Hi everyone! One of the blessings of San Jose moving to a COVID “Orange Zone” is that Kaiser has resumed many of its non-emergency medical treatments. This past Wednesday, Mom was my chauffeur for a migraine appointment, which reminded me of the first time I visited that particular neurology office last fall:
“Injections? Like, head injections?”
“Yes, in the head. Of course.” My new neurologist was rustling through a stack of brochures in the metal file cabinet by his computer. “Usually we try other things first, but right now you have migraine thirty out of thirty days. You only need migraine fifteen out of thirty days to qualify.” He finally found the sheet he was looking for and passed it to me. “You can read more about treatment here, maybe send me a message and let me know what you want.”
“So you’re saying these shots are the best recommendation you have?” Ivan looked skeptical.
“Like I said, you can read more at home. But they’re very safe. Very effective. I would give to my wife.”
I caught Ivan’s eye and nodded vigorously. Or as vigorously as I could. At that point I’d had a continuous migraine for eighty-four days. We’d just been transferred back to Kaiser from my time at the Stanford neuroscience center, and were hoping that a fresh set of eyes could tackle the migraine-half of what had morphed into seizure-migraine disorder. My attempt at signaling I wanted the injections must not have worked, because Ivan immediately began hedging.
“Yeah, I think we’ll talk about it at home and get back to you. Thanks for the brochure and all, but head injections might be a tall order.”
“I don’t need to talk about it!” I burst out. “I’ve been dying for at least two months now. I mean, I don’t want shots in my head, but I’ll take them if you think it will make this stop.”
The doctor hesitated for a moment, then opted to follow my lead. “You are the patient. We will schedule it as follow-up since my assistant needs time to get the injections ready. We will see you in two, maybe three days, then start treatment.”
“Wonderful! I – “
“I do need to tell you these do not work the same on everybody. Some patients feel better immediately. Some it takes two, maybe three rounds to see results. Some it does not work at all. But this is what we must try.”
“Rounds?” Suddenly the injections didn’t sound quite as appealing.
“Yes, rounds. We give injections every three months. If you do not see results after third round, then we stop.”
“Um…that just seems like a lot.” I couldn’t imagine nine more months of a continuous migraine. “I mean, how often do they not work?”
“With a case as difficult as you, I cannot say. Most patients do not have migraine thirty out of thirty days. But it’s better to see the glass half-full, yes?”
“Well – yes. Yes, I guess you’re right.” The doctor couldn’t have known, but that was the secular version of what I’d been blogging for the past three years. When had I stopped thinking like that? Was it just the hour of sitting under glaring fluorescent lights with a migraine? Or had I given up earlier?
Ivan must have sensed my inner distress. “Well, since Grace is sure she wants to go through with it, let’s go ahead and schedule. I’m off work since it’s the summer, so we can come as soon as you’re ready.”
Head injections. The brochure described all the marvelous benefits (and “extremely uncommon” side effects) of the treatment but somehow failed to mention the number or exact location of said injections. I didn’t find the lack of specificity too concerning, however. I’d had many more uncomfortable procedures than the average person my age, and figured this couldn’t be any worse than those. Most likely it would be easier. “Injections” probably meant two – no more than three – shots.
Something seemed wrong when the nurse called me back to the examination room, however. “Don’t you want your husband to come with you?” She looked concerned.
“You don’t have to worry about me.” I laughed. “I’m used to lots of needles.”
“I think he should come with you.” This was the first time a nurse had ever overridden a positive self-assessment, so I gave up and gestured for Ivan to follow us. A little moral support would be nice, even if it seemed like overkill for a couple of shots. But things only got stranger once I slid onto the exam table.
“Does ice sound good? Or numbing gel?”
“We could also do both.”
“I’m not really sure I need – ”
“Trust me. You want at least one.”
I willed my migraine brain to think, but it was moving in slow motion as usual. All I knew was that I’d never been offered painkiller for any kind of injection. “It’s just shots, right?”
“Why don’t we go with the gel. We can always do ice later if you change your mind. Oh, and here’s a hair tie. Do you mind pinning your hair up? Like, way up, so Doctor can see your neck.” Doctor can see your neck. Something was absolutely wrong here. I thought about asking what she’d meant but decided I’d rather enjoy a final few minutes of ignorance.
My neurologist shuffled into the room right after the nurse finished rubbing gel across much more of my forehead than I liked to consider. He dispensed with any attempt at small talk and immediately gestured to Ivan. “You want to hold her hand?” Neurologists were some of the less emotional specialists I’ve experienced, so this unnerved me more than the numbing gel incident.
“Umm…sure.” Ivan was caught off guard as much as I was. “Tell me where to go so I won’t be in your way.” The doctor indicated the left side of the table, then asked me to take off my glasses and lay down. I didn’t bother explaining that I wouldn’t be able to feel Ivan holding that hand. At this point all I wanted was to skip to the end of an appointment that had begun resembling a frustration dream.
And then the injections started. One. Two. Three. I made it! Except the needle kept going. Four…Five…Six…I realized the doctor was asking Ivan (and me) all sorts of idiotic questions: Ivan’s job, my school, where we lived, why we moved to San Jose. Looking back, it was probably some sort of distraction technique. It didn’t work. I was very aware of the needle going in and out of the left side of my forehead and temple, sketching the exact perimeter of the migraine. Then he switched to the right side. “Just in case,” he explained. Finally he asked me to sit up, but just as I was about to stand he cleared his throat. “Can I see your neck?”
“But I don’t have any pain in my neck.”
“You see the migraines, for some patients they come from the neck.” I sighed and lowered my head so he could reach the back of my neck, then began counting from where I’d left off. Fourteen…Fifteen…Sixteen…Sixteen. So that’s why no one told me how many injections I was going to get. No one in their right mind would agree to do that. Well, maybe someone who’d had a migraine for eighty-seven days. I don’t really remember how we left the office. All I remember is wanting to get home as fast as I could, praying that those shots kicked in immediately, and vowing never to go through that again if they didn’t.
They didn’t. But my neurologist did convince me try the second round – and the third – before I called it a lost cause. Perhaps I agreed because there wasn’t anything to try after that, perhaps because his straightforward manner made him more appealing than my previous neurologists, or because perhaps I was just biased. He’d taught at SUNY Syracuse before moving to California and happened to be rather familiar with Eastman, which is where I studied violin in early college. That original round of injections took place last August, followed by the second round in December, and the third round this past March. The third round actually fell on my twenty-seventh birthday (which I did not tell the doctor), and we finally saw some measurable results a couple of weeks later. After a year of regular treatment, I still have way more migraines than most people, but enjoy a few days each month without one.
Having a doctor say my own “message” back to me might stick with me even longer than the shock of getting sixteen shots when I’d bargained for two. God helped me build my post-accident life on the principle that He uses even the worse experiences for His glory, and somehow I’d lost sight of that. I’d lost sight of that so much that someone who (to my knowledge) doesn’t even know God thought I needed help looking on the bright side. We all go through seasons that seem hopeless, and we all experience seasons of grief and loneliness. But my prayer is that we’ll fix our eyes on the truth that these don’t last forever, and that God has a purpose – and has set an end point – for each one.