The Science of Pain--a podcast from Scientic America, with a transcript at the link.

The beginning of the podcast talks about empathy with pain, and I cannot imagine how disturbing it must have been to participate in the study that he ran.

After that he talks about pain as a disease, and the nature of chronic pain. Apparently it might not just be the drugs that make us stupid, but neural changes in response to pain that just don't get undone. They're still researching if they are permanent.

And Anthem Blue Cross for the block!

Well, I've joined the legendary ranks of the HMO-denied. They have determined that the ketamine treatment is experimental, so I can't have it under their plan. I'd have thought the simple math (1 ketamine treatment costs about the same as 1 ER visit) would have helped tipped things in my favour but no.

So where do we go from here? I can pay out of pocket under the PPO portion of my health plan, or I can appeal. I haven't thought much about either yet, although the former isn't tempting, what with the lack of a job sitch and all.

I hadn't honestly considered that they'd turn me down, not with all the wrangling it took to get this far.

::bites lip::

Everything has been pointing towards this. The meds juggling was just treading water, as far as my hopes have been concerned, such as they are.

Well, I see the migraine specialist again this coming Monday. That should be fun.

The cervical nerve block is both a therapeutic and a diagnostic procedure. Turns out that I received no alleviation of pain on extension and flexion (up and down motion) of my neck, but I wasn't supposed to. I did get more range of motion turning side to side, which means we move on to step two--Radiofrequency Neurotomy which is basically blasting the shit out of the offending nerves, a procedure that might provide relief for as much as two years.

I just hope they'll remember how poorly the Versed worked last time.

Bring on the new year--the procedure will be done one side at a time, left on the 8th, and right on the 22nd.

Add one more doctor to the stable

I have a new pain management doctor. One who seems very motivated and says that he has great interest in the problem I have with my shoulders and neck.

He diagnosed me with cervical facet disease and is performing a procedure on me tomorrow to numb the nerves in question. If this provides *any* relief for the neck and shoulder pain it is well overdue. I mention it all the time at the ER and to my other doctors, but apart from one recommendation of physical therapy didn't get much results. And the PT involved touching and manipulating the area which more than once sent me to the ER with exacerbated migraines.

He makes no promises, especially about the migraines, but the neck and shoulder pain needs attention too.

Looking Elsewhere

I have a simple Google alert set up so I can stay on top of new mentions of the affliction. It's usually pretty boring--quite a few "Migraines are worse than you think" articles, and every actual piece of news gets repeated in many places. But it's easy enough to keep up with and I do learn of sports stars and other celebrities who suffer with what I do.

Sometimes, though, one comes down the pipe that I don't know what to do with. The most recent of this type is headlined "Ayurveda may cure migraine." Ayurveda. Off the top of my head I thought something to do with yoga, but it's a full fledged alternative medicine system.

Which means, of course, it's nothing easy to try. But here's more the Indian Daily News & Analysis magazine had to say:

If not cure, the Ayurvedic Treatment Protocol (AYTP) comprising aahar (diet), vihaar (lifestyle) and aushadh (herbo-mineral formulation), promises conditions ‘close to cure’. Dehradun-based Ayurvedic physician Vaidya Balendu Prakash, the pioneer of AYTP, believes that migraine has been treated as a neurological disease for ages, and was therefore dealt with only through painkillers.

“After a close analysis of the disease, I found that it was more of a gastroenterological disorder rather than a neurological one,” he said. “Most of those suffering from migraine had issues like acidity and stomach problems. But modern medicine ignored this aspect,” he said. “So we altered the lifestyle and diet of those getting migraine attacks. And it worked within 120 days,” said Prakash.

I can't chase down everything, especially not at the same time. But I will make a note of this.

More Medication Manipulation

Still on the trail of the ketamine treatment. I understand that my specialist is pursuing it with my insurance company. I leave that in his hands, but I am impatient. My next appointment is the coming Monday. Hopefully there will be news.

Last tweak he performed was to add an anti-psychotic (Zyprexa) to my regimen, and to drastically drop the beta blocker (Inderal) and the anti-seizure (Depakote) medication. The goal being to lessen my dizzy spells and improve my appetite without "all the wheels falling off" (his words).

Jury's back in. I gained weight, which is good, but the migraines are wicked bad. Looks like Zyprexa is well known for weight gain, so that in addition to the lessened nausea are positive. But I'd trade some levelling off and even some dizziness for lessening the migraines again.

Huh. I notice that Zyprexa also has insomnia as a side effect. Check.

Hmmph.

Closing in on K?

We may be nearing something--there's someone in LA who might administer me ketamine. He does it for another condition, but my specialist seems guardedly optimistic.

Remuneration might be an issue. It remains to be seen how it will work out with insurance, although there is guarded optimism about that too. The specialist did say he considered paying half the costs if Blue Cross wasn't going to come through...his wife threw the appropriate fit. I couldn't do anything but laugh. I wasn't sure how to react. He just feels I've been this way too long.

Him and me both.

So if this happens, it could be soon--within a week or two.

Cross your fingers.