I wake up; the pounding in my head forces me to. I drag my sandy eyelids up and try to focus on the clock. 4:45 a.m. My mouth tastes like dirty socks and my stomach wants to heave. I make myself sit up and the room reels. The telltale rush of saliva into my dry mouth warns me that I don’t have much time. When the room stops moving I put my legs over the side of the bed. Somehow I’m vertical and staggering toward the bathroom.
I keep the shots of Imitrex ready to go. Finding the injector in the dark is not a problem. The container is on the bottom shelf of the bathroom cabinet, right where it’s supposed to be. My fingers fumble and pry up the lid on one of the twin ampules. The only reason I can do this now is years of practice. When my doctor first gave me the shots I was slower. The novelty meant I sometimes couldn’t prime the injection device properly and a spray of precious triptan would shoot across the room instead of into my flesh. When the headaches are really bad, sometimes that still happens. Migraines steal fine motor coordination. Gross motor skills are pretty much out the window, too, but it’s the fine motor I need now. And the dismay of seeing an injection that costs over a hundred dollars wasted into thin air has no equal. This morning I manage to load the syringe and press it to my flesh. My thumb hits the button on the end of the device and I can’t help but hiss as the sting of the medication hits my intramuscular tissue. It takes a couple of tries, but I manage to cram the injector into its holder and prime it for the next shot. Then I stagger a couple of steps to the sink.
Surely I will feel better if I get those nasty gym socks off my teeth. My hands tremble as I load my toothbrush. Applying toothpaste to my toothbrush takes extra time and effort. It’s hard. I turn the water on and wet the brush, then bring it to my objecting mouth. No sensation is good, because every sensation is amplified with a migraine. The sharp taste of minty-fresh explodes in my mouth and I rinse the brush again. I just want to peel off the cotton that coats my mouth, not breathe on anyone. I don’t want to sanitize myself yet. I just need to get rid of the grimness of first waking up.
Afterward, I grip the sink with both hands. The Imitrex still isn’t working, and even the slightest head movement is agony. Maybe if I lean here for a moment the drug will kick in. But not yet. The jack hammer in my skull subsides with stillness. When I think I can bear it, I move tentatively toward the toilet. Whether or not I really need to go, I need to sit down, and, at a distance of twenty feet, my bed is too far away. I miss the three-foot-tall stacked cube shelf that I used to have in my bathroom. I could sit on the toilet, pull it close, and rest on it, my head lying on my folded arms. Sometimes I would drift into unconsciousness that way and my husband would call to me, asking me if I was all right. If I had assumed that position, I was never all right. Now, though, the shelf lives at his house and the twelve-inch distance to the tiled wall is to far to lean, no matter how good the cold tiles might feel on my skin. I sway as I sit there.
My eyes are closed. I lose track of the minutes. I beg the drug to start working. I wait for the sensation at the back of my neck that signals its effectiveness. Nothing happens.
Eventually, I think I can make it back to bed. The nausea is a reminder that the meds aren’t working, and I know that on my way I need to get the Phenergan. Dr. Archer has prescribed it in a cream. Philip at the Drug Store compounds it and puts one dose into a syringe without a needle. A plastic cap at the tip of the syringe keeps the cream from drying out. It’s hard to get those caps off. I dread the effort, but I know it is necessary. If I start throwing up, I won’t stop. Vomiting with a migraine doesn’t make anything better.
I stand before the door of the medicine cabinet again, reach into the Ziplock bag that contains the Phenergan cream syringes, pull out a syringe, and start wrestling with the cap. Not only do I lose coordination with migraines, I lose strength. It takes me more than a minute to pry the cap off. With a grateful sigh I push the plunger and spread the cool cream on my wrists. I aim the syringe at the trash can and let it go. Of course I miss. I’ll pick it up later. Now it’s time to stagger back to bed and hope that the combination of drugs will stave off the nausea.
Too late, I forget that I have a bead of blood on my skin from the Imitrex injection. I know I smear the sheets with red as I lie down. I hope it has dried and I can brush off the crumbs of blood easily. I washed and changed the sheets just yesterday, using strong spot remover on the blood stains from last week’s migraines. They never seem to come out completely unless I use bleach. I care, but not enough to do anything but pull myself into a fetal position. My pillow is too hard. There’s nothing I can do about it except keep very, very still. My body is covered in a sheen of sweat from the nausea. I don’t want under covers yet. Warmth amplifies the pain. When the Phenergan kicks in, the sweat turns clammy, then evaporates, leaving a salty residue. Once my skin is dry, I find the coolest spot on the smooth sheets. I tug the top sheet over me, and a few minutes later pull up the quilt, too. The Imitrex still isn’t working. I am grateful for Phenergan’s fortunate side effect of drowsiness. I lie there, waiting for the Imitrex, and waiting for sleep.
Sleep evidently came. I am wake again. It’s 7:40 now, and the Imitrex has only dented the migraine pain. The nausea is mercifully gone, but even though every shift of my head doesn’t bring waves of agony, a full-blown migraine still actively assaults my head. I try to sleep again, lying still and letting my mind drift hypnotically. It’s no use. I’m awake and alert, pain and all.
I can dose myself with Imitrex again. After two hours, if I don’t have relief I can take one of the tablets. I carefully leave my bed and make for the bathroom. The blackout curtains in my bedroom don’t close completely, and the shaft of daylight stabs my eyes as I pass through it. I need a ladder to reattach the last drapery hook to the rod. Not now, though. I can barely walk steadily. Climbing a ladder is out of the question.
Imitrex’s packaging is intended to be impossible to open. Insurance only pays for nine pills a month, and they come in paper and foil-backed blister packs. Normally I take all the pills out of the blister packs and transfer them to a pill case as soon as I get home from the pharmacy. Stupidly, I neglected to do so this time. It’s a new box of pills, and I fumble even to tear away the box top to get at the blister pack. I still have no fine motor coordination, and tearing away the paper and foil backing is beyond me. Finally I stab the back of the pack with tweezers to get it open. The pill breaks as I extract it. It will leave a horrible taste in my mouth because of that. I swallow it anyway, and take a long drink of water to wash away as much of the residue as I can. Now for the other weapon in my migraine arsenal.
Hydrocodone. I hate it. I love it. I hoard it. Dr. Archer allows me twenty pills a month, but I rarely use them all. It scares me. The last thing I need is an opiate addiction. My tolerance to it is high. For all I know, I’m already addicted. I don’t know. What I do know is that hydrocodone is an extra lifeline for when the triptans don’t work. Today, I need it. Maybe I can go back to sleep. It will be an hour before either it or the Imitrex tablet will take effect. I shake the fat tablet into my palm and wash it down with water. I go back to bed.
I doze, but I don’t go back to sleep completely. After an hour, there is no change. I am tired of my bed. The cats have been anxiously head-butting the door and crying. They’re hungry. Their water dish is probably empty, too. I debate taking another hydrocodone tablet, but decide to wait. I want to see how the effort of climbing the stairs affects me, and if I take one now it will make me itch. Of course, I can always take Benedryl with it. The antihistamine will help with the itching and make me drowsy again. No, I’ll wait.
I should have taken the second pill. In my kitchen, I sink onto a stool at the breakfast bar and lay by head on my arms. The cool granite of the counter feels wonderful. The pounding in my skull does not. When it subsides, I reach for the bottle of hydrocodone I keep on my lazy Susan. The cats are sitting next to their empty food bowls, expectant. “Just a minute, guys,” I whisper. I run water into a dirty glass sitting in the sink and swallow the pill. I stand at the sink for a moment, waiting for the pounding to start again because of the movement. Thankfully, it does not.
The cats’ food dishes are on the floor. I squat slowly, not wanting to bend or even tilt my head for fear that blood will rush into it and the throbbing will begin again in earnest. I nearly lose my balance, but I’ve thought to hold the edge of the counter to ease myself down, so I have a lifeline. I’m shaky as I rise. The three steps to the bin of cat food in the pantry go well. I scoop food into one of the bowls. No wet food this morning, kitties. Sorry. I can’t bend over to get the can, and the smell of it would destroy me. I can smell the litter box across the room, and I know it needs attention, too. There’s no way. Not now. Not yet. Please understand and don’t do your business in the house plants, I beg them silently.
I sit on the stool again to recover from this round of activity. I need to eat something. Lack of food will only make things worse in the long run. I keep coffee in the fridge. Caffeine sometimes helps, sometimes hurts. As bad as this headache is, I decide to give it a try. Iced coffee with a bit of hazelnut-flavored sweetener and a dollop of milk. It isn’t as sweet as Starbucks, but then nothing really needs to be. My sister says those sweet coffee drinks from Starbucks are “a candy bar in a cup.” She’s not far wrong. I sit and drink. It tastes good. I feel stronger after sustenance. I mix myself another iced coffee, and munch on a few strawberries. The carbs will give me strength and energy.
It’s 8:25 now. I move to my computer, which sits in an alcove off the kitchen. I bring my coffee with me. I can sit relatively still, reading blogs and news, and wait for the hydrocodone to do its magic. Eventually, the itching starts. I keep a back scratcher next to the computer because my perpetually dry skin always itches. Itching from too much opioid is not satisfied as easily. I read. I sit. When I get up to forage for more food, my head reminds me that I need to stay still. I return to my computer chair with a small chunk of Havarti cheese and rice crackers.
A little after eleven, my phone rings. It’s Jan, wanting to go to The Full Monty at the Weekend Theater. She’s not sure we can get tickets. Tonight is the last night. Even though I tell her I am not up for it, she is determined to go. She will have to drive in from Hot Springs, so if the show is sold out then she’ll have a wasted trip and an hour’s drive home. I turn down the volume on the phone, because the conversation is unnaturally loud. I tell her I’m not feeling well, but that she is welcome to come by if she can’t get a ticket. I hope the show is not sold out. I hope she can go. I realize I need to go back to my bed. We hang up, and I take a deep, slow breath to steady myself. The phone call has brought back the raging throb.
I get a glass of ice water before descending the stairs to my bedroom again. I climb into bed. The sheets are smooth and cool, and I think again that I need to rehang that drapery hook so the curtains close completely. The shaft of midday sun coming through the opening stabs my eyes. My head hurts too much for me to turn my back to the windows. Besides, the light bounces off the wall; it doesn’t really go away if my back is to it. I close my eyes and hope for sleep.
I haven’t yet started to doze when I hear the garage door open. Jack is home. Lora is with him. They’re going to hang out in the basement. He brings me an icepack. I’m glad he’s come home, because I can really use that icepack. I drape it over my forehead, pressing its ends to my temples. The kids go to the basement. They know to be quiet when I have a migraine. Poor Jack. His whole life, his mother has been sick. Sometimes, she’s sicker. Like today. He has told me that by the time he was eight, he could read the labels on my meds and even spell hydrocodone. I don’t doubt it. I sent him to get them from the cabinet often enough.
I doze, and finally I sleep. It’s almost 5:00. The migraine has receded to the back of my brain. It’s still there, but right now it’s not attacking me. It doesn’t hurt. I go upstairs again. If I don’t eat a meal, I’ll suffer for it. I need protein, vegetables. I make a sandwich and chew it slowly. I don’t really want it. I’m not hungry. The consequences of not eating will be worse than forcing myself to eat now. I sit at the kitchen counter and read a magazine while I take unenthusiastic bites. I hear the kids come upstairs. They’re leaving. They chat cheerfully. Their good moods and the sandwich have combined to lift me up. Lora tells me she’s reading The Princess Bride, and I am delighted. It has been my favorite book since I was sixteen. I refused for years to see the movie, because I was so afraid that Hollywood would ruin it. I shouldn’t have worried. William Goldman wrote the screenplay for his own great book, so everything was as it should have been. Miracle Max and Valerie. Fezzik and Inigo Montoya. The Man in Black. Buttercup. Prince Humperdink. The Six-Fingered Count. Talking about it with Lora, I feel animated for the first time today.
The kids leave and I return to the computer. I need to sit still. If Jan comes tonight, I need to be functional. I’m functional now, but I don’t know how long it will last. I start writing this blog post. I feel myself tiring, but Jan calls at 7:30 to say she could not get a ticket to the play. For the last hour I have been checking the clock, wondering if she will call. About fifteen minutes ago I had decided that she must have gotten in, or I would have heard from her. “No, no, it’s fine,” I tell her. “Come on by.” I go downstairs to get the skirts I need to alter for my niece’s school uniform. They are hand-me-downs from her sister, who is shaped differently. As Jan and I visit, I rip out the hems. By 9:30, she says she’s tired and is going to get back on the road. I’m glad, because I’m fading, too. The headache isn’t back, but it’s skulking in the recesses of my skull, waiting to strike. And all those meds exhaust me. I’m happy to have seen Jan, though.
After Jan leaves, I rip the hem out of the last skirt, and I head downstairs with a fresh glass of ice water.
I read a little in Sacré Bleu, the newest book by Christopher Moore. I’ve had it since its greatly anticipated release, and I keep getting distracted from it. I love Chris Moore’s books. I wish I had his wild imagination. I want to keep reading, but my brain won’t let me. I’m too tired.
Another day sacrificed to migraine. Another day, gone.