Tag Archives: medication

Brain Fog & the Blahs.

So the post title might sound like an unappealing band, but that’s the state of things at the moment, I’m afraid. Nothing big and horrible, just a whole bunch of small irritations and disappointments compounding to make me feel generally – ugh.

I applied for a job, which was huge for me; I’ve been talking myself out of it for so long that summoning the courage to actually apply took a lot. I sorted referees (terrifying! I hate asking people to vouch for me), bought interview-appropriate clothes (I’ve lost 16kg and all my tailored stuff now looks ridiculous) and updated my resume (a.k.a. engaged in a brief exercise of ‘let’s look at all the ways in which I have failed’). I didn’t hear back, so I’ve been doom-and-glooming about that, even though I rationally know that at least now I’m prepared for the next thing that comes along. I also was recommended for a position a friend is vacating, and was assured that I wouldn’t need to interview or anything, I’d just get it, and haven’t heard back about that either. I feel like, hey, you don’t even know how crap I am yet! Och well.

I’ve just switched to the slow-release of oxycodone, after being on fast-release for a couple of years. The latter worked well, but makes me hyperactive, so at night-time I’d have to choose between sleeping in the next three hours or pain relief. It also wore off too quickly to get by with one dose during uni days when out for several hours at a time, and the facial-but-especially-my-nose itching which has been a constant side-effect for me had worsened to the point of being unbearable lately.

So, I asked for slow-release, and on all those counts it is better – but the pain relief is less effective. And pain relief is kind of the most important thing when it comes to pain medication, right? I’ve been waking through the night feeling like the muscles in my back around my facet joint are burning (new and exciting pain symptoms, yay!), and my gait is worse because I can’t force my leg through the swing as I take a step in the way I need to. And because I am eternally terrified of seeming like a junkie, I will have to put up with it for a month until this script runs out.

Worse, I’m going on a date with my partner tonight, and have been looking forward to it, and now sitting through dinner and a movie is looming, horrible and insurmountable. I am determined not to (for the umpteenth time) get halfway through dinner and have to go home because my back hurts, but I also get really surly and curt when I have to work through pain. Not the best setting for an enjoyable romantic evening.

And last but most importantly for me, oh god the brain fog. It’s been particularly malicious for the past week or so. I’m trying to finalise a research proposal and rewrite then incorporate some theoretical content into a literature review, both of which are fairly highly demanding cognitive tasks (at least for me). My usual coping method during particularly bad bouts is to put the hard stuff on hold and do mindless busywork tasks, but my deadlines are looming and it needs to get done. It’s like mentally walking through very deep mud trying to have ordinary conversations (I felt like the world’s biggest moron in my last supervisor meeting), let alone produce fluent academic writing. It’s massively frustrating to be sitting there, knowing I know the perfect word to describe a complex concept and yet not for the life of me being able to retrieve it.

So, after all that whining, in an attempt to be constructive; help! How do you manage brain fog when you have to work through it? Any strategies that might help? I’m open to anything!

Link Round-Up.

Happy Easter to those celebrating, and happy long weekend to everyone else!

I decided to ignore my normal no dairy, grains, or soy rules for Easter and just eat what I wanted. It was delicious, but I feel pretty disgusting now; fatigued and moody with a pretty distressed digestive system. In a way, I think it’s good for me to fall off the wagon every so often, because it reaffirms how much better I feel normally, and that what I am usually doing is the right thing for my body.

So in case anyone else is in a chocolate-induced cloud of bleurgh, here are some distractions!

A piece from Laurie Edwards on the differences in medication efficacy between genders, the higher incidence of women with chronic pain, and the impact of these issues on equitable treatment. I know I post a lot of links on gender disparity in chronic pain, but it’s an issue that keeps popping up in my dissertation research and one I’m passionately interested in.

If you are one of the lucky ladies (or gents!) on steroids for autoimmune disease, you’re likely dealing with a whole host of sucky side effects. This article has some suggestions for how to combat one of them – dry skin.

Michelle at Living with Bob wrote this wonderful post on dealing with the all-too-frequent criticisms that seem to permeate the lives of individuals living with health issues. How many times have we all heard, “You just need to x, y, and z! You’re not trying hard enough!”? I think the perspective shift she discusses is essential.

Amanda at Celiac and Allergy Adventures has some great ideas for identifying and coping with social situations in which food allergies or intolerances may be an issue. I don’t handle gluten, dairy, or soy well, but tend to feel uncomfortable requesting special accommodations, so I usually just don’t eat or eat it anyway and then leave suddenly when I make myself sick. I know this is ridiculous and I’m working on being assertive!

A chronic pain topic I think is incredibly important and not talked about enough; Tracy from Oh What a Pain in the… discusses some difficulties and potential solutions around having sex when you have chronic pain. A friend who did a multidisciplinary pain treatment had a fellow classmate come up to her and quietly ask her if she had any difficulties in this area. This poor lady was suffering and didn’t feel like she could discuss it with her doctors or bring it up openly in class even though it was severely affecting her marriage and quality of life. This breaks my heart. Sex is important to our health and we should talk about it!

Is there anything you’ve written or come across that you think I should know about? Let me know!

In, On, Move: A Wellness Series.

At the start of the year, I made some resolutions, which I’ve managed to maintain reasonably successfully. The core aims I had were to care for my body and try and minimise the strain on it by being mindful of what I put in my body to nourish it, and what I put on my body in terms of personal care. I also wanted to focus on moving my body when I am able in a way that celebrates the function and strengths my body has, rather than beating myself up because I can’t do things ‘right’, or as punishment for unhealthy eating, or purely to burn calories for aesthetic reasons.

I realise these things probably sound like no-brainers, but it took me a long time to start being kind to my body post-chronic pain and illness. I fought my limitations, berated my body for its weakness, and restricted food and pushed it to exercise in ways that made me unhappy because I was trying to mould it into something it wasn’t. My mental shift has been gradual, and I still have lapses, but I feel like I’m in a much better place than I’ve ever been before in appreciating my body and prioritising my health and wellbeing.

Wellbeing is a huge part of my approach to living with chronic pain and illness. The goal of a lot of current chronic pain management programs, when they can’t cure the source of pain, is to maximise wellbeing, or physical and mental health, even in the presence of illness and pain. My goal is to be as well as I can be given my circumstances, and the resolutions were my way of prioritising that.

Because I’m nosy, and I like hearing about what others do in their pursuit of health, and also because I use this blog to keep myself accountable for continuing to try and implement positive change, I wanted to start sharing some things I’m trying and enjoying in terms of food (in); beauty, personal care, and cleaning products (on); and ways of moving my body (move, obviously).

As with absolutely everything on this blog (and elsewhere on the internet!) these are suggestions. I like recommending what I’ve found helpful, but people vary! You may not have the same issues I have, and you may not approach things the same way I do, and that’s fine. If, however, you see something you think would be helpful for you, please, please, make sure with your health providers that it is safe for you to do, with your particular set of circumstances. Especially in the case of movement, one size does not fit all where sick people are concerned!

In: Having been in a particularly chocolate-craving frame of mind lately, I decided to give making my own chocolate a go. I don’t tolerate dairy, and soy also leaves my digestive system disgruntled, so since cutting those out of my diet store-bought chocolate is pretty hard to come by. I’ve had some luck with organic, raw varieties like Pana and Loving Earth, but they get expensive! I tried this recipe, which was quick, easy, and delicious. I used maple syrup as the sweetener and added in sultanas and crushed cashews to make a Cadbury Fruit and Nut imitation (apparently I am the only person alive who enjoys it!), but the potential varieties are endless. Tastes amazing, and no tummy dramas = bliss.

On: My skin has been struggling this week. My dermatitis seems to be getting worse and worse, and I’ve tried a variety of creams and serums which seemed promising for a day or two, and then exacerbated the problem. I also had a couple of giant, sore pimples, courtesy of having a couple of higher-dose oxycodone days.

My go-to emergency mask is just two parts organic raw honey to one part baking soda. I add in some oats if I’m particularly itchy. I just put the ingredients in a bowl, mix them with a finger, and then goop it on to a dry face (and in this case, chest and arms). Be warned, this can be messy, so do it over the sink. Leave it on for 10 – 30 mins (I like to have a bath in this interim so I’m not dripping honey everywhere), them add some warm water to your hands, work it in to exfoliate with the baking soda a little, and wipe off with a warm washcloth. Use a cotton ball dipped in half-and-half apple cider vinegar and distilled water as a toner afterward if you feel like going full hippie (by the time I followed up with my usualy moisturiser I no longer smelled like a bizarre salad, in case you were wondering).

I have crazily sensitive skin and this doesn’t bother me, but if you’re concerned, either patch test or use less baking soda to begin with. The honey is antimicrobial and helps with infections. I find this leaves my skin smooth, settles the flakes for a day or so (I tend to use it the day before I have somewhere nice to be), and takes the redness and swelling out of spots. Plus, I get a childlike glee out of smearing food all over my face. Just me?

Move: I have been all about yoga this year. I’m noticing distinct differences in my muscle strength with brief daily practice that fill me with glee, and most importantly, they can be done in the privacy of my lounge room, which means I can fearlessly wear a sports bra and shorts, and also do my routine directly in front of an air con vent. Key considerations to getting through a Western Australian summer! (Useless fact: the highest temp in my state this summer was 49 degrees Celcius, which is 120 degrees Farenheit. I can’t even.)

I’ve been mixing up back, neck, and shoulder routines from Ekhart Yoga on Youtube, with this and this being current favourites. She often outlines accommodations if you can’t manage a pose, but generally speaking hatha, yin, and restorative yoga are helpful for people with pain or injury. Several of these poses and stretches have been recommended for me by my physiotherapist, so they suit my issues, but be careful to find something that suits yours if you’re interested.

I’d love to hear what you do to keep yourself well and get some new ideas (like I said, nosy).

The Patient.

While being fully aware of the beneficial effect of a positive and optimistic mindset on pain management, I am also a firm believer in the therapeutic value of validating experience. So in the interests of being honest and accepting about what I am feeling: I feel awful.

My 16-hour excursion just over a week ago (public transport, a lecture, errands, a meeting, a car trip, more public transport, and several hours at a crowded music festival alternating between standing and sitting on the ground) precipitated a massive system shutdown. Which I expected, but I didn’t think it would be this severe. I realise I probably deserve it for going so overboard, and I think it was worth it, and I realise when you can’t cure chronic pain you have to find ways to live your life anyway. But ugh. So awful.

I managed to avoid drinking at the festival, but ingested a lot of refined sugar and somehow inadvertently some gluten (don’t ask me how I know!), which potentially have made this worse. I also got sunburned at uni yesterday, so I’m headachey and extra-fatigued on top of already being bone-weary, nauseous, and brain-foggy.

I don’t have the energy to prepare meals, or to make myself eat them, so I’m eating one meal a day. I don’t have the energy for yoga so my stress and muscle tension are worse, and the gains I had been making in flexibility are diminishing. I’m behind in my reading because my brain won’t work and I’m exhausted, so by the time I get into bed I’m too stressed to sleep. Then I end up double-dosing my sleeping medication, waking up med-hungover and late, and wasting half the day gearing up enough to do basic tasks (don’t ask if I’ve showered today). I’ve had to go back up to my prescribed painkiller dose, which I had been reducing successfully, which makes me stupid while it’s working and exhausted once it’s over.

The cycle is frustrating and predictable, but feels unavoidable. I feel stuck.

There are things that are incredibly difficult for me and yet helpful, like being kind to myself and asking for help when I need it. Sometimes I get the vague suspicion that these things are what chronic pain is in my life to teach me. The lessons are hard. But in the interests of doing them, I’m asking.

What do you do at times like these, when you are at a loss and nothing is helping? How do you pick yourself up again?

I’ll start, and I will implement these tonight (or may the gods of internet accountability smite me!), even if it means getting further behind on chores and uni work, because if I am not well, none of those things get done anyway.

I will eat a healthy dinner even if I am tired, because my body needs fuel to function.

I will have a warm bath with Epsom salts, while watching an episode of something cheerful and trashy.

I will do 20 minutes of yoga (I like this one at the moment) and I won’t skip through the meditations because I’m too busy.

I will listen to this and remember to be patient and wait it out.

I will get into bed and have a cup of passionflower tea.

I will turn off the light by 10:30.

I will breathe deeply.

I will trust that this too shall pass.

Your turn. I would love to hear your suggestions.

Fun Facts.

[I want to preface this by saying that I am not currently mentally prepared to engage in a discussion regarding the ethics of inducing pain in animals to advance scientific knowledge. However, given this study has already been done, I think sharing and learning from its findings are a way of making animals’ suffering not be for nothing. As with all things, you are free to respectfully disagree.]

So, we know social factors influence pain experience. And you guys, I just found out mice with pain who are allowed to hang out with their sibling mice experience greater pain relief from narcotics. Adorable. Go hug a mouse. Or your family. (If you have a mouse as a family member, you win at pain relief!)

And if you don’t trust mice, women given electric shocks while holding their spouse’s hand found the pain less unpleasant (as compared to women holding a stranger’s hand, or no hand), as it reduced the perceived threat of the pain. Takeaway lesson for the day: if you can have your family or a loved one present during a painful treatment or intervention, do it!

References:

Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: Social regulation of the neural response to threat. Psychological Science, 17(12), 1032-1039. doi:10.1111/j.1467-9280.2006.01832.x

D’Amato, F. R. (1998). Kin interaction enhances morphine analgesia in male mice. Behavioural Pharmacology, 9(4), 369-373. doi:10.1097/00008877-199807000-00009

Pain Management as a Human Right.

I just came across a quote that resonated so strongly with me that I wanted to share it. For anyone else who has ever been junkie-shamed (as I call it; humiliated and belittled for use of or desire for prescription narcotic pain medication), as I have, or believes, as I do (and as an emerging body of research supports), that adequate pain management is a right of all individuals, regardless of the potential for opiate addiction.

The quote is from Margaret Somerville, a medical ethicist.

“To leave a person in avoidable pain and suffering should be regarded as a serious breach of fundamental human rights [and] can be regarded not only as unethical, but also as negligence … It also should be treated as unprofessional conduct; that is, it should constitute a basis for disciplinary action by the relevant professional licensing body.”

The article citing the quote, for anyone interested in reading further, is: MacDonald, J. E. (2008). Anti-oppressive practices with chronic pain sufferers. Social Work in Health Care, 47(2), 135-156. doi:10.1080/00981380801970285

I hope your pain is adequately managed today.

Stealing Beauty.

This post is going to be vain and self-indulgent, but I’m putting it out there anyway in case any of you can relate.

I hate what my illness has done to my body. Not in the reduced function and pain (although that sucks too), but to my appearance.

So much of our identity and how others perceive and therefore treat us is constructed from the way we physically present ourselves. I’ve been looking at research into healthcare professionals forming judgements based on their beliefs and attitudes about pain and pain patients, and how that reflects their practice (hint: it does, and often not in good ways). It has been said that it is hard work presenting as a credible pain patient, and that this is particularly difficult for women. We are faced with the dilemma of having to appear ‘sick’ enough to warrant treatment, while still not looking like we’ve ‘let ourselves go’ (because that might mean we’re depressed, and that might mean the pain is all in our heads). I’ve actually had a (male) general practitioner tell me I would feel better if I put more effort into my appearance. My mother, while seeing a (male) lawyer regarding a motor vehicle accident (she was in a full leg cast at the time), was told “she was made up so she couldn’t be that bad”. We can’t win.

But truthfully, that isn’t all of it. It’s not even the visible illness markers, like my cane, or a walker, or my surgical scar (which I am oddly proud of and wish I had the chance to show off more often). These things are interpreted by the general public as signifiers of specific problems, which, while still a bit embarrassing at times, are associated with legitimacy and sympathy, and a sense that it’s not your fault.

The things I find humiliating, and that I get furious about, are the little, silent things about my appearance, that others don’t attribute to my illness. My frizzy hair, the result of autoimmune hair loss and my body’s feeble attempt to slowly regrow the lost hairs. The thin patches in my hair from the same. The ironic extra hair on my extremities caused by my body’s lack of capacity to regulate temperature, and the excessive sweating caused by the same. My frequent inability to deal with this hair because sitting at a salon or bending to shave my legs is physically difficult. My red, blotchy, flaky skin, courtesy of the autoimmune rash and dermatitis that has now spread over my face, chest, back, and upper arms, and which does not consistently respond to anything. The numerous unexplained small bruises I’ve been experiencing since I got sick. The white toes and purple feet and legs of Raynaud’s phenomenon. The two or three kilograms of bloating that can follow consumption of any dairy or grains and make my clothes immediately ill-fitting and awkward. My hunched, limping gait on days when I am stiff and sore but not bad enough for a walking aid. My need for appropriate (and usually un-fancy) footwear to negotiate walking and stairs when I can’t feel my leg.

Then there are the physical indicators courtesy of pain and pain medication that I fear get read as ‘junkie’; shaking, sweating, a face full of pimples, scratching at my ever-itchy nose, and dilated pupils, accompanied by rushed speech and trouble concentrating.

Pain and sickness are ugly on me. I hate that people who don’t know I’m sick might interpret these things as laziness, or a lack of awareness. I hate that it takes me twice as long to look half as decent. I hate the expensive and often ineffectual hunt for beauty products I can use without disrupting the ever-so-delicate ecosystem of my body, and that the products I do find often don’t work as well. I hate that this illness is stealing what should be my ‘pretty years’, when I’m at a good weight for me, and I’ve grown out of youthful awkwardness, and society still wants to look at me. I hate that the social phobia I conquered as a teenager is re-emerging, based on all these fears and insecurities. I hate that it’s vain and self-absorbed to talk about these things, even in the midst of a society that teaches women that their value is based on their appearance.

Most days, I can get over these things. I can square my shoulders and head out feeling ugly and self-conscious. But today I can’t, and that’s okay. I’ll try again tomorrow.