Thursday, April 7, 2011

the smallest show on earth

This is my second week without Diet Cola.  My caffeine intake is now limited to two large mugs of coffee. Coffee is necessary for the maintenance of meaningful life.

Some days, I am even restricting myself to a single mug of the stuff.

This is only remarkable if you consider that the two-mug limit was a step down from my normal thermos of goodness. 

Fred and I drink different coffees, made at highly divergent strengths.  Then, too, I stop pretending to sleep around 4:30 am.  and Fred comes to bed anytime between 2 and 5 am.  As neither one of us can tolerate old or reheated coffee, it no longer makes sense to brew for one another.  I still do when he has to be rousted from our warm bed in order to drive me somewhere.  It just feels nice and couple-icious to call out "Would you like some coffee?" and to know just exactly how he takes it, right down to the correct teaspoon to use when measuring out his sugar (a spoon from two patterns ago).

More Spoon Weirdness:  This same spoon is one I use when eating yogurt.  For some reason, possibly its cheap formulation, the yogurt coats its back really nicely, enabling a prolonged and delicious lick...

Yeah, so... I switched to having the occasional Diet Root Beer -- a little over-the-top in Cloying Factor but cold and wet.  Without caffeine.

For years, I bought into the myth that caffeine would boost the impact of my pain medication.  What a crock.  Well, not entirely.  As a vasoconstrictor, it is very useful against the evil headache -- usually about 60 mg of caffeine in combination with acetaminophen, aspirin, etc.  In theory, caffeine blocks adenosine, enabling a greater hit of dopamine (and jingle-jangling epinephrine).  Whatever... for me, absent a headache, caffeine does not seem to help the performance of pain relievers.

Has my sleep improved?  One aspect of it, yes!  I am able now to catch up to 2-3 hours of snoozing in the early part of the day.  In other words, I can get up, take some pain medication, work for an hour or so, and then go back to bed and catch some Zzzzees.  Sad to say, the absence of Uncle Kitty Big Balls and Sam-I-Am is also a big part of this new opportunity, as they each were powerful advocates of humans not sleeping but instead tending to the state of their food bowls.  Sammy employed the Bounce Technique and was heartless in its application.  He was also adept at Book Destruction, knowing that the sound of ripping paper would wake me when The Bounce had failed.  UKBB, on the other hand, was a One-Trick Cat.  He had a raspy, distinctive, annoying voice.  He planted his considerable girth near my left shoulder, fixed me in his mournful gaze, and let loose a barrage of "feed-me-feed-me" meows from his phlegmy voice box, a sound akin to that produced by the handheld electrolarynx.

Electorlarynx user Roger demonstrates New TruTone Electrolarynx. Uploaded
from GriffinLaboratories's Channel

Without UKBB's electronics and Sam-I-Am's book destruction and body bruising, without so much caffeine raging through my system, I have achieved better and longer sleep, at least at the tail end of the nightly effort.  Falling asleep still occasions frequent tears.  My legs simply won't give me a freaking break and the moment of relaxing into the bed, which ought to be an "ahhh" experience?   Well, it isn't.  Crying about it is a relatively new response that my stern Id is not supporting, but even so, I have begun to wail and rale against the unfairness of it all -- for roughly 90 seconds and then Marmy usually appears, ghostly in the darkness, framed against the light of the doorway, chirping chirping chirping. This schizoid chick-impersonating cat is a sweet witch at night, and chirps at me until I fall asleep. Waking with her hot, long hair on my neck 40 minutes later is almost worth it. As I shoo her away and begin the process of pulling her fur out of my eyes, nose, and mouth (sometimes even an ear... what happens during that 40 minutes is something of a delicate mystery), her chirping transforms into the more familial representative *Ack*-*Ack* of Annoyance.

I have done a review of systems several times daily, checking for improvement in pain levels, in edema, in temp, even. There has been no postive result as yet from the ketamine treatments.

Tuesday, I went into the pain institute and had a "review" of the process. The party line was that my lack of response meant that further infusions were pointless.

Thank God, La Bonne et Belle Bianca Castafiore decided to come with us that day. I sat there, crushed, fumbling for words to try and change their minds... but La Castafiore did an amazing impersonation of Picard's "Make it so!" -- and so they did, agreeing to another round of three treatments at higher doses. Because of the increase in strength, there will be a 10-day interval between infusions.

So... Ketamine Infusion Number Four at 125 mg will take place this coming Monday. They were able to schedule me an hour earlier which probably will help with the rush hour traffic we have had to fight on the way home. If the last treatment is any indication, I am in for some temporary unpleasantness but am fervently petitioning God, gods, and the universe in general for an inspiring result, some significant pain relief that will tell us whether this is worth continuing.

In what was a touching but really silly moment, the Ketamine Guru's PA decided to promise me that if the ketamine endeavor proves a complete crap-out, "[they] will find *something* to give [me] some relief, [we] promise!"

Shades of my former cardiologist promising me I would never die while under his care. Where do these people come up with this absurd hubris?

Anyway, she was a very nice, well-intentioned woman, and her "promise" already had the tiny little itty bitty Flea Circus cheerleaders twirling and spinning on the head of a pin, hitting all the expected notes -- Prialt, Fentanyl ("to get you off of Methadone!"???), Butrans...

Oops, I gotta go... I just got an urgent email from the Central Bank of Nigeria.

*WARNING* The following video may cause serious itching and scratching...

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