Horrid day for a migraine. Could have been worse.

7 June 2008 at 22:41 (Accessibility, Migraine, OMG, Pain, Sleep)

Yesterday: it is very sunny, so bright the out of doors looks like over-exposed photos, all contrasty lights and darks and washed-out colors; even the trees were flickering masses of surface brilliancy against their internal heavy gloom. The previous night’s storms guaranteed humidity and muddy passage, and the tailwinds still rattle across the landscape, scratching the yet-unpruned peach tree branches against the outer wall of my bedroom. A few houses away, there is the repeated doppler roar of someone taking advantage of the clear skies to catch up on overdue mowing.

Cradled between layers of pillows, with the sheet and cotton quilt and heavy wool blanket pulled up to my ears, I lay stiffly. Mostly still asleep and not even close to the stage of stretching groggily or opening my eyes, my conscious awareness surfaces uncertainly through layers of internal sensory checks, transversing clouds of anxious, nonsensical dreams with endlessly repeating plot-less terrors.

For some reason I could not yet fathom, the usual morning physiological data-gathering was running very slowly, as though entire sections of my brain either could not communicate or were withholding information. At times like this, I am highly uneven, having some high cognitive functions but lacking other more basic ones. Pieces of random information drift by, sometimes contained in the phonemes of words that repeat like the short loop of an advertising jingle, but slide away without having been decoded for any meaning. I become briefly aware of just one or two sensory indicators of the outside world: water running through the sink downstairs, or the crackling of a cat’s jaw as it yawns so wide the ears fold backwards.

The mental sticky-notes I told myself at bedtime flutter by intermittently, “I need to get up early to take the bags of brush down to the curb before the truck comes by,” and “I still need to do a prelab and upload it before 11:59 pm,” and “I need to finish that cover letter for the job app,” and “The cable repair person may be here at 8:00 am,” and “I need to drive my daughter back to her college town.” Things to do, people to be, and most of all, irrevocable externally-imposed deadlines to meet. The bad part is, were this a Saturday, this could be much worse.

Slowly the information collects, like tiles of satellite photos that must reach critical mass for the terrain to be understood. One points out that I did yard work yesterday, several short jaunts out to pull weeds from the vegetable patch and to bag the pile of brush. This means I will be achier today, and the stiffness will require me to move about more carefully for a few hours. I should not plan on doing any heavy work today.

But I don’t yet stretch to test my joints, as the recalcitrant parts of my brain yield the messages previously withheld: my head hurts, a pain so large it has expanded beyond my brain case to my eyes, my ears, my nose, my jaw … somatically I feel like an embryo that is mostly giant head and bulgy eye buds, primitive heart throbbing all the way from not-quite gills to the tip of the tail. The analogy is more than apt; I want to retreat to someplace womblike, to a time before any serious neural development. The world is too bright, too noisy, too heavy with gravity, too full of responsibilities, too full of wracking pain, and it is no wonder newborns cry out with their first gulps of air.

An urgent report from the digestive system bursts into the command office: my stomach is zigging whilst the pipes south are zagging. A complaint for attention from the bladder and kidneys is shelved, and the verbal miao of annoyance from the cat curled by me is likewise ignored as I rummage up enough nervous commands to curl up my knees and squash a pillow against my abdomen. Usually the pressure is enough to reduce the distress below the barfing threshold.

Thresholds are everything. I’m running an understaffed mental command center with half the bridge crew incapacitated, and the messages don’t arrive with any consistency, either never getting in, or haltingly reaching their destinations, and overloads on the pain processors keep clogging up the communication and motor control systems. Every small action I manage to perform physically is directed towards reducing some sensory input to a less intolerable level.

This is a helluva day to have a severe migraine. In addition to the inescapable deadlines, the sensory overload is cranked up with subwoofers. The mega-wattage sunlight slices through the gap along the edge where the window shade wasn’t straightened out. Barefoot hubby is thudding down the stairs hard enough to rattle doorknobs, opening and closing and absurd number of kitchen cabinet doors, and slurping breakfast so loud I can hear it upstairs at the other end of the house. He never realises how loud he is when he doesn’t have his hearing aids on. It doesn’t matter anyway, because everything sounds multiply louder than real life; even the crackle of turning pages is unbearable.

Oh please-please-please don’t let the phone ring. This is so horrifying a concept that all of my energies are directed to pulling together information buried in different files: job functions says there is a phone in my bedroom; spatial memory reports that it is on the bedside table; proprioceptive memory claims that I could potentially reach it, but proprioception says a lot of things that are not entirely accurate. I don’t even know where on the bed I am relative to the bedside table.

Having acertained all that, I lose conscious processing for an undefined time period while trapped in an inside-out whirlpool of psychedelic fractals that are trying to shred me into a mince of scrambled brains. (That’s the poetic version; the real version was more like the being-torn-apart pain during latter end of L&D, trying to push an oversized baby through the birth canal, and the obstetrician urging push-push-push while the irresistible force fights the immovable object until I am seeing stars for needing to inhale again.)

This latest spasm ebbs by, and some unidentified household noise skewers through to my consciousness. Eventually I remember that I was going to do something dreadfully important, but am left with naught but gnawing need and no memory of what. An alarm clock on someone’s mobile phone sounds, and I grasp the intent again: unplug the damn land-line phone near my head. Sensor check; which side am I lying on? Left. That means my other arm is free. Quick, master the motor control …

There is no quick. I muddle through steps most people are not aware of: the abstract idea of moving my arm, of visualising moving my arm, of finding the sensations of the covers and pyjama sleeve to help locate my arm, of adducting and abducting and rotating bones and muscles and tendons and joints and ligaments, omigod every hair in my skin hurts as it brushes something ping-ping-ping, struggling with tangles of bedding, I want to get my arm free, I don’t want to pull the covers off my head.

Where the hell is the table? Grope, grope, augh I’m wracked with chills (the air conditioning is set to 75°F, now intolerable), oops spatial memory forgot the update about the half-dozen books stacked on the table. I manage to knock books and phone to the floor. Not good enough; don’t want to listen to automated recording telling me the line is open. Must unplug something. Emergency data request is made to job functions; I pant with distress until the delayed reply says to unplug the line from the wall into the back of the phone. Crap, you know what that means: open one eye, just a little– !!!!! — just a little, try again, found it. Squinch out plug. Drop phone. Retreat under covers.

Another pause. It’s not a break. All that has worn me out, and the stretching is making my innerds lurch and gurgle. (The only saving grace is that having had the hysterectomy, there are no more cysts and endometriosis gripping me in knots.) I am curled under the covers, contemplating my navel with an intensity that Zen masters disdain, but all severe pain sufferers well know.

More ebbs out to the uncharted depths, punctuated by waves that throw me briefly onto the beach of consciousness. I may be able do small things that help when I am aware, but mostly I am just aware, and “awareness” is for public service campaigns, not hours-long episodes of head-splitting pain.

Worse, I recall that I have deadlines. Things to do, people to be, and most of all, irrevocable externally-imposed deadlines to meet. I need to ask hubby to curb the bags of brush, and to wake the kid to hold vigil for the cable repair person. I need to take some medication, the sooner the better, but it’s packaged by some masochist who sees fit to preserve tiny pills under two layers of cardstock and heavy foil, plus I need water as my tongue has glued itself to the high arch of my palate.

But first I have to get hubby’s attention. Croaking his name yields no results; he still hasn’t put on his hearing aids, and is in another room or floor of the house anyway. Eventually I’m inspired to fumble for my mobile phone (used as bedside clock while it recharges nightly) and call him. This also yields no result as his phone was likewise parked, silently blinking. At some point he wanders by while I’m vaguely cognisant, and I flap a hand at him. Through much communicative confusion, he finds my meds on the bedside table, I manage to swallow from a glass of water without spilling it on the bed, and lastly, he finally understands my reminders about the trash and waking the kid. Hours later I stumble and crash about, groping my way to the bathroom a mere six feet from the bedroom door, to soak in a hot bath.

The good news is that things improved enough for me to complete and submit the necessary classwork. At least it was a Friday migraine, instead of a Saturday migraine. I had thought that an online class would be more accessible, and it mostly is, aside from the labs. The instructor had posted in the syllabus that either being late for lab or missing the lab would result in being immediately dropped from class. (Seems draconian to me, but I’m not making up the rules.) Although I understand the rationale for encouraging attendance in the intense and brief period for a summer laboratory course, I am not sure that the possibility of legitimate absences was fully considered.

I would not want to see my entire summer’s scholastic effort go to waste due to unavoidable circumstances, such as one of these migraines. I got a note from my doctor and made accommodation arrangements with the uni’s disability access service department, which means that should I be too ill to attend, I will not be dropped. But as the professor pointed out, the Saturday labs for this class are equivalent to four labs in the other classes, two from the previous week, and two from the week ahead. Naturally, I cannot make up a couple labs ahead of time in the advent of an unexpected illness.

Unfortunately, the deadline to change classes was Wednesday, and a couple of the labs that I would have needed to have done had already passed. So I’m stuck with this class. If I’m too sick to attend, I won’t be dropped, but I will only be able to make up half of the points for the lab by attending two lab sessions with another class during the following week. This is when the “Rule of the B’s” applies; it doesn’t matter if I feel like “death warmed over” — if I’m not actually bleeding, barfing, blacked out, burning up with fever, or have a broken bone, I had better be there.

Crap.