I am my own guinea pig.
I hesitate to write about this in a public medium. For one thing, it's prone to eliciting responses I have no desire to instill or see. For another, it's the sort of thing that tends to make me doubt the intentions of the person who's publicly talking about it.
There is little to be gained by writing publicly. I doubt most people would even understand where I'm coming from in any genuine way, and there is nothing more unsatisfying than talking past people. (The delight some people take in speaking above people notwithstanding.) But I've been wanting to make a public entry, and since I decided to do something about the issue, it's become a fairly dominating part of my life.
Been sorting out my head pretty concertedly since last October. There have been marked ups and downs in that process, but my moods have stayed out of the extremes I had been accustomed to since adolescence, and the increased baseline level of stability has been lovely. In general, it's been a good thing, in spite of a few bumps along the road.
Sorted through a lot of my motivations, acknowledged a lot of my failings and strengths, saw how my history and experiences fed into and nourished who I was. Killed a lot of my ego, particularly many of the aspects that were most destructive to happiness and health.
This had side effects, namely a marked decrease in self-loathing and self-aggrandizement (they are nowhere near as different as most people claim, and I honestly doubt that one can occur without the other). The most noticeable change was the fact that I stopped seeing the endurance and self-infliction of pain and misery as an indisputable mark of virtue.
I've self-injured since I was six years old, if not longer. At the time, I'd shove sewing needles into my skin, pull the skin up, and twist it until the skin started to split. Little things like that. Not particularly painful. But it got worse, and as it got worse, I started to hide it. Getting attention for it would have defeated the point, which made it very important that no one knew. The issue wasn't a desire for pain, but a desire to endure pain with no supports or external signs of distress. Because that was virtue. There are reasons for that, too, but going into it would take far too long for the purposes of this entry.
Thought about it a little further, and connected other tendencies to that desire to self-injure, to endure misery. In this case, I'm talking about what was effectively a religious tenet for me: Thou Shalt Not Take Pain Medication.
I have migraines that cause extreme motor weakness and numbness, frequently to the point of actual paralysis, around once per week (more, if I've been exposed to certain triggers). I have been in chronic pain in an increasing number of joints since I was ten years old. And I religiously didn't take pain medication.
There's a certain absurdity in this. Granted, my migraines have never been helped by any medication I've tried to alleviate them, but that isn't an excuse for ignoring the pain in my joints. (Early-onset osteoarthritis is documented as galloping in my family, to the extent that surgery for it in our twenties is not uncommon, and that's just one issue.)
I always had better health than my sibling and mother, but even I was prone to spraining and dislocating my ankles and knees whenever I tried to run, and having constant pain in and around those joints dating back to middle school. And I never tried to do anything about it. Never brought anything up to a doctor, never took medication for it, just lived with it without complaining. Pushed as hard as I could through it. Because that was virtue.
And the great thing is: That's finally striking me as fucked up. The shitty thing is: There doesn't seem to be much I can do about it.
More joints have joined the party, things intensified, et al. I don't want to go into the fine details, because it's just life. It's been life for longer than it hasn't, and I'm not actually bothered by it. Nor do I want pity, or to imply that that's my desire.
It's fine.
It's just annoying that I can't seem to do anything about it.
That's a slight exaggeration. Did a lot of research, and have found that stretching helps a lot. Have faith that exercise, carefully employed, will eventually help as well (currently, it just hurts). I was already employing pretty massive quantities of distraction and generalized thought techniques, because I found nothing lacking in virtue in those methods of dealing with pain. Also learned to be more conscious of where my joints were, and whether they were hyper-extending, which has all done a surprising amount of good.
Those alone get me to the point where I can think clearly more often than not (a novel experience, compared to the past year or two), but they don't help me get any more work done.
To add more, unfortunately necessary, background: The desire to maintain my capacity for speech has led to me dramatically decreasing my activities/housework over the past three or four years, in particular, because if I didn't I wound up a gibbering mess who literally Could Not Think past the level of pain.
The level of progress is good. Really good, actually. Better than expected for such simple changes. The trouble is that with that alone, I really couldn't do much housework without, once again, turning into a gibbering mess who can't follow a logical conversation without asking for clarification five times.
I really wish I was exaggerating. It's embarrassing, particularly for anyone who knew me when I was younger.
For the past few weeks, I've been playing with over-the-counter pain medication. Researched to figure out the risks and possible dosages, and settled on 3000mg of acetaminophen with 3200mg of ibuprofen per day as a maximum. That was if I cut back to one drink per day. Which I've done. Much more easily than I expected, actually, given that alcohol has been a very consistent part of my life since I was sixteen.
Been fiddling to try to figure out what works, what doesn't, how little I can get the medication down to, how much help I can actually gain through those methods.
And naturally, because my activity level and mood and luck with sleeping has been variable, the results have been variable. I'm still not very far along in figuring out exactly what's needed, nor what I should expect.
I can say that the trials are frustrating.
I'm still not sure how much ibuprofen I should actually be taking. I can say that the effects clearly last longer when I take higher doses at once, but the half-life drop-offs become even more painfully noticeable at higher doses as well, which makes it feel markedly like a situation of diminishing returns. In addition to that concern, there's the fact that any dose of ibuprofen higher than 400mg causes increasingly extreme headache, disorientation, and dizziness. Acetaminophen, if taken simultaneously with the higher doses of ibuprofen, does a very good job minimizing the headaches, but obviously does nothing for the disorientation and dizziness. This is good, because when I was taking it in staggered doses, it wasn't doing much at all. Allowing me to take higher doses of ibuprofen is better than nothing.
I just still can't figure out if the higher doses are worth it. The disorientation is less mentally debilitating than the pain before taking the pills, amazingly, so that isn't even a question in my mind. The question is whether I could theoretically get by with just 400mg of ibuprofen every four hours. Occasionally, generally when I slept better and am happier and don't do much, it feels adequate to keep my head in I-can-think territory. But that combination is a bit rare.
Yesterday, I took 800mg of ibuprofen and 750mg of acetaminophen shortly before bed, and pain still kept me awake well into the small hours of the morning. It's problematic.
So, as can be seen, sometimes 800mg feels like it does nothing. Sometimes, by contrast, 400mg seems perfectly adequate. The jump in effectiveness from 200-400mg is certainly a lot more noticeable than anything above that range was -- which lines up with studies I've read about -- but I keep feeling like if there's anything else I can do to help, I should be doing it.
And I'm running out of options. And still being kept awake at night, and frequently turned into a gibbering mess because of it.
But sometimes, I'm almost okay now. And I really like that. Which is the real point of this entry, in spite of what it might look like. Feeling good is good. Don't take it for granted, 'kay?
I'm looking forward to when I've done enough trials on myself to be comfortable saying that higher doses and acetaminophen are useless, or I can definitively decide that those additional steps help. Then I should be able to stop thinking about it, and live a little better than I have been.
I like that idea.
There is little to be gained by writing publicly. I doubt most people would even understand where I'm coming from in any genuine way, and there is nothing more unsatisfying than talking past people. (The delight some people take in speaking above people notwithstanding.) But I've been wanting to make a public entry, and since I decided to do something about the issue, it's become a fairly dominating part of my life.
Been sorting out my head pretty concertedly since last October. There have been marked ups and downs in that process, but my moods have stayed out of the extremes I had been accustomed to since adolescence, and the increased baseline level of stability has been lovely. In general, it's been a good thing, in spite of a few bumps along the road.
Sorted through a lot of my motivations, acknowledged a lot of my failings and strengths, saw how my history and experiences fed into and nourished who I was. Killed a lot of my ego, particularly many of the aspects that were most destructive to happiness and health.
This had side effects, namely a marked decrease in self-loathing and self-aggrandizement (they are nowhere near as different as most people claim, and I honestly doubt that one can occur without the other). The most noticeable change was the fact that I stopped seeing the endurance and self-infliction of pain and misery as an indisputable mark of virtue.
I've self-injured since I was six years old, if not longer. At the time, I'd shove sewing needles into my skin, pull the skin up, and twist it until the skin started to split. Little things like that. Not particularly painful. But it got worse, and as it got worse, I started to hide it. Getting attention for it would have defeated the point, which made it very important that no one knew. The issue wasn't a desire for pain, but a desire to endure pain with no supports or external signs of distress. Because that was virtue. There are reasons for that, too, but going into it would take far too long for the purposes of this entry.
Thought about it a little further, and connected other tendencies to that desire to self-injure, to endure misery. In this case, I'm talking about what was effectively a religious tenet for me: Thou Shalt Not Take Pain Medication.
I have migraines that cause extreme motor weakness and numbness, frequently to the point of actual paralysis, around once per week (more, if I've been exposed to certain triggers). I have been in chronic pain in an increasing number of joints since I was ten years old. And I religiously didn't take pain medication.
There's a certain absurdity in this. Granted, my migraines have never been helped by any medication I've tried to alleviate them, but that isn't an excuse for ignoring the pain in my joints. (Early-onset osteoarthritis is documented as galloping in my family, to the extent that surgery for it in our twenties is not uncommon, and that's just one issue.)
I always had better health than my sibling and mother, but even I was prone to spraining and dislocating my ankles and knees whenever I tried to run, and having constant pain in and around those joints dating back to middle school. And I never tried to do anything about it. Never brought anything up to a doctor, never took medication for it, just lived with it without complaining. Pushed as hard as I could through it. Because that was virtue.
And the great thing is: That's finally striking me as fucked up. The shitty thing is: There doesn't seem to be much I can do about it.
More joints have joined the party, things intensified, et al. I don't want to go into the fine details, because it's just life. It's been life for longer than it hasn't, and I'm not actually bothered by it. Nor do I want pity, or to imply that that's my desire.
It's fine.
It's just annoying that I can't seem to do anything about it.
That's a slight exaggeration. Did a lot of research, and have found that stretching helps a lot. Have faith that exercise, carefully employed, will eventually help as well (currently, it just hurts). I was already employing pretty massive quantities of distraction and generalized thought techniques, because I found nothing lacking in virtue in those methods of dealing with pain. Also learned to be more conscious of where my joints were, and whether they were hyper-extending, which has all done a surprising amount of good.
Those alone get me to the point where I can think clearly more often than not (a novel experience, compared to the past year or two), but they don't help me get any more work done.
To add more, unfortunately necessary, background: The desire to maintain my capacity for speech has led to me dramatically decreasing my activities/housework over the past three or four years, in particular, because if I didn't I wound up a gibbering mess who literally Could Not Think past the level of pain.
The level of progress is good. Really good, actually. Better than expected for such simple changes. The trouble is that with that alone, I really couldn't do much housework without, once again, turning into a gibbering mess who can't follow a logical conversation without asking for clarification five times.
I really wish I was exaggerating. It's embarrassing, particularly for anyone who knew me when I was younger.
For the past few weeks, I've been playing with over-the-counter pain medication. Researched to figure out the risks and possible dosages, and settled on 3000mg of acetaminophen with 3200mg of ibuprofen per day as a maximum. That was if I cut back to one drink per day. Which I've done. Much more easily than I expected, actually, given that alcohol has been a very consistent part of my life since I was sixteen.
Been fiddling to try to figure out what works, what doesn't, how little I can get the medication down to, how much help I can actually gain through those methods.
And naturally, because my activity level and mood and luck with sleeping has been variable, the results have been variable. I'm still not very far along in figuring out exactly what's needed, nor what I should expect.
I can say that the trials are frustrating.
I'm still not sure how much ibuprofen I should actually be taking. I can say that the effects clearly last longer when I take higher doses at once, but the half-life drop-offs become even more painfully noticeable at higher doses as well, which makes it feel markedly like a situation of diminishing returns. In addition to that concern, there's the fact that any dose of ibuprofen higher than 400mg causes increasingly extreme headache, disorientation, and dizziness. Acetaminophen, if taken simultaneously with the higher doses of ibuprofen, does a very good job minimizing the headaches, but obviously does nothing for the disorientation and dizziness. This is good, because when I was taking it in staggered doses, it wasn't doing much at all. Allowing me to take higher doses of ibuprofen is better than nothing.
I just still can't figure out if the higher doses are worth it. The disorientation is less mentally debilitating than the pain before taking the pills, amazingly, so that isn't even a question in my mind. The question is whether I could theoretically get by with just 400mg of ibuprofen every four hours. Occasionally, generally when I slept better and am happier and don't do much, it feels adequate to keep my head in I-can-think territory. But that combination is a bit rare.
Yesterday, I took 800mg of ibuprofen and 750mg of acetaminophen shortly before bed, and pain still kept me awake well into the small hours of the morning. It's problematic.
So, as can be seen, sometimes 800mg feels like it does nothing. Sometimes, by contrast, 400mg seems perfectly adequate. The jump in effectiveness from 200-400mg is certainly a lot more noticeable than anything above that range was -- which lines up with studies I've read about -- but I keep feeling like if there's anything else I can do to help, I should be doing it.
And I'm running out of options. And still being kept awake at night, and frequently turned into a gibbering mess because of it.
But sometimes, I'm almost okay now. And I really like that. Which is the real point of this entry, in spite of what it might look like. Feeling good is good. Don't take it for granted, 'kay?
I'm looking forward to when I've done enough trials on myself to be comfortable saying that higher doses and acetaminophen are useless, or I can definitively decide that those additional steps help. Then I should be able to stop thinking about it, and live a little better than I have been.
I like that idea.