ICP Monitoring: What Happened, the Results, and What We are Doing Next

26th February 2012 By 4 Comments

I got home from the hospital on 22 February. This blog post is intended to explain what happened, the results (and what they mean), and what we are going to do next in dealing with my severe chronic headaches.

I have to assume that my readers do not know all the ins and outs of neurosurgical treatments and diagnostic tests, so I’ve tried to write this post in such a way as to be as clear as possible. When you are a neuro patient as long as I have been (my entire life), you get used to talking in different ways depending on who you’re talking with. I’m used to talking most frequently to doctors, so if what I say confuses you or is too technical, let me know and I can try and boil it down.

As always, please write to me if you have any more questions, or leave a comment at the bottom of the post.

The Recap:

I had elective intracranial pressure monitoring done from 17 February-22 February 2012, to rule out whether or not my shunt or hydrocephalus is responsible for my chronic severe daily headaches. We knew going into it that there was a possibility of the hydrocephalus or shunt being completely uninvolved in the headaches, and this test was the way to find that out.

In my case, there are two outcomes to this procedure:

1) It shows that there is something abnormal about my ICP, which could account for the headaches, in whole or in part.

2) It shows that my ICP is within normal range, and is therefore not a factor in what’s causing the headaches.

What we found out is the second point: my ICP is within normal ranges. 

ICP monitoring is not a treatment; it is a diagnostic test only. My headache levels and frequency remained the same in hospital as they have been for the past few years. We (DH and my other family members who are intimately familiar with my medical history) are not surprised by this because we were aware that ICP monitoring is not a treatment in the sense that it, by itself, would have any effect whatsoever on the headaches. So, at the end of it, we well expected me to be feeling pretty much the same (shitty) as I did before having the monitoring done.

 

What Happened:

I was hooked up to it for 48 hours initially (which is the standard amount of time for continuous monitoring), and when my neurosurgeon (“consultant” in UK English, and “attending” in American English) came in on Monday morning (21 February), he wanted me to have the monitor on for an additional 24 hours. At the time he said this, he didn’t explain things further, and I was happy to stay in for another day (though not ecstatic about it) because I was able to get him to explain why he wanted to extend my length of monitoring. He wanted more data: in a sense, he wanted a bigger sample size of the way my ICP behaves over time.

If you know anything about statistics like I do, having a larger sample size of the data you want to collect is, most of the time, a good thing. It means that the neurosurgeon has more information to work with. So, I could well appreciate the need for more data. My case is complicated, and the more information we have, the better the chances of understanding what is going on.

The Results: 

My ICP is in the range of normal. This means that it is not causing my headaches. They also checked everything else:

-I’m not overdraining, which means that
-The shunt is still tied off, as it should be
-My ventricles are a decent, normal size, and are not appearing to be slit ventricles
-There is no evidence that my hydrocephalus is “active”; that means that the ventricles are not enlarged
-There are no leaks of cerebrospinal fluid (CSF)

I asked the neurosurgeon registrar to explain how exactly they know that it’s not my ICP that is responsible.

If I had either low or high ICP, they would have seen a longer run in the data of numbers being closer together, during certain activities like sitting up, lying flat, coughing, straining, etc. For example, my pressure, if it were low, could remain at -1 for 6-8 hours. It didn;t show that. My data shows a mix of different numbers all over the map, but nothing that is particularly high enough or low enough, for a long enough time, to make them pin down the ICP as a cause.

What We are Doing Next:

The neurosurgeon has referred me to:

-Neurology unit, where presumably we will continue to investigate what kind of headaches these may be. I have also been referred to

-The pain unit.

For now, I’m under orders to stay on my current medications, which include sustained release morphine pills (maintenance), Tramadol and Gravol, with Diazepam for sleep (breakthrough medications).    However, since the hospital doesn’t dispense Tramadol, they gave me Oramorph for breakthrough pain while I was there.

Nurse: “Would you like some Oramorph?”

Me: “Hell yes!!!”

It worked much, much better than Tramadol for breakthrough pain, and so when I see my GP on Tuesday, we’ll be asking her to put me on Oramorph oral solution, instead of the Tramadol. For some reason, hospital staff are much less stingy than GPs with regard to prescribing opiates that have a chance of working.

...Or else it gets the hose again.

It tastes like crap, but Oramorph worked very well.

 

The State of the Union is that my headaches are exactly the same as they were before ICP monitoring. This is an expected scenario because by itself, monitoring doesn’t treat anything (unless it’s the type of patient who requires the CSF to be drained, and then they put in a special type of monitor which provides for draining off the excess CSF at the same time as monitoring the pressure). This is the type of ICP monitoring that my friend, Alexa, had.

The type of monitor I was on was the least-invasive type, did not require CSF to be drained, and they didn’t need to shave off any of my hair (for which I am grateful).

The reason we’re just in a waiting pattern right now is because a GP is not qualified to try out any migraine or other headache medications on me. That’s what neurologists are for. So, when I see the GP on Tuesday, they will not be permitted to change any of my medications except to replace my Tramadol with Oramorph.

"I'm sorry, but we are off the Bullshit Painkillers That Aren't Going to Work menu, now."

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Shit My Neurosurgeons Have Said: “Choke Yourself!” (NSFW)

15th February 2012 By Leave a Comment

I’ll be going into hospital this Friday to have Intracranial Pressure monitoring done. It’s scaring me, so I went on Facebook looking for hugs. Or giggles.

In a Facebook group for low ICP and CSF Leaks, someone started a humour thread:

“The things consultants said that made you laugh/speechless?”

I’ve got a few of those!

My Canadian neurosurgeon did a shunt tap and measured my intracranial pressure with a needle and manometer in 2007: “I don’t think I’ve ever heard you say, FUCK! before.”

Another one from my Canadian neurosurgeon, on asking me to perform a Valsalva maneuver: “Choke yourself!”

(Shades of Full Metal Jacket, anyone? NSFW.)

I looked at him like he was nuts, and asked if he was sure he wanted me to do that. He did indeed, but he actually meant, “press down on the jugular/carotid on both sides”: it temporarily relieves my symptoms, which suggests overdrainage.

Some really dumb people have asked if I’m an autoerotic asphyxiator, and of course I’m not. I don’t touch my windpipe, impede my breathing, or in any way derive sexual pleasure from this. It’s a simple Valsalva maneuver – that’s all.  People have sick minds.

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Commander Data to the Bridge, Please!

13th February 2012 By Leave a Comment

A public service announcement:

Beware, peeps: my severe pain, lack of good sleep, and meds (morphine, Tramadol, etc) can make me very blunt at times.

I’ve been kicked out of closed groups on FB and message boards even when I’ve explained the medicine, neurosurgery and neurology behind it many, many times. Like I said to a spoonie Facebook friend – some people just. Don’t. Get it. – especially if they have never had to deal with chronic pain. 

1) I have a big problem when people are being willfully, continually ignorant or stupid – about anything – and I have no problem telling them straight to their faces.

2) I can’t interpret sarcasm AT ALL, either. On the other hand, I have a quirky sense of humour and love giving hugs and cuddles, so hopefully that balances things out.

"I just...love scanning for life-forms!"

My DH calls me “Data”, after the Star Trek Next Generation character, because:

3) I really have a tough time interpreting emotions right now. 

I think a lot of the reason behind it is that sarcasm simply cannot be adequately communicated in a print-only format. So much of human emotion is conveyed by facial expression and tone of voice – and that’s something Facebook cannot provide.

4) I tend to ask people directly if they’re being sarcastic – it’s the only way I can know for sure.

We now return you to your regularly scheduled programming.

Sidenote: I’m composing lyrics based on the “Life Forms” song, set to the music of Andrew Lloyd Webber’s Music of the Night from The Phantom of the Opera. 

And I just have to include this. This post would not be complete without it.

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“Holocaust Memorial Day – Black Triangle” by BendyGirl

27th January 2012 By Leave a Comment

http://benefitscroungingscum.blogspot.com/2012/01/world-holocaust-memorial-day-black.html

Today, Holocaust Memorial Day, this article by BendyGirl highlights something very important for me: that disabled people were the first to be targeted by the Nazis. Her eloquence is superior to mine today, but I will try and give a brief summary, and you can click on the link above to read the article.

The “black triangle” mentioned in the title refers to the concentration camp badges that the Nazis designed. Disabled people and “asocials” wore it.

Different colours designated the prisoners in whatever way Hitler’s regime had marked them as “undesirable”. The large variety of different combinations and colours boggles the mind – a testament to the Nazis almost compulsive need to label everyone and to keep records of the atrocities they committed.

Yellow Star/Yellow Triangle: Jews – this is perhaps the most familiar one. The yellow star was created by superimposing one triangle over an inverted one.

Pink Triangle: Homosexuals – the movie Bent (with Clive Owen and Lothaire Bluteau) tells the story of a gay man’s ordeal at the hands of the Nazis, and of how he falls in love with another prisoner when he’s thrown into Dachau concentration camp. (“Bent” was a slang term for gay people.) He denies his sexuality by identifying himself as a Jew and wearing the yellow star instead of the pink triangle, believing it will make it possible that he might survive longer. Horst, the prisoner he falls in love with, wears his pink triangle with pride. The ending ripped my heart out.

Dachau is also one of the camps that had “the most elaborate system” of branding the prisoners with these labels.

Black Triangle: “Asocials” – this broad category included the disabled, lesbians, and the “work shy”.

If you were unlucky enough to be in more than one category, one triangle would be superimposed over another. More information about them can be found here.

Although today, the disabled are not forced to wear identification badges, we’re still singled out and cannot be invisible much of the time due to the nature of our individual disabilities. We’re immediately identifiable to the naked eye if we limp, use a cane or wheelchair. For those of us with “invisible disabilities”, it’s more difficult because we’re in some way expected to “prove” that we are disabled because there may not be readily identifiable characteristics to our disabilities.

I was at the doctor’s yesterday, and I was finally put on extended-release morphine for my severe, chronic headaches that are caused (probably) by low intracranial pressure secondary to hydrocephalus. I was very nauseated as I walked into the consultation room with my husband, and as we entered I told the doctor this because I wanted to know where I should throw up if I needed to: in the sink or in the garbage bin. I’d had a very severe headache for most of the morning that continued through the appointment.

After my husband’s appointment, I went next.

As I sat down next to her desk, the doctor’s first words were, “Well, you look healthy.”

Disabled people are not invisible even if you can’t see their pain.

Some days, I wish that I could be.

As BendyGirl ends her post, so will I:

To mark World Holocaust Day, please remember,

“First they came for the disabled people
And I did not speak out because I was not disabled.”

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A Proper Pain Scale – Update!

15th January 2012 By Leave a Comment

I’m seeing the doctor again tomorrow for another adjustment to my pain medications. The current ones (Topiramate, Imigran) are NOT working, and I’m on a waiting list – apparently a very long one, for intracranial pressure monitoring. Pain levels (intractable headaches) are far too high. Ideally they should be negligible, but since we don’t live in a perfect world, I’ll settle for “I’m not screaming two hours before I’m allowed to take the next dose of Gravol”.

I can handle pain that is below a 6/10 on my scale. My 6 is probably a non Spoonie’s [normal person's] 8.

I take Imigran whenever I damned well please, even though technically you’re only supposed to use it a few times a month. Sometimes it works, and sometimes it doesn’t.  They can kiss my tukhus. But luckily the doctors know I’m taking that much, because they refill it without a fuss.

Here’s the pain scale I use, written by Allie, over at Hyperbole and a Half (reprinted here): http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

“1:  I am completely unsure whether I am experiencing pain or itching or maybe I just have a bad taste in my mouth.

2:  I probably just need a Band Aid.

3:  This is distressing.  I don’t want this to be happening to me at all.

4:  My pain is not fucking around.

5:  Why is this happening to me??

6:  Ow.  Okay, my pain is super legit now.

7:  I see Jesus coming for me and I’m scared.

8:  I am experiencing a disturbing amount of pain.  I might actually be dying.  Please help.

9:  I am almost definitely dying.

10:  I am actively being mauled by a bear.

11: Blood is going to explode out of my face at any moment.

Too Serious For Numbers:  You probably have ebola.  It appears that you may also be suffering from Stigmata and/or pinkeye.”

 

How this applies to me: 

Below a 6 is basically nothing to me. I don’t take meds, and I just do my thing: knitting, posting online in Amazon, etc: ”Hey, I’m not wearing any pants. I didn’t know that about giraffes. I’m sorry your cat died; can we talk about something else?”

So, my 6: “Ow. Okay, my pain is super legit now.”

Is your 8: “I am experiencing a disturbing amount of pain. I might actually be dying. Please help.”

When I get to a 9 or higher (“I am actively being mauled by a bear.”), I lose the ability to talk, and just make vague sounds.

15 January 2012: I’m not leaving the office tomorrow without something, and mark my words – it will not be paracetamol or another migraine medication, because those won’t do beans.

16 January 2012: Idiot put me on Tegretol and insists on treating these as migraines. Refuses to explain why.

18 January 2012: Had to discontinue the Tegretol because it caused severe RLS. It didn’t do anything for the pain.

UPDATE! January 28, 2012

A different doctor at the practice finally relented, and, after an hour-long appointment of wrangling and discussion this past Thursday morning, put me on sustained-release morphine, plus instant-release Tramadol for breakthrough pain. Gravol for the nausea, and Diazepam so I have a better chance of getting some sleep (which also means DH gets a better chance of sleep).

[As I walk into the office on Thursday morning]: “I’m going to throw up. Where do I do it – the garbage bin or the sink?”

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Gravol is making me stutter (NSFW)

8th January 2012 By 3 Comments

I take Gravol, an anti-emetic, for pain relief. I have hydrocephalus, and the headaches I get are caused (probably partially) by low intracranial pressure (ICP) and slit ventricles. When my pain is very high (above a 7 on the pain scale), the only words that come out of my mouth are obscenities. Furthermore, one of the side effects of Gravol is extreme drowsiness and difficulty talking, including stuttering and holding my breath (particularly when I’m most sleepy).

Consequently, I have great empathy for this man.

The King’s F****** Speech

I have also had speech therapy, but it was not for stuttering. My voice is normally very high and soft to begin with, and this makes it more so. Having spastic cerebral palsy (CP) means my entire body is tense a lot of the time, and it follows from this that my shoulders, neck and throat are also tense; so go the muscles of the diaphragm.

People who don’t know me well sometimes tell me they have difficulty hearing me.  More than once, when speaking on the phone with a stranger, they ask if I have a cold or if I am crying. To them, my voice has a sniffly or nasal quality; to me, it sounds normal. I don’t really like talking on the phone because it makes me nervous, so odds are that makes it harder to speak.

There have also been times when patronizing condescending twats people think I’m much younger than I am, simply because of the sound quality of my speech and the spasticity of my limbs. I am over 25, and have more than once been mistaken for being, at best, younger than a teenager. and, at worst, a developmentally delayed 8-year-old. I am not the only person to have experienced this treatment. Wikipedia’s article on cerebral palsy has an entire separate section regarding misconceptions:

Spastic cerebral palsy, the most common form of CP, causes the muscles to be tense, rigid and movements are slow and difficult. This can be misinterpreted as cognitive delay due to difficulty of communication. Individuals with cerebral palsy can have learning difficulties, but sometimes it is the sheer magnitude of problems caused by the underlying brain injury that prevents the individual from expressing what cognitive abilities they do possess.

Disturbingly, this section’s source was taken from a website (which you can find in the reference section to the Wiki article) that lumps cerebral palsy (which is a constellation of symptoms) under the much larger general rubric of “developmental disabilities”. I don’t think that’s a good idea, or at all an accurate way to go about it. Having cerebral palsy does not guarantee the patient will have developmental disabilities, and hearkening back to what I said a few paragraphs back, the source of the Wikipedia reference needs to re-examine their findings. Assuming that patients with CP have a learning disability does a great disservice to those of us who do not. (Again, that’s another “first question” I’m asked – another example of a symptom linked in the public’s mind with cerebral palsy that is inaccurate.)

I’m not crying constantly.

I don’t have a cold.

I’m well over the age of eight.

I can wipe my own ass, and I cook my own food.

I’m married, and highly sexual. (Yep, disabled people HAVE SEX! And we love it!) 

I don’t have a developmental disability. My GPA was 3.89 in university before I had to start taking all of these fucking painkillers.

And for all these reasons, I’m not here to inspire you.

Should I assume that just because you live in Texas, you enjoy wearing large white cowboy hats and stomping around in giant leather boots? Of course not.

I eventually got so annoyed by having to explain these things (to people I didn’t know and would probably never meet more than once) that I started speech therapy in 2008.

Many of the exercises that Logue has Bertie (King George VI) practice in The King’s Speech were exercises that I did:

  • -Timing how long I could say vowels for while using a stopwatch (“Anyone who can shout vowels at an open window can learn to deliver a speech.”)
  • -Deep breathing with the diaphragm (“Up comes Her Royal Highness…and down c0mes Her Royal Highness…”)
  • -Loosening the jaws by making silly noises with them
  • -Stretching the shoulders and neck by rolling them forwards, around and backwards
  • -Practicing vowels (“Mmmmmmmother…fffornication!”)

Oh, come on!!!!

I hope you have enjoyed reading this bugger fuck shit post.

 

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What the fuck is going on medically with me (NSFW)

27th December 2011 By 1 Comment

 

I try not to rant in blog posts. I’m supposed to be mature as I enter my thirties, right?

The Seaspray shawl is slowly growing. Because I’m really sick now with what we suspect is shunt overdrainage (low intracranial pressure), there are very few days when I feel like knitting, so it’s coming along more slowly than I would like. I’ll get there.

 

 

 

 

 

 

 

 

 

 

 

I’m scheduled to have ICP monitoring done in January (date uncertain; I’m not holding my breath given the unreliability of callbacks from my neurosurgeon’s secretary), and I’m going to take the Seaspray Shawl and/or the Shivanaut Scarf to the hospital with me to work on them.

I’ve been picking the brains (ha-ha…) of people I know on Facebook who have had this procedure done because I’ve never had it, and they say it is not painful (the monitor is placed under either a general or a local anesthetic; I’ve been informed it will be done under general), but when it is in for 48 hours, it gets very boring, especially in the cases where the patient isn’t allowed to move around much. So, for sure I’m taking knitting to the hospital, and my Kindle as well.

If the ward allows it, I’ll take my laptop so I can watch movies on it. With luck, they may even let me have internet. When my friend Alexa (aleha ha-shalom) was in hospital and had ICP monitoring as part of her treatment, she had internet and updated it constantly.  Whether or not Internet is allowed on the ward depends on the hospital, the ward, and what’s going on in the ward; if wireless would interfere with any equipment (such as telemetry for epilepsy), then it’s probably not allowed. It would be particularly helpful to have Internet because Google Calendar is how I keep track of how much medication I take. However, my backup plan is to get a nice journal from Paperchase.

My pre-operative appointment is this Thursday, December 29, at the ungodly hour of 0815h. Can I persuade my husband to take us to McDonalds for ten cups of coffee or tea breakfast? If we don’t get a date for the surgery within 2 weeks after that, when we’re to phone my neurosurgeon’s nurse, arrive at their homes with torches and pitchforks and a lynch mob, and start bugging her.

Or I could just kill them. With an ax. In the face.

Every day I have severe headaches within 10 minutes of going vertical. The pain is never below a 7/10 on the pain scale. I take 6-8 Gravols a day to cope with it, which knock me out for 4-6 hours per dose. Topomax doesn’t work, because these are most likely not migraines. Raising the dosage of it would be pointless. Imigran, a migraine abortive, sometimes works, but more often than not doesn”t, and just leaves my hands numb and tingly. I’m not even supposed to take it because I have asthma. My GP gave it to me because she didn’t know what else to give me.

Sometimes, wanking works. Yep. I said it. You heard me loud and clear. Thank you, Easily Aroused. Endorphins relieve pain. I’d much rather use sex for pleasure, though. I do not enjoy thinking about sex this much. I think it should be reserved for special times, for pure enjoyment. My husband bought me a copy of EA’s book, “Five”, for Christmas this year, and being able to hold the book in my hands, rather than leaning over a computer screen, is so much easier for me. It has some of my favourite stories, that are no longer available on EA’s website.* Love and cuddles, darling DH.

Bureaucratically speaking:

I understand perfectly well that I am not an emergent patient, so this means that my procedure waiting time is going to be elongated.

That doesn’t make it easier to deal with.

My initial appointment with the neurosurgeon was on 27 September 2011. He scheduled an “urgent” CT scan. We waited, and made periodic phone calls to his office to inquire about when it would happen. Meanwhile, the headaches continued as described above.

The CT scan was performed on 21 October 2011.

After many phone calls and left messages on answerphones, we didn’t get the results letter until 24 November 2011, which stated that the ICP monitoring might, take place in January, with a pre-op appointment on 29 December.

The last excuse for taking a month to read my CT scan results was that the clinic was “waiting for my medical records to be transferred from one clinic to another”. I’m too well-bred to type out what that sounds like. The kindest, most restrained thing I can say about it it with might be ass-covering, excuse-making, incompetent, paperwork-losing bullshit “foot-dragging”. Nothing of this sort, at least not delays of this caliber, happened to me in Canada. Delays – yes, of course! Patients who are sicker take precedence. That is completely logical and completely understandable. I’m not vomiting because I’m taking enough Gravol to prevent that. I don’t want to go to the ER because I’ve done that lots of times and it never comes to anything useful.

But a month between action, or at least responses to inquiries? *clucks tongue* I’ve never had that happen before.

27 September2011 – Initial consultation and shunt series x-ray. Neurosurgeon ordered “urgent” head CT.

21 October 2011 – Head CT performed. Radiologist suggested that results should be in by a week or so. Phoned for them, and they were not.

24 November 2011 – Received results letter with plans for ICP monitoring, but no date set for surgery because we needed to confirm agreement, which we did. Eventually received letter setting up pre-op appointment for:

29 December 2011 – The pre-op appointment went fine. They took blood, BP, etc. We’ll start phoning the neurosurgeon’s secretary for a surgery date at the end of next week if we don’t hear anything by then.

__ January 2012 - TBA

 *EA (in a brilliant marketing decision) decided to make a little money off his genius. He still publishes new stories, which are excellent as ever. I hope he sticks around. I’ve also recently discovered a female counterpart, who is just as high-quality of a writer. You can read her at 

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Stents and Shunts

26th December 2011 By 1 Comment

Sometimes people have confused a shunt with a stent when talking to me about my hydrocephalus, probably because their experience of stents in the media or with loved ones is more frequent.

I have a cerebral shunt for hydrocephalus.

Prince Philip, the Duke of Edinburgh, has recently had a coronary stent implanted.

The functions and purposes of shunts and stents are quite different, and they are placed in different areas of the body.

 

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Rhys Morgan’s “Remission” – My Adaptation

28th November 2011 By 2 Comments

Rhys Morgan – The Welsh Boyo blogger famed for cracking down on Miracle Mineral Supplement (MMS) and other alternative medicine quackery, wrote this brilliant post about his remission from Crohn’s disease. I asked him if I could adapt it for my own chronic neurologic and neurosurgical stuff, and he gave the go-ahead. 

For the last time, before I get any more stupid comments suggesting some ridiculous quacky cure…

Unless you are a neurologist/neurosurgeon or some expert on migraines or hydrocephalus, I don’t care what cured your friend when you suggested it to them, I will not use your cure/treatment.

This includes:

  • Standing on my head – with or without my bum against a wall and my legs raised over my head (yes, someone has actually recommended that to me!) 
  • Herbs
  • Essential oils
  • Aromatherapy
  • Unproven treatments
  • Cutting out dairy (sugar, chocolate, coffee, tea, babies, red meat…)
  • Actually, cutting out anything from my diet

The main reason for this is because I’m on a treatment that is (sort of) working.

I am in remission. But my headaches cannot be cured. They’re not the kinds of headaches normal people get.

I like my milk. I like my food. They do not cause me any headache-y issues.

None. Nada. Zilch. Nothing.

Therefore, cutting them out of my diet would be pointlessly cruel to myself. I don’t need to cut them out, therefore I won’t.

A shunt for my hydrocephalus is not the same thing as a stent. Every time someone confuses these two things when asking questions about the shunt, and I have a headache that is a 7 out of 10 on the pain scale, it is very aggravating and tiring to have to explain the difference, again. I’ve provided an explanation of the difference between these two devices here.

I don’t go round trusting any ol’ person. If I want any serious advice on my hydrocephalus or treatments for it, I will go to my doctor. Not the internet.

Kthxbi.

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Hamlet Takes Medication

27th October 2011 By Leave a Comment

Oh, that this too, too brittled flesh would melt
Thaw and resolve itself into a dew,
Or that the Everlasting had not fixed
His canon ‘gainst self-medication. Oh God, God,
How weary, stale, flat and unprofitable

Seem to me all the ERs of this world
Fie on’t, fie, tis an unweeded garden
That grows to seed. Things rank and painful in nature
Possess it merely. That it should come to this:
But two months in pain, nay, not so much, not two,
So excellent a painkiller, that was to this
Gravol to a Tylenol, so soothing to my headache
That he might beteem the winds of heaven
Visit my forehead too roughly. Heaven and earth,
Must I remember? Why, he would hang on my eyes
As if increase of appetite had grown
By what it fed on: yet within a month -
Let me not think on’t; frailty, thy name is Advil
A little month, or ere those pills were old
With which I drugged myself,
Like Sleepy, all yawns, why he, even he -
Oh God, a pill that wants discourse of pain
Would have worked longer! – mixed with my Tylenol,
My Advil’s supplement, but no more like my Gravol
Than I to an athlete. Within a month,
Ere yet the salt of most pained tears
Had left the twitching in my pale face
Gravol increased. O, most wicked speed to post
With such dexterity to mixed medications!
It is not, nor it cannot come to relief.
But break my heart, for I must hold my tongue.

I wrote this in February, 2006.

 

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