At my last neurology appointment, my doctor put me on a new migraine preventative, because the old one wasn’t quite getting the job done. It was reducing the incidence of medium and big ones, but it wasn’t getting rid of my everyday, low-grade headache. This new one was originally designed as a tricyclic antidepressant, which explains why my pharmacist was so suspicious of it when I was first prescribed it. (As soon as he realized it was for migraine, not depression, he was on board.) And, best of all, it worked! My daily headaches went away, and while I still got migraines, they were fewer and less painful. Excellent.

Except, as it turns out, the damn thing was giving me tachycardia. So I duly emailed my neuro, she asked me to back down my dose to see if a lower dose would eliminate the side effect, I did, it didn’t, I emailed again, and she told me to titrate it all the way down.

My brain is pissed. It really liked this drug, you see, and this drug got taken away from it. I think my body also takes longer than the average bear to adjust to things, so the standard two-week-per-dose taper was probably not quite enough.

As a result, I had 24 straight days of migraine with pain at a 3 or worse. I can’t take the emergency meds often — triptans can only be taken rarely lest they cause rebounds — and I was saving those for the days when the pain climbed up to a 5/6. Nothing else in my toolkit was doing anything at all. A 3 on the pain scale might not sound bad, and in relative terms it isn’t, but the sheer relentlessness of it just wore me down.

I finally emailed my neuro to ask what we could do while my brain calmed down and before my appointment next week, because I was running out of cope. She prescribed an NSAID that knocked it down to a 1. Today it climbed back up to a 2, but I’ve also got PMS, and my migraines tend to get a little worse with PMS.

I knew, all that time when it was a 3 or higher, just how much it was knocking out my ability to write, or really think, or have ideas, or do much of anything, but it’s astonishing how much of myself showed back up as soon as the pain was dialed back down. So often, with the chronic stuff, we just have to keep marching along, because we have no idea when things are going to improve and life goes on. But hot damn is it rough. All I wanted to do was to lie down and cry (except that would have made the migraine worse) and whine about how awful and unfair it was. Even now, when things are better, even if not all the way better, there’s a part of me that is really sad that the last four weeks of my life got so derailed.

All of which is to say, hi. I’m hoping we can keep the inflammation in my brain to a dull roar so I can return to writing and thinking, because there’s so much I want to say here. I just need the brain space to be able to say it.