/pain go away and they only knock you out but nevertheless, I've been sent home with more (and stronger) oxycodone to take at bedtime. They'll call me if any of the other tests show anything (I'm not holding my breath) and next week I'll be back at my family doctor's to see where we go from here.

Apparantly I asked during the LP if it could be MS and although I have no idea where that thought came from, nor do I remember asking, the doctor assures me I don't.

Next week, for those of you who may be interested, I will post a couple pictures of my brain (isn't it cool that I work there?). In the meantime, in addition to not having MS, let's see what we've ruled out this week.

For anyone who may be thinking of ever sleeping with me, I don't have any form of hepatitis (A through G) or HIV.

For anyone who may have slept with me, I am not pregnant (although er, I could have told them that.)

The pictures of my brain rule out stroke, aneurysm, hemmorhage, big tumors, and intracranial pressure.

The lumbar puncture rules out (take a deep breath here) heart failure, cerebral edema, subarachnoid hemorrhage, meningeal inflammation, purulent meningitis or tuberculous meningitis, hydrocephalus, or pseudotumor cerebri.

Decreased CSF pressure can indicate complete subarachnoid blockage, leakage of spinal fluid, severe dehydration, hyperosmolality, or circulatory collapse. Significant changes in pressure during the procedure can indicate tumors or spinal blockage.

Decreased glucose levels can indicate fungal, tuburculous or pyogenic infections; lymphomas; leukemia spreading to the meninges; meningoencephalitic mumps; or hypoglycemia. Increased levels of glutamine are often involved with hepatic encephalopathies, Reye's syndrome, hepatic coma, cirrhosis and hypercapnia. Increased levels of lactate can occur the presence of cancer of the CNS, multiple sclerosis, heritable mitochondrial disease, low blood pressure, low serum phosphorus, respiratory alkalosis, idiopathic seizures, traumatic brain injury, cerebral ischemia, brain abscess, hydrocephalus, hypocapnia or bacterial meningitis.

Changes in total protein content of cerebrospinal fluid can result from pathologically increased permeability of the blood-cerebrospinal fluid barrier, obstructions of CSF circulation, meningitis, syphilis, brain abscesses, subarachnoid hemorrhage, polio, collagen disease or Guillain-Barré syndrome, leakage of CSF, increases in intracranial pressure or hyperthyroidism. Very high levels of protein can indicate tuberculous meningitis or spinal block.

IgG synthetic rate is calculated from measured IgG and total protein levels; it is elevated in immune disorders such as multiple sclerosis, transverse myelitis, and neuromyelitis optica of Devic.

Numerous antibody-mediated tests for CSF are available in some countries: these include rapid tests for antigens of common bacterial pathogens, treponemal titers for the diagnosis of neurosyphilis and Lyme disease, Coccidiodes antibody, and others.


Whew. Double whew. I know he was looking for meningitis (and specifically some form of fungal meningitis which presents like I had) and they'd already ruled out Lyme disease in Shilo but we've just cleared out a SHITLOAD of things that could be wrong with me.

The blood tests further ruled out any liver function issues and I'm sure about 8 million other things because, of course, they continue to be abnormally normal.

I guess some of those things above will be the results we're still waiting for.

(And, oh yeah, he doesn't think I'm crazy either. I checked.)

Is the pain I don't remember and two BORING days in the ER worth ruling out all this stuff in one big schwack?

Yeah.

If We Can't Fix You, We'll Just Get You Seriously Baked.

Since Saturday my neck had been really stiff and sore just around my spine and I spent the first couple days thinking I'd slept funny but by the time I got to work yesterday and it had been five days with the headache I've had for the last two months getting worse, I thought maybe I should check in with my doctor.

I figure either it was a drug reaction (they told me it would take a couple weeks for the drug to fully kick in) or I was getting worse or the drugs just weren't going to help.

He wasn't in. So I called the pharmacy - could I be having a drug reaction? They told me no, they didn't think so but if I had a fever I should probably see someone.

One of our nurses took me down to the emerg to get my temp taken and since it was slightly high we decided I'd go check myself into emerg while there were still staff around to do my shift if they had to.

I sat from 2:15 until 7:45 (see? no perks for being an employee). They came and took my blood pressure once an hour and it would be waaaay up, then the next hour, waaay down.

The last round of blood tests on the 13th were normal. The only thing they told us was that I have a low risk of CAD (coronary artery disease).

The blood tests last night? Normal.

The ER doctor doesn't think I have a headache. He thinks it's head pain. Which, don't you know, is different.

He wrote me a note for three days out (which may as well just say..."Jen will not be coming to work, nor paying her bills this month. Thankyou.")

Then he gave me something he figured would make the head 'pain' go away. Then he sent me home.

Tomorrow morning I have to get up and go to the hospital he's on shift at and if my head feels better, great, we'll talk about what needs to be done next. If not? I think he wants to do a lumbar puncture.

Anyone want to come and hold my hand while they stick a needle in my spine? Fuck.

The drug they gave me? Oxycodone, which is Oxycontin without the Ibuprofen (considering I'm already on an anti-inflammatory).

Jesus. It is a killer drug. I got home, took my pill and about 15 minutes later as I'm in the washroom washing my face I watched my pupils go from full dilation to pinpoints in the space of about 5 seconds. Then it felt like my whole body sort of blurred out around the edges and seeped into the space around me.

I went to bed. I can't handle anymore weird shit.

I'm about an hour past when my next pill was due (I had to wobble down to the library because I have NOTHING to read) and yes, my head still hurts. I'm about to take that pill and lay back down on the couch.

How's your day going?

The Most Beautiful Words in My World

blah blah blah "these additional actions may explain the high potency of diclofenac - it is the most potent NSAID" blah blah blah

"maximum daily dosage"

"sustained release"

Aren't they pretty words? Don't you wish you could pet them?

Yes, the pain of having to move my arms BECAUSE THAT'S WHAT YOU DO WHEN YOU ARE ALIVE finally got to me. To be honest, I passed my ability to deal with it (in addition to, saaaaay, ohhhh, life) about 2 weeks ago

No, they as of yet / still have no idea what is wrong with my arms / shoulders. Briefly, this week, polymyalgia rheumatica was considered as the symptoms and progression over the last few months is perfect. Well, except I'm not over 50, but whatever.

Alas, lab results faxed to me today indicate, as usual, abnormally normal levels.

What's important here? After eight months of being on some sort of anti-inflammatory / pain killer and/or refusing to take any more anti-inflammatory / pain-killers due to the fact that my stomach has eaten itself - I get to take the good stuff.

The really good stuff.

So, I don't actually care about the rest of it so much anymore.