Tag: Migraine

Categories
Startups

Day 857 and 3 Bag Cascade

I’ve developed a system for travel crisis management that has seen me through many a storm, workers strike, airport security involuntary cosmetics tosses, gate check “full overhead” confiscation, and other ways you might become involuntarily separated from your luggage. Perhaps even permanently at the rate you hear of luggage getting lost on transcontinental flights.

Disability Planning.

My system is pretty simple and a bit sad yet it’s crucial but I cannot be without certain items. I have a medical condition (ankylosing spondylitis) that requires delicate management. I carry a anti-inflammatory that is an injection pen that must be kept refrigerated. I carry a full travel pharmacy including solutions for all major issue from from digestive troubles to anaphylaxis, and analgesics or “forcing function drugs” for emergencies. Most are stored in labeled plastic bags but a few few controlled substances have to remain in their bottles or they can be confiscated by customs unless I can prove the prescription. In other, words. I can’t let the airline ever get their hands on it and it has to be provably mine.

Aer Grey Duffle Backpack

My backpack is my hand luggage under the seat item. In it I keep my travel pharmacy, a basic quart bag of grooming & cosmetic basics, all my electronics & their chargers, and a BagSmart packing cube with a change of pajamas (including under wear, bra, & extra socks). This functions as my purse for the duration of travel so includes wallet, phone, passport, chapstick, hand sanitizer, extra warmth layer, and other essentials. Even if my carry on bag gets checked against my will and lost in transport, I can still survive on what’s in this bag no matter where I end up.

Grey Muji Roller

Alas this bag isn’t sold anymore but it’s a soft top 4 wheel overhead. It’s my typical one week trip companion. It will go overhead unless something happens so this contains a week’s worth of basic clothing, shoes, and purse that could function for an entire trip if necessary. It is all organized and labeled in BagSmart compression cubes. I keep the majority of my secondary cosmetics here as well so I can shave, shower, do some hair and makeup. If I have a checked luggage failure (it’s lost forever) I’d be alright. I also keep a week’s worth of supplements while a month would go into the checked bag. I also keep 2 detergent tablets in this and the remaining in checked. Yes, I bring my own detergent because allergies.

Tumi Alpha Bag

For longer trips like say a month in Europe I do a checked bag. I pack stuff that I’d prefer to have larger sizes of like toothpaste & body lotions and my preferred shampoo, conditioner and styling products. Still 3 oz but no sense in lugging if you have the luxury. I also pack all my professional and going out clothing in here if it’s not absolutely necessary on landing in which case it would go into the grey carry on. I have dresses and separates that can handle anything from cocktail to family office for a month.

How It Works

I have every item listed in a packing template in Notion but I also do a ritual where I write it all out on a note pad and note the placement of each item in the cascade failure packing stage as either backpack, carry on or checked so I always know where everything is at all times. I’ve never been separated from anything critical like medicine or an electronic. Every time I travel I refine the lists and procedures.

Categories
Preparedness

Day 798 and Snowblind

I’m a big believer in working from your gut. I will qualify that your “gut” is only helpful if you have a good information diet, a grounded worldview and some amount of actual experience. But I’d wager if you are intelligent and have common sense, your instincts are, on average, telling you something worthwhile.

So I’m a bit concerned that today my gut is going just absolutely haywire. I don’t have any rational inputs that would warrant any alarm, either specific or generalized. I’m already a Doomer with a capital D but I’m an optimist about it as we muddle through most things. So I would share if I felt like I had something actionable. I don’t. The storms have to be weathered and we can merely batten down the hatches.

But I’ve got a migraine that cannot seem to be tamped down with even a double dose of Imitrax and I’ve got the unverified and unnerving sense that it’s because my entire input system is overloaded with garbage. Which is modestly weird as I’ve torn out a huge amount of inputs in order to prevent that from occurring.

I feel as if, in my attempts to not overload my meat space system, I may be shutting out a bigger warning. But my sense making capacity is lost in the day. I am flying without instruments. It feels like I’m in a snowblind.

Usually this is not problem as I’m a good pilot of my own psyche. But my autonomic nervous system is still pretending like the existing inputs are offering relevant or useful information. I can’t turn it off despite having turned down every possible source of volume.

And I don’t know what that means. Is something about to happen? Because no matter how hard I tamp down the inputs I’m still getting a read on my instruments. It feels like the point in the disaster movie that the sensors go haywire and the birds start dropping from the sky. But I’ve honestly got no idea what’s going on. EDITORS NOTE: SVB collapsed.

I’ve written this out early today just in case I need to further ramp down my sensory inputs and cannot write later. Take this as a single fuzzy reference on the ground background of cosmic radiation noise. Maybe put on a tinfoil hat or something.

Categories
Emotional Work Medical

Day 762 and If It’s Not A Yes Then It’s A No

I was supposed to drive my husband to an appointment today. I’d put it on my calendar and was prepared to make sure it happened because that’s what wives do right? It was an easy and obvious yes. I didn’t think anything of it.

Around noon I noticed I was becoming intensely sound sensitive. I asked my husband if it felt really bright outside even though we had cloud cover. I felt a little bit nauseous but I’ve been taking some antibiotics so I dismissed the symptom.

It was only when some silverware clattered onto our wooden dining table I realized something was wrong. I full on screamed. I jumped and shrieked liked like a poisonous spider had just bit me. A massive overreaction to a noise that objectively was neither that loud or that threatening.

“Honey, is it possible you have a migraine?”

Alex Miller

Despite the litany of easy to diagnose symptoms, I had managed to ignore the obvious. I had a migraine. And from the looks of it a pretty severe one.

I’d woken up feeling amazing so I wanted to tackle the day with all the energy I had. But as it waned I got angry. If I’d bothered to look at the emotion I would have seen that underneath the steam of the anger was hurt. I felt betrayed by my body. I had a 95% recovery score on my Whoop. How dare it let me down? So I just ignored it.

The kicker to the story is I kept trying to ignore it. I took one Imitrax even though it seemed like a two Imitrax migraine. Alex asked me if I was sure I would be OK to still drive him this afternoon. I waffled a little bit and said I dunno I am sure it will be fine once the migraine medicine kicks in.

I don’t like to drive after taking Imitrax as it tends to make me a little sleepy. And I really wanted to help Alex by driving him. So I just took one and hoped for the best.

An hour later Alex came into the dark bedroom and said “honey you know if it’s not an immediate yes then it’s a no, right?”

Apparently I did not. I took another Imitrax and Alex found another ride. Hopefully I learned my lesson.

Categories
Medical Startups

Day 696 and Edge

I’m enjoying a migraine this weekend that was both strong and as of yet unbeaten. Perhaps I overdid things on Thanksgiving and Black Friday. But I’ve been stuck in bed in a dark room for the last 48 hours or so.

While this sounds a bit miserable, I can assure you it is also part of my edge. When my physical works shrinks my cognitive capacity unfurls. I very much liken it to the traditional super hero dilemma of being gifted with something that makes living a normal life a challenge.

I may be stuck inside struggling with light, noise and smell but I can still do most of my core deep work. I can’t take calls or go to meetings but I can be on my phone and my Kindle. I can intake information and I can synthesize that information when I’m in darkness.

And that is 90% of my job. Be informed and make the best decision you can. Those decisions are generally done when you are calm and fast. And I get the benefit of being in rest and digest as often as possible as it’s what keeps me alive.

I’ve got a generalized theory related to finding one’s edge. It’s pretty simple. If other people perceive it as a weakness but you understand how to wield it as a strength then your got an edge. People dismiss you sure. But being underestimated is one hell of a way to get on the better end of a trade.

And so while I’m here looking like I might not be worthy because of some set of heuristics that’s have typically worked well for you I’m actually the one that has a leg up on you. You would do well to think about all the ways in which you can leverage talent and insights that trade below their value. You can make a lot of money betting off of truly underestimated viewpoints.

Categories
Preparedness

Day 620 and AQI

I am in the throes of a horrifying migraine. The take two Imitrax and pray type. It’s also the nausea inducing type so I’ve not eaten all day. I feel awful. And it’s mostly not my own fault even though I often like to blame flares in symptoms on my own lack of discipline or purity in maintaining some Platonic ideal of lifestyle or wellness regimen.

It is fire season in the west and I’m sure some, if not most, of my migraine is tied to the horrifying air quality that is choking out thousands of miles of California, Washington, Oregon, Idaho and Montana.

An AQI reading of western America on September 12th at 3:48pm Mountain Time from PurpleAir

The AQI or air quality index in my neck of the woods is 160. Unhealthy for sensitive individuals is the coy and somewhat misleading phrase used. It means in practical terms visibility is so bad I can’t see the mountains a few miles away.

Montana is at the moment free of any major fires. Our colder temperatures, lack of pervasive fire beetle blight, and reduced density makes it statistically safer than the Colorado front range when it comes to total fire danger. But it’s no safer from prevailing winds and the pollution from fire in other states. In order to escape from it entirely I’d probably have to leave the continent.

I’ve obviously opted not to leave my home region of the mountain west even if I have accepted moving to a more northern and protected corner of it. But there is a certain existential “No Exit” sense I have with AQI and fire season in general. It may just be my lot in life. Maybe it’s everyone’s lot. To give up your homeland is a complicated fight. I expect for some of humanity it must involve either certain death or the prospect of great riches

Categories
Chronic Disease

Day 559 and Stuck

I got stuck on the couch today. I’m not entirely sure why but I’m in the middle of a massive symptom flare. The pain is so acute and unrelenting that if I so much as sit up from bed I’ll get stuck in that position. I made the mistake of trying to eat lunch on the couch around noon and didn’t work up the capacity to get back into bed for over an hour.

This is becoming a theme on bad days. I’ll find myself upright for forty minutes completely unintentionally because moving, even to a more comfortable position laying down, is so painful I will put it off until I simply cannot remain upright anymore. It’s just that bad. Even the higher grade pain management isn’t doing shit. I’m just stuck in the pain until an even worse pain develops.

That’s probably a good metaphor for life. We will stay in an uncomfortable position until it’s so intolerable we simply must change. And I’d love to wax philosophic about that but I mostly mean it literally. If you’ve ever wondered how I got popular on Twitter, it’s simply because it’s the only thing I can do when I’m physically stuck in place by pain. I thank the internet Gods that this has been monetizable through investing or I don’t know what I would do.

You could almost surely correlate the number of tweets I send with the pain scale of my day. If I’ve tweeted more than 50 times on any given day it’s probably because I am over a 7 on the pain scale. It’s 2pm and I’ve tweeted 32 times today not including my DMs. I keep hopping the pain will abate enough that I can shower but it doesn’t show any signs of letting up today.

Frankly I’m just relieved it’s only my spinal pain and not anything else more exotic. Earlier this week I was dealing with being itchy and then I had a migraine that took 48 hours and several Imitrax to break. Regular old spinal pain is at least a recognizable and normal return to form. But until this nerve storm abates I’m stuck. At least until something worse comes along.

Categories
Medical

Day 545 and Stretched Time

Time has never acted like it is linear in my observation. It extends and stretches when you wish it could speed by. And it slows and circles back when you would most prefer it go quickly. Time is relative is a good joke, but also might be more related to a curse.

As I was waiting for a food delivery order today I could feel time unspooling. It stretched on into two episodes of some engaging but fundamentally disinteresting Netflix show. My head began to hurt. I remember taking an aspirin and getting a snack. I recall a phone call made to the delivery service order. And then my sense of linearity starts to fray. I’m not sure what happened next or in what order.

I think it was clear a migraine was coming on in the middle of this first act of swollen stretching time. But I couldn’t tell you for sure. Once pain hooks up with time it requires a Buddha or someone enlightened on the ways of Jhana. Still I tried to push myself out of the path of this time. Why not ordered a pizza as a replacement meal. That might be quick? I blamed the blooming migraine and it’s sister nausea on a lack of food. But in reality I was past the point of being helped. I was simply trying to avoid the oncoming path of the migraine.

I recall a pizza arriving but not the original delivery order. I made an attempt to eat. But I was in the grips of the time expanding migraine now. I took an Imitrax. I had some CBD. Perhaps terrapins and triptans could convince my mind that the moments of pain were short and fleeting. That was my best hope for experiencing the migraine in a positive way.

I put on a face mask. I sunk into a mindfulness practice. I noticed and turned over the kinds of discomforts I found myself in one by one. The emotional fears that I wanted distance rose up. The pain that bubbled around my body tightened, giving me a rationale for not wanting to being touched. A mind that wanted to drift far from others overlapped with my normal mind, this mind wasn’t forced to endure the noisy input from the world. All those experiences rose and burst forth and dissipated. Pain, distance, and fear came and went.

Consciousness seemed possible again. I had the sense that I could articulate some of what happened to me over the past three hours. That perhaps I could codify it in writing. It wouldn’t be as vivid but it would be there. The fear and failure and disprovals still existed but less acutely. The pressure on my mind had become less swollen. Time wasn’t threatening to extend out any other direction but forward. And maybe I could finally enjoy a bite to eat again. It has been five hours total since the migraine began.

Categories
Medical

Day 489 and Day Dreams

I had a dream during the day today. I mean the rapid eye movement kind not the fantasyland imagination. I had laid down to rest my eyes while my migraine medication worked it’s way into my system.

Generally I don’t fall asleep in the middle of the day. This is doubly true if I’m beating back a migraine. Triply so if it’s a particularly bad one. This migraine was so bad I needed nausea medication as well. I frantically texted my husband in the other room to help me look as I couldn’t locate my medications as keeping my eyes open triggered cascades of lightning flashes behind my eyes and nausea so bad I was afraid I’d lose the contents of my stomach.

I put on noise canceling headphones and a face mask and passed out. I woke into a dreamscape city that resembles the west village in New York. I was being instructed by a coach of some sort to forgive someone. Maybe it was myself. Maybe it was a cofounder of a past startup. The texture of the city was busy. Tourists were everywhere blocking the sidewalks. I recall a conversation about the end of the pandemic. Perhaps everyone was out celebrating. There were posters for movies or shows on every available service. I distinctly remember one in front of a fry shop that had media quotes promoting Billy on the Street combined with Family Guy characters. I’ve never seen Billy Eichner’s television show.

I woke back up nearly four hours after having originally gone to lay down. I felt dazed. I had the slightly unsettled feeling one gets upon waking in a bed that is not one’s own. I was disoriented and dizzy even laying down flat. My nausea still has not disappeared entirely. But the migraine had mostly passed.

Categories
Chronic Disease

Day 472 and Missing Out

I never had headaches in my twenties. Migraines were a cultural phenomenon I was aware of it never experienced. After I did fertility treatments about four years ago my body went though a number of changes for the worse. I developed an inflammatory condition. And I became acquainted with migraines.

My migraines are the light and sound sensitive type. They leave me nauseous enough I have a prescription just for that. I’ve tried a number of treatments for the migraines prophylactically, but only Imitrax really helps once it starts. If I’m lucky I can turn one around in 3-4 hours with medication and a cold dark room.

Today wasn’t a day where I could turn it around fast enough. And I feel sad and alone and depressed about it. I was supposed to meet friends for a nice meal to celebrate with them and I’m missing it because I couldn’t control the migraine fast enough. Alex my husband made it to dinner with our friends but but alas at home in a dark room waiting for my Imitrax to kick in.

I debated if I could force myself into showing up but it was decided the amount of pharmaceuticals required wasn’t passing a cost benefit analysis. I tried to make a case for it saying if I just tossed enough pain medicine at the migraine maybe I could do it. But the rational vote from Alex was a veto. And he’s right if it takes an opioid to get me out the door that’s not something I can justify for a social event.

The irony is I actually dislike fancy dinners out. I find them to be exhausting. Having to sit on uncomfortable chairs and socialize for two hours is very expensive energetically for me. It probably takes a day to recover from the energy expenditure and I often have to up the doses of my stabilizing medications. I tend not to say yes to them as it’s expensive for me and I don’t enjoy them.

So I don’t know why I’m so upset that I’m missing this dinner. But I am so upset. Maybe it’s because I’ve had months of stability without any issue. When I said yes let’s go I expected to be fine. The last time I recall having a major crash was in early February. Since then I’ve flown internationally, lived on my own, and made it to a crypto conference in Miami with little incident. So maybe I was due for a bit of a crash. Maybe it’s just inevitable that if you push you need to rest.

But I feel miserable, inadequate and guilty about it. Like I should have tried harder. Should have taken more drugs. Or at very least been more upfront that sometimes my body is unpredictable and I find it challenging to have be “on” and in public for social things that aren’t strictly speaking crucial. But now do you tell beloved friends that they aren’t crucial? You can’t really. I just have to hope I can do it. And mostly I can. But not today. Today I couldn’t.

I feel like maybe I owed my friends a performance. I can perform in even dire circumstances. I never miss a dinner or event or appearance at which I’m required professionally. But I don’t hold myself to that stand personally. Sometimes things happen and I just can’t do it and I have to let my body dictate my schedule.

That reality makes me feel isolated and alone. Because I can’t make the same commitments as regular people to socialize and enjoy normal things. There is always the risk that I’ll have a bad day. And I save my energy for work because I have to. So that means I don’t get to have a normal social life like other people. I don’t usually mind but today I do. Today I’m missing out.

Categories
Medical

Day 408 and Getting Ahead

My first piece of international travel since the pandemic began is coming up. I’ve not been on an airplane in over two years which is wild. But I needed to get a booster shot for my travel papers.

I was a bit nervous about how I’d react. I didn’t have the easiest time getting vaccinated. But I had a mild case of Omicon in December which made me slightly more optimistic about it.

I got caught in a snowstorm getting the booster yesterday. Which is so far the only inconvenience. I slept fine last night. I didn’t appear to spike a fever. I had no aches or pains other than the ones I live with normally. I’m so far enjoying having little to no reaction.

I did however take very good care of myself. I felt a migraine coming on mid-morning and I rushed in with all the good drugs. I wasn’t going to let myself suffer at all. And I am suspecting that keeping any and all stresses away has in fact been excellent for my body. Just another reminder that drugs are in fact good. Loving yourself can often mean mean treating yourself kindly. Removing the option for suffering and maybe all recovery can be this easy.