As I drove the 25 miles north to Mercy Pain Management today, I took shaky deep breaths and did some positive self-talking, feeling like my heart was going to pound out of my chest. I repeated in my head “I will NOT freak out. I WILL not freak out. I WILL NOT FREAK OUT.” I put the Frozen soundtrack on even though the girls weren’t in the car, and belted out “Let It Go” with abandon. “I’m never going back / The past is in the PAAAAAAAASSST…”
I concentrated on the serendipity of the appointment falling on July 1, the first day past Migraine Awareness Month, when so many of us are feeling rejuvenated and ready to keep fighting. I thought about the name of the clinic, “Mercy.” Though it indicates the Catholic system of care in our area, it also just sounds kind and loving. Mercy. And the receptionist who was so nice on the phone, and was able to get me an appointment in just one week, though they had told Dr S they were booking into late July. And, she’d explained, they called the physician there “Dr Mitzi” to distinguish her from her husband, who also practices there in anesthesiology. Dr. Mitzi. I mean, how cute is that?
When I arrived, I saw that the office was basically a storefront, but it didn’t look shady like the last pain clinic. I got out of my car with my pink bag of prescriptions and some paperwork I brought just in case, showing I’d been approved for Disability, had taken a chronic pain class, and currently see a pain therapist. I had my “I am a super hero” water bottle, knowing I was going to have to pee in a cup. I was 1/2 hour early.
The waiting room was small, but clean and comfortable. I sat with my paperwork and began filling it out. I was heartened somehow to see the pain contract was in there as though the medication was a given, and was relieved to see “will not seek opioid medication at other offices” rather than something more strict due to my worries about the ER. It also said “MAY be subject to random pill counts and drug testing.” I dutifully listed all my meds and supplements; all my procedures and therapies. I was glad I’d been so early. J sent a text that said “I have a good feeling. It will go well.”
I turned the paperwork in, and did a little research on my phone about Medication Overuse Headache and opiate use in migraine. I know a lot about it, obviously, but thought a little refresher couldn’t hurt. And I was right, something jumped out at me right away. “When the overused medication is withdrawn, the sufferer will have an approximately two week period where headache pain will increase. However, after that time, the migraine cycle will return to normal [paraphrased].” The realization hit me then – yes, I do tend to use a lot of imitrex as well – but with just a couple reprieves, I had been without narcotics since February. And my pain did not change. It continued to be daily or almost daily, not changing in character or frequency at all, and in fact, got more severe. And my quality of life, not huge to begin with, plummeted.
Satisfied, I returned to finishing The Hunger Games on my Kindle app and was just loading Catching Fire when I was called back into a patient room. A young, very friendly nurse weighed me and took my vitals. My BP wasn’t too high which surprised me. I said, “My pulse is always in the 90’s, just so you aren’t alarmed. Plus I’m a little nervous.” (Ha, “a little.” More like, “I’ve been shaking for days.”)
She smiled kindly and said, “Nothing I haven’t seen before.”
She spent about a half hour talking to me about my headaches and entering my information – ALL those meds – into the computer. I eyed the paperwork nervously where I’d written “Rare marijuana use – last time May(?)” but she didn’t mention it, though she asked about tobacco, which she joked about with me a little when I said I’d quit for my husband in 1999 but that now HE’S a smoker. (She said, “Aw man, I’d be like, you’re outta here,” jerking her thumb backward.) I asked if I could get some more water from the tap. She said she could get me some from their filter but I said tap would be okay. I thought it tasted great.
The nurse left and I read Catching Fire and sipped my water, thinking about peeing in the cup for the test. Suddenly I had to go kind of bad. Oh well!
It wasn’t too long before the door opened and Dr. Mitzi walked in. She looked to be 50 – 60 maybe, and was wearing a gorgeous lapis lazuli necklace and a lab coat. Her dark brown hair was pulled back into a sloppy pony tail with wisps around her leathery freckled face. I guessed her to be of Indian descent. Her accent was light and lilting.
“Hello, I am Dr. Tam_________. How can I help you today?” I was caught off guard by the starting fresh after I’d filled out all that paperwork and talked to the nurse, which is one of my least favorite things about going to the ER. They KNOW why you’re there, asking you to tell the story again is just like trying to catch you off guard. Even in hideous pain I’m sometimes tempted to look up and say, “Um, I think my ankle is sprained.” DUDE I’VE HAD A KILLER LEVEL 8 MIGRAINE FOR THREE DAYS WHY DO YOU THINK I HAVE AN ICE PACK OVER MY EYES IN A DARK ROOM AND I’VE ALREADY TOLD TWO NURSES!!!
So anyway. I took a deep breath and said, very aware of my bladder, “I have chronic headaches that are kind of a combination of migraine and cluster.” She asked who was prescribing my current medication, and I told her about Dr. T, and explained the oxygen. I tried, as briefly as possible, to fill her in on Dr H, my hysterectomy, going up to MHNI, Dr. P, and that my pain medicine was discontinued at that time, which I didn’t agree with. She asked me some very thoughtful questions, and I realized that it didn’t seem like she was challenging me, that “on trial” feeling I can’t stand. She was genuinely wanting to help me.
She asked what preventatives and antidepressants I’d tried, and I listed them all. She nodded and typed into the computer. She didn’t ask about my latest CT or MRI. She did ask whether Norco or Percocet worked better for me, and how much I’d taken those in the past. We discussed the ER, and she said I would definitely be able to still go without breaking my pain contract. She said “Yes, I want you to be able to spend time with your children. Very important. I will definitely help you, prescribe some Percocet. The urine test, will I see anything strange there?”
Another deep breath. I told her about rare marijuana use, that the last time was in May. Her face was so open and non-judging that I said I hoped it would be legal medicinally soon, but for now it was hard to know what the best strain would be, that it didn’t seem to help for pain. She listened and nodded like she did about the other meds we’d discussed.
I REALLY had to pee by this time. She did a quick exam, and said the urine test would take a week to come back. She said “In the mean time, I could write you for a small amount,” and I said, oh yes, thank you. Then she mentioned going out of town, and she said, “Ah, no reason to make you run around. We’ll just do this, you come back to see me in one month. We say, two a day.” The next thing I knew she had a printed out prescription for 60 Percocet, and signed it with a flourish.
“I truly hope this helps you,” she said. “It was nice to meet you. See you in one month.”
And that was that. My eyes burned with tears of gratitude and the need to get the drug test over with. Dr. Mitzi had seen a person in pain, and helped.
My friendly young nurse came back and handed me the cup. Finally. And I made my new appointment for July 29 and thanked the receptionist for being so nice, which seemed to genuinely please her. I was sort of in shock. I couldn’t have dreamed it would go this well. A pure, sweet victory; the feeling of validation and being cared for properly. Out of purgatory, at long last.
I sent J a text with 6 different smiley face emoji and got into the hot car, blasting Frozen again.
“People make bad choices if they’re mad or scared or stressed / But throw a little love their way and you’ll bring out their best!”