notes from the insomniac

A couple of days ago I mentioned weird shooting pains I was having on the right side of my head. They were gone the next day and have yet to come up again.

Here's the best thing I could possible interpret from them in light of the fact that I've been Migraine-free since Sunday: THE PAINS WERE MY MIGRAINE EPISODES SAYING GOODBYE! Several especially painful Migraine episodes from the past were doing their own version of waving goodbye, having set up residence my head for years. They finally decided to leave me alone, and as the most painful ones left my world forever, they zapped their way out for a memorable exit.

Welcome to my dream world, folks.

In truth, I felt pretty amazing Monday, health-wise (especially in the evening), a feeling I've not experienced in a while now. Tuesday was even better, and today's pretty good but not as good as the first two days of the week.

Let's talk about what's not so hot: NOT BEING ABLE TO SLEEP. That's right, kids: that little insomnia problem I've not mentioned much on here reared its ugly head again. (Awhile back, a friend led me to a little song I love about insomnia--I pretend the song's about Migraines. I mention it in a post that's over two years old. Unfortunately the link to the free download isn't working right.) In the last couple of years, I've had some sleep issues, and they've really plagued me during their short stays. When I got off Amitriptyline a few months back, the glorious side effect it causes--sleepiness--was gone. I had trouble staying asleep through the night, and forget about 3 AM bathroom breaks. Those left me tossing and turning for what seemed like forever, nervous I would miss out on too much sleep and be tired or headachey the next day.

This insomnia is markedly different. I can't fall asleep at first but am not worried or frustrated about the problem. In fact, I haven't been sleepy at bedtime in a few days now! Very different from how I was feeling up until last week when I was exhausted almost all. the. time. Usually I feel exhausted when I wake in the middle of the night, it's just that I can't fall asleep. For the past few nights, I've felt energized and wide awake during sleepless times. Last night I couldn't fall asleep 'til 1 (after having climbed into bed at midnight). Woke up at 2:30 to pee and was up until 3:45 or so. Fell asleep for thirty minutes or so and was back up again at 4:15 and stayed awake 'til 6. My alarm went off at 7:20 and I snoozed a bit (yes, in the morning I was able to snooze) and then got up and was pretty chipper and energetic.

This afternoon I took a nap, which was probably a mistake for someone who wants to sleep normally at night. But I cannot read a book without getting sleepy-eyed (even if it takes an hour during insomnia bouts), and around 4 PM I fell asleep despite my not feeling tired.

I'm a real piece of work, I tell you. Let me know if you can identify with this issue--and definitely let me know if you think I'm right about the Migraines waving goodbye and leaving me forever. Ha.

Is it working?

When my loving, good-natured friends and family ask me about my healthcare regimen, I try to remain energetic as I list the things I ingest each day, the activities I try to do to keep the Migraine attacks at bay.

I take 400 mg of Vitamin B2 each day--that's about 23,000 times the recommended daily allowance. Ha! I read a study online linking that daily intake over a long period of time to an overall decrease in Migraine frequency. I started taking the vitamins each day not because of this googled study but because of my neurologist's very strong suggestion--the search is what came after his suggestion.

Along with the B2 is a capsule of Magnesium. 500mg of it, to be exact.

Added to that daily list of fun things to swallow?

• 300 mg of Zonegran/Zonisamide (which is now finally generic, I suppose, for the price went down from $100 for a month's supply to about $40 at my local grocery store pharmacy)
• Omega-3 (fish oil)
• 20 mg Amitriptyline (Elavil), which I was on long ago, got off, and just recently re-started

I go to my massage therapist/cranial sacral therapist whenever I can afford it. Unfortunately, this hasn't been too frequent of late. For my last few appointments, she hasn't done much cranial sacral therapy because my visits have been right after a Migraine headache and she is unwilling to manipulate my cranium at all and possibly trigger another attack. (Thank you, wonderful woman.)

Of course exercise is always recommended, as long as I don't overexert or overheat myself and get a Migraine that way. I definitely don't get as much exercise as I should; this I know.

Minimizing exposure to triggers is something I've gotten quite deft at; managing stress is another lifelong issue I'll never master, but I am coping pretty well (for me).

So back to the subject of this entry. Back to the question that I am always faced with as soon as I tell my friends and family about my lifestyle changes, my new (or old) medications, that new trick I read about in a medical journal:

"So, is it working?"

I feel like I don't know what it is that's doing the trick--or not doing the trick--anymore. I have a so many elements in my life, so many chemicals running through my system. How am I to tell which one is the one that's working? Is it their complicated, complex relationship with one another that does the trick, at least most of the time? If I removed just one of the pills each day, would the whole system come grinding to a halt and leave me in pain, or would I feel even better than I do now?

I am not in a well-controlled scientific study. I cannot aptly determine which medication is the one that's working best for me. Part of me thinks that my body has gotten a bit better on its own over the years and that I could cut out all this expensive treatment and get just as many awful Migraines as I do now--and have just as many gloriously pain-free days as I do now.

But most of me is pretty sure the medication's helping. That I need the neurologist's words, reassurance, and comfort. That this disease is certainly way bigger than I and that I may never know what it is, exactly that's working--or how well it's working at all.

So my answer to family and friends remains the same. I don't know. I just don't know.
Were this a personal essay, one with sparks of humor and hints of charming self-deprecation, my answer would provide you with an amazing conclusion that would make sense of it all.

But it's just not the case here. I just don't know what's helping, and I'm too scared to take something away to find out if it hurts.