Crappy night, perhaps the worst yet. Jan and I watched a couple programs collected on the DVR after the World Series game, which meant that we were up until midnight. That didn't bother me as the steroids were still kicking in. But I had a fierce headache by the time that was over that two aspirins didn't touch. With that kind of pain, I was up for good by 4:30 a.m. Not so good.
I believe I have reached a conclusion about the source of the headaches. While they may be exacerbated by sinus-produced neuralgia, that is not the primary source. I now believe they are pressure headaches produced by the leakage of cerebro-spinal fluid into the brain, caused by the chemo. Here is my reasoning and history on this. When I had a hemi-laminectomy on my lower back (L5-S1) done by Corky Terry in the old Logan hospital (I was 41 yrs old), we made the decision to go into surgery based on a cancellation in the OR. That meant that they shot the marker fluid into my spinal canal in the morning, and did surgery that evening. Post-surgery, I had blinding headaches for about a week. Seemingly they would recede on their own--at this late date, I don't recall what meds we might have used, it seemed to me we walked around the block--and then I would sleep the sleep that heals. I figured the headaches were due to the staining of the cord in close proximity to the surgery. Only half correct as it turned out. Bob Stephenson, who did my prostate, 20+ yrs later, told me that the culprit was the bore size of the needle used to pierce the dura of the spinal cord. They now use a much finer bore, et voila, no headaches. I feel that if we had had the usual week between the piercing of my cord and the surgery, the hole would have healed and I wouldn't have had any headaches, either. Post hoc reasoning, yah, yah. Anyway, note the function of the walks during these headaches. They got me upright and probably relieved the cranial pressure.
Anyhow, I have been getting these headaches regularly for some time now, a time that predates my diagnosis (Aug. 25?). How much time before? Not really sure: the better part of 6 months, maybe a year.(An omen?) We would be watching a movie in bed and I would have to get up to relieve the headache pressure. I thought a lot of things: We were too close to the screen; my glasses finally needed to be changed. And, on occasion, taking my glasses off (I am 20-20 in my right eye) seemed to put off the headache somewhat. It was sinus related. It was neck tension. But the most consistent cure was to simply stand up. I would wander about the room until the pain receded, still watching the show, and then lie back down when I felt better. We have a piece of literature on chemo-induced headache that seems to support the pressure theory. For me, lying there and watching a show produces the headache. In the great room, I can sit in my recliner, usually only a little reclined, and the problem essentially doesn't show up. Seems pretty definitive.
Well to finish this diatribe, by 4:30 I was a little queasy. (An aside: when I have used the term, urpy, in prior posts, I meant, and mean, queasy, not upchucky. There has been no upchucky to date.) And my head was really hurting. I held off for an anti-emetic until 6 a.m.--a scant 6 hrs since the prior dose. And saints-be-praised (by someone), I recalled that I had a bottle of Canadian aspirin avec codeine. According to the label I can take up to ten of those a day for 5 days if need be. So I popped one at 7 a.m. and almost instantly the head was gone. But note: I spent the two and a half hours dozing and sleeping in the recliner, therefore, mostly upright during that time. And we know from experience that works. So, if the headaches continue--and I don't really expect that--then they can be controlled. Looks like more recliner time and switching the DVR to the great room.
I have managed to choke down a couple cups of herbal tea and a portion of Cream of Wheat laced with agave syrup this morning. But I essentially have no appetite, and still feel like I am hungover. The three steroidal prednisone pills I have taken so far are doing their usual lift--two more to follow in a couple minutes--and with the exception of the appetite, I think I can get through the day. Kicks rehearsal tonight? We'll see.
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