Saturday, October 5, 2013

Frailty, Anxiety... Clarity

I think I've figured something out, and I think it's important. And I think it bodes well for me.

Very well. Perhaps immeasurably so, if I'm right.

But yes, I'm going to make you wait a minute for it. Because that's how I roll: MEAN!

First, a bit of an update.

Did I tell you I had an MRI a few weeks ago? I don't think I did. Well, I did. I've had a few over the years-- pretty standard procedure for we of the history-of-massive-head-injury-and-chronic-migraine set, as one might presume.

They always tell me that there is no significant increase in risk of stroke or cancer or tumors or anything like that with a massive head injury (although they know now that there is an increased risk of stroke in the months after a TBI, which I almost certainly had back then, before such things were diagnosed that way. Glad to have dodged that bullet.). Same with migraines. They give us these tests to rule out other causes for the symptoms that we are experiencing, not to find complications of the conditions we know we have. 

But it's always a little weird and scary anyway. One's inner hypochondriac tends to speak up rather forcefully when one's head is locked in a cage inside a giant, rattling, clacking, clanging, beeping, screeching tube. 

(And seriously: what's with those MRIs, anyway?! Have any of you had one recently? The noises! What purpose could they possibly serve? It's like a sound check for every single weapon and/or emergency alarm effect ever used in any sci-fi movie or TV show ever made. Over and over. Paired with rumbling and shaking and clicking and clacking and banging and clanging and dancing and prancing and all the other reindeer.)

Way primitive for such a high-tech procedure.



I did okay, though. It was funny, they kept asking me if I was claustrophobic-- my doctor, when he told me I needed to get the test; the nurse who called me to schedule it; the receptionist who checked me in. Everyone. And every time, I answered, "Yes, I am extremely claustrophobic."

Was I willing to do this test?


And that was it. End of subject. I kept hoping they'd offer me something soothing to ease my way-- they usually give you a valium or something, sheesh-- but nope, nothing, nada. Pssh.

Which was fine, as I couldn't have taken it anyway. I had to drive myself there and then home again immediately afterward to pick up my kids at a friend's house. But it's the principle of the thing.

So there was little claustrophobic ol' me, head locked up like Hannibal Lecter, rolled into the tube about as far as my waist. My hands were folded over my abdomen, and if I steepled my fingers, they touched the ceiling, so it was about 4" above my nose. 

Close quarters.

I was in there for about 20 minutes. Loud noises, as I said. And I did fine. No big deal. They check in with you frequently, in between 2-3 minute bursts of noise, and they keep lots of cool, fresh, moving air in the room so you don't feel stifled.

So anyway, I did the test, and had a couple of weeks before my next appointment with the doc, during which I might have let myself get a little nervous about the findings if it weren't for my finely-honed dissociative abilities, so instead I immediately forgot all about it.

PTSR, you are so good to me sometimes. ;>

I went and saw the doc on Tuesday, and he told me that he'd gotten the results (it took me a minute to remember what the hell he was talking about, so thoroughly had I deleted the information), and that there was nothing of concern in the findings: no tumors, nothing that needed another look. There was, however, a good deal of scarring on the brain and evidence of the injury. He could see where all of that had taken place.

I wonder what, if any, implications scarring on the brain will or could have. I'm going to ask him next time. I never think of good questions in the moment-- I need to process things for a while first. This is a really irritating quality in a person. When that person is me. 

I also wonder if I can get copies of those brain scans. I want to see them. I see the doc again in November, and I'll ask. If I can, I'll post them here. Cool, right? 

You can see my braaaaaaaains!

Another week on Cymbalta and Topomax, and I'm feeling a bit less muddled, but I suspect I haven't found the right med balance yet. I'm still out of sorts and not quite right. Since I haven't been on the full dosage for a month yet, the doctor and I agreed to wait until my next appointment before we change the levels, but I have a feeling I'll be increasing my dose.

I am experiencing two contradictory things: I think I'm sleeping better at night (I haven't been wearing my Fitbit lately to measure my sleep effectiveness. Gotta get that thing back on so I can see!), and I have still been ridiculously, overwhelmingly tired during the day.

I told the doctor this the other day, and he thought it was odd-- that neither drug should make me sleep better, and neither should make me tired, beyond the initial ramp-up-period sluggishness. 

I didn't really have a response to that. I know how I feel, and that's how I feel.

But then, yesterday, I thought of something that makes a lot of sense.

This is the thing I figured out:

We now know that the Wellbutrin was causing me constant, low- to mid-grade anxiety for about a year and a half, and that element has now been removed. 

What if it was that constant agitation that was keeping me from getting better sleep? What if it was the Wellbutrin that was causing my poor sleep, and also my agitation during the day that kept me from feeling the overwhelming exhaustion that I'm feeling now?

So now that it's gone, my body is really feeling that vast sleep deficit?

AND, my body is actually finally able to start making up for it?

I have taken NAPS lately, people! NAPS! ME! Like, THREE OF THEM!

I am not a napper. But lately, I just can't help myself, I can't keep my eyes open, and it has been helping. I've been going to bed a little bit earlier and actually falling asleep, and I've been staying asleep, and the Cymbalta has been helping my back pain which has made sleeping more comfortable, and I've been a teeny bit more refreshed in the morning.

What if removing the Wellbutrin solves the sleep problem?

And if it does, here's a better question, and one I can't wait to experience the answers to:

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