The Florida Experience (Health News & Photos)

We thoroughly enjoyed our week in Florida.  

I always thought it was sort of corny that every Canadian on the east coast dreams of wintering there, but now it all makes sense. 

I never tired of this view (which never looked the same twice as the light changed):

I have a lot to report on the health front.  

I'm providing this mostly to help others, so don't feel compelled to read all this if you are not a headache sufferer!

The Sunshine Skyway Bridge 

(tall enough for ships to pass under and sorta scary to drive across)

If you recall, I went to see the famous Dr. Mark A. Piper, a world-renowned oral/maxillofacial surgeon who specializes in TMJ surgery.  He trained at Harvard as a dentist and Vanderbilt as a surgeon.  If you have any jaw problems (or bite issues or bruxism) and related head pain/discomfort, he is your man.

The session with Dr. Piper cost $1800 and the CT/MRI was $955.  I was in his office from 7:15 am to 3:30 pm and had a whole range of analyses done, as well as a long meeting with Dr. Piper and his assistant Julie to discuss my issues.  

Several other patients were in the clinic at the same time, so Dr. Piper and his assistants were in and out all day.  I had to leave the clinic for my CT and MRI, which took about an hour.  After that I was given 1/2 hour for lunch.

Palm trees outside Dr. Piper's office in downtown Saint Petersburg on a balmy February day.

Dr. Piper was thorough, kind, and patient (he took time to read my entire 4-page health history very carefully and asked me many questions).  He did not jump to conclusions and took a lot of time to listen, evaluate, and gather all the information he needed to help me understand what might be causing my headaches and in particular if it could be related to my jaw.

Palm trees at The Pier downtown.  This is Tampa Bay!

He took about an hour to review my MRI and CT scans and sat with David and I to review them.  He found that:

1.  I have some TMJ disease but not enough to warrant surgery.  My TMJ disks are not in perfect shape but they are both pretty good.  I was level 3a on his Piper TMJ classification system, which goes up to 5b.

2.  My TMJ disk may still be contributing to headaches, so he did some nerve blocks (marcaine injections) to see if they helped.  More on this later.

3.  I don't have a normal cervical spine!  C1 and C2 have anomalies which may be contributing to headache (cervicogenic origin).  He said I could see a specialized chiropractor who addresses this area but was not sure it would help as I have a bone spur on C2 that is really limiting my neck mobility.

4.  I don't have any other head pathology (e.g bone) and my sinuses are perfect (i.e. not sinus headache).

5. I do, however, have an enlarged pituitary, which needs to be addressed immediately (I am seeing my GP on Wednesday).  He said this may or may not be a pituitary tumor, and it can be contributing to the headache.  

Since I'm not experiencing really unusual non-headache symptoms, this may be a non-secreting tumor (doesn't affect hormones) but can cause serious issues if it  continues to grow.  It can press on the optic nerve and cause blindness or can bleed out and cause sudden very serious issues (like inability to maintain your blood pressure).  It needs to be evaluated and watched.  

(I will let you know.  As you can imagine, I'm a bit worried!)

6.  To deal with the bruxing (grinding/clenching), he prescribed a new medication Trazodone (which affects serotonin).  I'm supposed to take this in lieu of my current headache med (which is very sedating).  However, I took it the past two nights and laid awake until 4am the first night and 2am the second night before getting up and taking my usual med (which helps me sleep).  I will have to call Dr. Piper to see how to proceed as I can't take this and not sleep.  Sleep is a problem for me after being on sedating meds for many years.

7.  I need a thicker bite guard (splint) to wear at night. The thicker-than-normal splint prevents the jaw muscles from getting a good grinding position. I will just look like a hockey player at bedtime.

Our amazing beach (that's David).  There was no public access so it was lovely and peaceful!

Lastly, Dr. Piper did some nerve blocks in my head and neck.

Nerve blocks are injections of analgesic into nerves (and are a bit unpleasant as the needle goes in pretty far and can ZAP the nerve (oww!) and the needle stays in there and wiggles around).  AAHHH!

The first day he did 4 nerve blocks on the right side.  The first was in my neck, the second and third behind my ear, and the fourth in my right TMJ.  The reduction in my headache on the right side was about 30%, so not very significant.  That means the nerves and muscles in that area are not creating all the pain in my brain but are contributing some.

I came back the second day for one more nerve block, this time in the left TMJ.  He did two injections (very painful but brief!) and instantly my headache improved maybe 75%.  This suggests much of my headache is coming from the TMJ on that side.  I was shocked and amazed.  

Unfortunately, I had an adverse reaction to the injection (which can happen) and the left side of my face became totally paralyzed for 8h.  It looked like I had a stroke.  

My left eye would not close for 2h (really...it was WIDE open) as the motor muscles were paralyzed, so I had to either close both eyes (it would only stay shut if the other eye was also closed) or hold it manually shut when the other eye was open.  So we came straight back to the apartment and I went to bed until the motor function came back.  Ugh!  

But it was not too hard to lay in a quiet room with the ocean waves crashing on the beach outside.

So...

The good news is that the nerve block worked!  Although it has worn off, my headache has been a lot better since, maybe 4's and 5's instead of the usual daily grind of 8's and 9's and 10's.  He said that the nerve block can help to re-set the nerve and some people get relief for a long period of time.  I pray this is me!

I will repeat the various nerve blocks with my neurologist (I think a surgeon has to do them) to see if they work again.

This may give me a tool for controlling pain.

So the bad news is that there is no magic bullet to totally cure my headaches (like jaw surgery, as I was hoping), but I have more understanding of my head issues and the nerve blocks helped.  

Now, there is just this pituitary thing to fret about...

Critters sunning themselves...

Have a nice week and thanks for reading.  

I will resume my regular posts soon.

Stop the World

I have been meaning to write a blog by this title for some time. What that means is that I have been feeling overwhelmed for a long time. I'd like to stop the world long enough to hop off, do a long list of things, sleep for about 6 weeks straight, and then hop back on. Stop it turning and stop time flying long enough to catch up (whatever that means).

I know that "falling behind" is purely psychological and that whether I accomplish anything today is really irrelevant (perhaps only to my boss). But still, sometimes it seems to me like the world is going so fast that I can't keep up.

In the past month or so I've had terrible headaches, worse than normal, which has knocked the wind entirely out of my sails.

Two weeks ago, I started a new drug (for pain) called Nabilone (also known as Cesamet), which is a cannabinoid. Nabilone is a synthetic form of THC, which is the active compound in marijuana, and has been found to help with all sorts of things, mostly with the nausea and pain of chemotherapy.

For the first few days it just made me sleepy and relaxed and a little "out of it" at work, but when I increased the dosage last weekend, I felt definitively stoned, for lack of a more euphemistic term. I'm not sure if it's helping my headaches, but who cares! I want to sleep all day, eat the whole time I'm awake, and I feel great! In the last week, I think I've gained about 5 lbs from having the full-time munchies.

Seriously, it's a dirty drug with a side effect profile that isn't great. And my pain hasn't really subsided by any great measure. Anyone who experimented with "mary jane" in their 20's will recall the (a) spaciness and lack of focus (also called happiness) (b) the general relaxation (c) the pasty dry mouth (d) the slits-for-eyes (does anyone else find it bright in here?), (e) the sense of joyful well-being and (f) the insatiable hunger for junk food.

If I manage not to lose my job and gain 100 lbs in the next month, I think this drug will be a success.

A few weeks ago I started to feel seriously depressed, and luckily that seems to have passed thanks to lots of sunshine (after two weeks straight of rain) and, perhaps, my new drug. I think my deep psychological rut (which felt like an abyss only a week ago) was a combination of my depressing trip home, the exhaustion of chronic headaches, a third round of sinusitis, a serious bout of the flu, and some miscellaneous work and home stress.

I don't think I actually fantasized about killing myself, but I did think a time or two how nice it would be to drift into a nice, warm fuzzy sleep and never wake up again. Or what I should say is never wake up with another blistering headache and have to go to work again. Plus, six weeks straight of post-nasal drip and sinus congestion is enough to make you go postal.

That being said, of course I would never willingly "do myself in" but I was pretty close a couple of weeks ago to checking myself into a nice hospital for a total and complete nervous breakdown. I think this would be an effective way to Stop The World, as they say. Plus, how lovely would it be to have an IV bag of liquid valium and a friendly nurse to change my bed every day and volunteers to bring around books and magazines and ice cream on little carts?

Yes, the chronic psychological stress of headaches and family worries took its toll. I was totally lost and didn't know where to turn. So I cried and slept and didn't sleep and raged and wept and got up and went to work every day anyway.

Oh, and did I mention I am now officially fat? I am not sure when it becomes official, but let's just say that my little cute micro fat rolls I developed this winter - they now have their own little rolls of fat, making double rolls. Seriously, I probably weigh about 150 lbs which isn't obese and isn't the end of the world. But after years of working so hard to stay at my ideal weight, I am not happy with this extra 20-25 pounds. But I have zero energy or desire to take it off. Well, I have the desire, but I don't even know how to start modifying my diet. I was always so strict with myself and exercised religiously, and now that I have let it all go, I don't even know where to start.

I don't mind the way I look, really, but the social pressure is ridiculous. Everyone is so thin these days and the teenaged girls are positively skeletal. Buying stylish clothes is hard, even at this weight (hello thighs!). And don't even mention bathing suits to me. Sometimes those burqas (burkas) that Muslim women wear don't seem like a bad idea. Imagine not having to do your hair every goddamned day? No more ridiculously complicated and tight women's clothing! No more shopping for ridiculous shoes! No more worrying about stupid outfits! I would consider this a blessing at least 3 days a week. I love fashion, but I hate trying to be fashionable when most stores don't seem to want to dress my (now very) curvy hourglass figure. Fuck 'em. I'll just wear my burka today.

So anyway, that's my self-pitying essay.

In other news, and there is always other news as the world continues to turn, with or without me:
- We have a wonderful trip planned for September (two weeks!) that I'll tell you about soon.
- My young cousin Alex graduated from university with his education degree and so we're hosting a little grad party for him and his girlfriend Chelsea (who also graduated!) tomorrow night. I've ordered a Congratulations grad cake and we will barbeque buffalo burgers and have salads and enjoy our glorious back yard.
- We've done plenty of gardening in our yard and it looks lovely. This includes working on all the beds, planting new perennials and annuals, and lots of containers. Despite my bout of depression, I managed to get lots done in the garden! Spending money at garden centers is a wonderful cure for the blues. I will post photos soon.
- I've done virturally no decorating. I did temporarily hang lovely new silk curtains in the living room but still have to get the appropriate rods rigged up. I hate window hardware!
- I went to my dermatologist today and he removed two annoying little moles (right near my bra straps) that have been rubbing and annoying. He also prescribed a medication for my face - I've had no end of dermatitis since moving to Calgary - which he said will clear up my skin beautifully. Unfortunately the medication is Accutane, which is a horrid drug that is a teratogen and causes birth defects and dry mouth and prevents you from healing properly (causes scars if you need surgery, etc). It is a nasty evil drug. Luckily I do not plan to get pregnant soon. But still, do I want this toxic drug in my system? Would I rather live with a flaking dry peeling red face or liver damage? I'm not keen to take this drug, but he's prescribed a low dose for 2 months and will see me again. I'm torn, because my skin looks great one week and awful the next and I'm tired of its rebelliousness! I'm tired of zits and red rashes and itchness and rosacea. That's what I get for being a fair-skinned english rose, I guess.

Oh, and to top off this wonderful month, I fell down the stairs on Tuesday night! I bruised my tail bone and all the muscles in my hips and butt. I could barely walk before today. As I was going downstairs, I reached out to pet the cat (who was coming up!) and lost my balance and started to fall. Since I was wearing slippery gym sockettes on my feet and my Lululemon yoga pants (very slippery), this did not help with stopping. So I fell all the way to the bottom. I really thought I had a broken back when I landed. Let's just say, I've learned how to put on my socks without bending over this week. And I've also learned that when you cough or sneeze, your little tailbone wags just like a puppy! Ouch! Coughing kills my coccyx. Who knew?

So, after that shitty month, I'm happy to be alive (and still employed and able to barely fit into a few of my once-baggy clothes). And thanks to my new Mary Jane drug, I'm fairly happy.

I still wish I could stop the world long enough to get back in shape and do some of my summer projects, but the world doesn't work that way, sadly. So back on the horse for me until the next wipeout. High ho!