Distress Data Diary

Dear Diary,

Wait a minute, this is a migraine diary; useful and important, but not such a “dear” topic.

Dear Diary,

Today I had another migraine.  The symptoms included:

As mentioned, I’m putting together a diary of migraine details for an upcoming appointment with a specialist. The other week I had one so bad that my son had to take me to my GP for a Toradol injection, to be taken with a fresh dose of Imitrex — “fresh” in both meanings, because earlier I had taken my last and slightly-expired pill.  I’d planned on asking the pharmacist to order a refill, but of course, had been unable to go into work at the grocery!  (The irony.)

“Have you made an appointment with a neurologist?” asked my doc.

“Headache speshlist; don’ remember whom.”  I held my wallet in front of my nose and squinched one eye open a millimeter to pull out the correct business card.

“Oh good, that’s just the person I wanted you to see.  Takes forever to get an appointment, though.”

“In April,” I mumbled.

“Yeup; takes forever.  Okay, I’ll have the nurse come in with the injection, and I’m writing you a ‘script for some more Imitrex.”

” ‘Ank-you.”

When I do get to see this new specialist, I want to be armed with a good data set so we can maximise the efficacy of our first appointment.  But to do that, I had to figure out what kinds of data would be needed.  This in turn meant researching the various types of headaches, migraines, and symptoms.  I got to learn lots of great new words!

If the headache is bilateral (both sides of the head), then it’s a regular tension-type headache.  I’ve had some intractable ones that linger for a couple-three days, despite various medications.

Unilateral headaches (just one side of the head) are the migraine sort.

There are the icepick migraines that feel like someone just stabbed you in the head.  Although intense, they are mercifully brief — just a minute, though there can be several repeats throughout the day.

Migraines can be temporally divided into three stages:  the prodrome or early-warning symptoms, the migraine itself, and the postdromal after-effects.  If I wake up with a migraine, then I don’t have the benefit of prodromal symptoms to alert me to take some medication and stave off the worst effects.  However, one of the benefits to keeping data sheets is the ability to suss out what sorts of symptoms are prodromal, so I can have better self-awareness.

A persistent tension headache can turn into a migraine (ugh).  Eating much wheat also seems to be a trigger for me; a small cooky isn’t bad, but a couple slices of pizza will do me in later (not to mention digestive hoo-hahs as the gluten works through my kishkas).  Barometric pressure drops — especially those that bounce back up from a swiftly-passing storm — are notorious for making my ears and head hurt.

The cognitive and mood factors can be less obviously related to migraine prodrome: brain fog, depressive state, insomnia, or light sensitivity.  You might think these would be pretty obvious, but the problem with chronic pain (from hypermobility+osteoarthritis+TMJ, especially combined with 11-13 hour work days) is that one gets into those viscous circles of pain-sleep problems-depressive states.  Throw in everyday hyperacussis and UV-sensitivity, and sometimes it’s hard to sort out what is which.  “Ain’t we got fun.”

Once I started researching various migraine symptoms, I had a much better means of both identifying and describing the various symptoms I experience.

One thing that quickly became apparent was that like snowflakes, no two migraines were precisely the same.  This is interesting from an objective point of view, but it also means that I have to spend a bit of effort to verbally identify the symptoms I experience during each migraine, and then shortly thereafter note them.  Although a cognitive task that I cannot always perform throughout the entirety of the experience, it does afford me the opportunity to detach part of my consciousness to that objective state, which gives me one step of remove from the intensity of the experience.  (My research background is useful in so many ways.)

An Aura can include visual disturbances such as:
Scintillating scotoma the classic flickering/shimmering/sparkling arc, zig-zag or castle crenelation effect;
Drifting phosphenes phosphenes are “stars” you see if you stand up too quickly or sneeze; phosphenes can also refer to the geometric patterns that happen when you press on your closed eyes;
Diplopia just the fancy word for double vision;
Oscillopsia when objects appear to oscillate, vibrate or bounce;
Photophobia “the light, augh! too bright!”
Allodynia pain from nothing in particular, or something that wouldn’t normally cause pain, “augh the sheet’s touching my arm!”;
Osmophobia “the smells, augh! too overpowering!”
Olfactory hallucinations smelling things that aren’t really there;
Phonophobia when even the clattering of dust particles falling is too loud;
Hyperacussis I startle overmuch at sudden or sharp noises — well, even more so than usual;
Auditory hallucinations hearing things that aren’t there, nor are related to my tinnitus;
Synæsthesia Feeling sounds, and other odd cross-sensory effects;
Paresthesias tingling or numb feeling like “pins and needles”, or like someone is yanking on my kneecaps or tendons;
Vertigo, nausea, vomiting, chills or clamminess;
Ataxia a “lack of order” or bad muscle coordination;
Disarthria / aphasia disarthria is trouble speaking clearly, and aphasia is problems with speaking and understanding, or making sense of reading things.

Once all that is over, there is the postdrome, or “migraine hangover”. I’ve no idea how one compares to a drinking hangover — I’ve never drunk that much! But it is something like having the flu: weakness, generalized muscle aches, laterality confusion (right v left), fine-motor difficulties, exhaustion, lack of appetite, intense thirst, intermittent strabismus (wandering eye), temporary dyslexia / reading comprehension, auditory processing lags, concentration problems, or once in a while, feeling energetic — “wow, I’m no longer in pain!”

Then of course, the was the issue of creating a useful data sheet, one that was both complete and easily used — and this is where my dual backgrounds in behavioral research and typography+layout blend well.

As with any sort of biological data, it is important to note the frequency, intensity and duration.  In addition to those classic factors, there are also the sorts of factors that one more often considers in ecology: the type, season (if any – only a data set of more than a year can determine that), and the extent, in this case, the extent of the disability that results from migraines.

I’m sorted the pain and disablement into three levels:
1 annoying pain, workable
2 moderate pain, reduced work
3 severe pain, incapacitating.

With the diary, I can then sort out the frequency, intensity and duration of the issues. So far I’m relizing that it’s much more of a problem than I had realized. It’s not so much that one gets used to pain, but that one gets used to being in pain, to headaches as a way of life.

Damn, but April’s a long ways off.

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Bird of Prey

baby bib made from starry sky print calico, with Klingon Bird of Prey ship outline embroidered in green floss

Uncloaked!

Pureed pea and carrot torpedos fired, the ship is more visible!

Naturally, I love chemicals!

This is a continuation on my previous post, “Attention, grocery shoppers!”

So the other night my daughter was complaining of her ingrown toenail that’s been bothering her for the past month.

“Why don’t you soak your foot in Epsom Salts?” I suggested.

“What’s that?” she asked.

“See that blue milk carton atop the fridge?” (That’s where we keep our first-aid/pharmacopeia.)  “It’s magnesium sulfate*.  Bath salts. It’ll help draw out the inflammation and such.”

“Salt?!” She winced

“Mineral salt, not sodium chloride table salt,” I added, while refraining from explaining about ionic bonds.  Her hubby the medic prepared her a foot soak and explained that magnesium sulfate is a natural mineral salt that’s mined and used for all sorts of things.

While she soothed her cold, sore feet in warm water, I had a mental chuckle over “natural chemical”.  To many people, the two words are antonyms — and very distant opposites at that.  As I’ve said before, a “chemical” is simply a substance with a defined composition.  Minerals are chemicals.  So are sugar, water, caffeine, theobromine (mn chocolate), baking soda (sodium bicarbonate), all the ingredients in your can of soda, and so on.

Natural means that something is found in nature, with or without some processing.  Apple juice and olive oil are natural because they squeeze the bejeezus out of those fruits.  (Botanically, fruits are the parts of the plants with the seeds inside; olives and tomatoes are vegetables insofar as cookery and taxation are concerned.)  Vanilla extract is a natural flavor because vanilla beans are used.  Other natural flavors use plant and animal products.

Artificial, which is what many people really mean by the word “chemical”, means a substance produced synthetically.  In my organic chemistry lab, we made (minute) quantities of isopentyl acetate, which most of us are familiar with as artificial banana flavor used in candies or instant puddings. Imitation banana flavor is obviously pretty fake!  But imitation wintergreen is not so readily identifiable, nor is it dissimilar from naturally-distilled wintergreen essence, aside from the fact that the natural distillation will have additional “impurities” that add more depth to the flavor.

The divisions between natural and artificial are fairly straight-forward.  But the definitions of “organic” aren’t!  That’s because we have different meanings for the word organic in different contexts.

Once Upon A Time, O Best Beloved, there was just chemistry, that field of natural philosophy that the scientific method dragged out of the abyss of alchemy.  Organic materials were those which came from natural sources, and were deemed special and beyond the production of the laboratory; they were somehow still deemed to have a “vital force”.  However, in the early 19th century, urea (yes, the stuff of urine) was artificially synthesized, thus dispelling that last thread of medievalism.

Nowadays, organic chemistry occupies itself with materials composed of hydrocarbons, that is, molecules with both Carbon and Hydrogen atoms.  So instead of natural materials, there are a lot of well, unnatural materials involved, such as plastics, drugs, fertilizers, house paints … ordinary everyday stuff, most of which we wouldn’t want to live without.

In addition to the chemistry definition of organic, we have a couple of other usages.  When I’m teaching about composting, we use the term organic in its original sense of “from something living”.  If it used to be alive, you can compost it and create lovely humus (although fatty things will smell, so we leave meats & dairy items out).

Organic gardening and farming is yet another story.  Synthetic fertilizers and pesticides cannot be used, and transgenic plants are most always frowned upon as well.  (I have mixed feelings about transgenics; not about the processes, which are simply more specific means of breeding, but about other economic and agro-ecological issues.)

Unfortunately, the history of organic growing is fraught with heavy doses of woo, including planting by moon-signs, astrology, companion planting, and whatnot.  Fortunately, the professional realm has abandoned these, because professional growers have a lot of energy, money, time and effort invested (and of course, documentation work, because nothing officially exists without documentation).  They can’t afford to waste time on nonsense.  Unfortunately for the gardening end, lots of this woo still propagates through the vacuum of teh interwebs.

Last on my list of definitions is the oft-misapplied sense that anything “natural” or “organic” must therefore be safe.  This is bullshit.  There are lots of natural poisons!

Conversely, artificial does not automatically mean dangerous. For example we’ve been using synthetic acetylsalicylic acid (commonly known as aspirin) for decades, instead of the salicylic acid derived from willow bark that was painful to swallow and digest.  The name salicylic acid comes from the genus Salix, in reference to the willow. (Interestingly, wintergreen flavoring can be made from … aspirin!)

There are many organic materials that can be derived both naturally or artificially, and the molecules have no magical memory about where they came from previously.  A nitrate is a nitrate is a plant fertilizer, and a pan’s a pan for all that.

Now if you’ll excuse me, I’m off to nom on some banana Laffy Taffy.

* Technically magnesium sulfate heptahydrate, for chemists and those who actually care — you know who you are.