The Not-So-Gentle Answer: 7. Classic Migraine

contra-lateral, adj., fancy Latin phrase for “the other side”

Classic migraines are preceded by a visual aura, it’s like a pain-free warning between 15 minutes and an hour before the pain smashes into your brain.  The pain is usually contra-lateral to the aura (if the aura affects the left field of vision, the pain is on the right, and vice versa).  No two sufferers have the exact same same visual aura, although the sparkly kinds are common, but the symptoms all sound like strokes in the visual cortex (to doctors who don’t themselves have migraines).

The last migraine I had was before chemotherapy in 2010, and I had hoped they were gone for good.  Oh, well: I had another migraine over the week-end.  The reason I bring it up is that, with my profound thromboctyopenia (Not So Gentle, episode 4) I have to be careful about bleeding.  It was an anxious wait for the pain phase to start, to distinguish a migraine from a small intra-cranial bleed.

And if it wasn’t a migraine? Go to the Emergency Department for a platelet transfusion, a head CT, urgently adding a neurologist to my game of “collect all the specialists”, and hoping the haematoma is reabsorbed (surgery is contra-indicated).  At the other end of the spectrum, a really big intra-cranial bleed is easy to diagnose: I will be dead before the ambulance can arrive.  Given a choice, I prefer the migraine.

On the treatment front, my oncologist is looking at giving me astonishingly high doses of Dexamethasone to attempt to attack the lymphocytes in the bone marrow, followed by two cycles of Bendamustine + Mabthera to finish the job, in order to qualify as a bone marrow transplant recipient (Not-So-Gentle, episode 6).  The Bendamustine isn’t on the PBS, but it isn’t quite as expensive as the Mabthera was ($3K < $5K per cycle), and I will need less of it (2 < 4 cycles).  I’m researching grants from a couple of charities who work in this space.

I have confidence in my oncologist, and I have confidence in my treatment.  I accept this gift.

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You may be interested in reading the other Not-So-Gentle episodes: (1) Introduction, (2) CLL, (3) Neutropenia, (4) Platelets, (5) Commensals, (6) Infections, (7) this post.