A Nervous Truce

This morning was the San Diego neurologist appointment.

Which felt oddly like the final boss battle of this whole saga.

Or at least the point where someone with a Very Large Brain Map might explain what the hell had been happening.

Instead, the appointment started with a question.

“What are you hoping for today?”

Which is a surprisingly difficult question when you’ve spent the last few weeks mostly hoping the inside of your skull would stop trying to murder you.

I said, truthfully, that I didn’t have expectations.

Which, technically, was accurate.

Emotionally, however, I apparently had several.

The neurologist listened to the story.

Nodded in the places where doctors nod.

And then confirmed something I had mostly already suspected.

The origin was probably that first night.

February 11th.

Sleeping wrong.

Which is both comforting and deeply irritating.

Comforting because it means there isn’t something more sinister lurking inside my brain.

Irritating because the entire cascade of pain that followed might have started with something as mundane as a bad pillow angle.

Bodies are weird like that.

The part that was new, though, was the explanation for the pain intensity.

Apparently my brain already has a well-established migraine pathway.

Which means when the occipital nerve got irritated, my brain didn’t just register “hey, something is uncomfortable back here.”

No.

It escalated immediately to migraine-level pain.

Which explains a lot.

The Detroit neurologist had been correct about the medication approach.

Gabapentin.

Muscle relaxants.

Aleve.

The whole “tell the nervous system to chill out” strategy.

The San Diego neurologist suggested one additional thing.

Physical therapy.

Specifically to strengthen the neck and prevent this particular nerve from getting cranky again.

Which makes sense.

If a system fails once, reinforcing the weak point seems like a good plan.

He also suggested I could experiment with reducing the muscle relaxant to half a dose every eight hours.

Mostly to see if the wooziness improves.

Which would be nice.

Because right now I feel slightly like someone who is permanently one glass of wine into the evening.

Functional.

But… floaty.

There’s also a follow-up with a neurology PA scheduled for June 1.

Which was the earliest available appointment.

I’m on the waiting list.

Because of course I am.

And then something interesting happened.

I walked out of the appointment feeling… disappointed.

Which is strange.

Because objectively this was a good appointment.

Nothing scary.

Diagnosis confirmed.

Treatment plan validated.

Additional prevention strategy added.

All good things.

And yet.

Disappointment.

Which made me stop and ask myself what I had actually been hoping for.

An MRI, maybe.

More tests.

A definitive, capital-letter explanation.

This Is Why™.

Or perhaps a magical pill that makes everything immediately stop.

Something decisive.

Something dramatic.

Instead I got something much quieter.

“Yep, the other doctors were right.”

Which is rational.

But not emotionally satisfying.

I mentioned this to my friend in Detroit.

Remember the PA who arranged the impromptu neurologist consult?

She said something that immediately rearranged my understanding of the situation.

“I get it,” she said. “That’s what always frustrates me about neurology.”

Which made me pause.

Because this is someone who works inside the system.

“What do you mean?” I asked.

She replied:

“It’s an art as much as a science because there’s so much we don’t understand about the brain. It’s still mostly a mystery.”

Then she added a comparison.

“Cardiology? Easy peasy. It’s a pump. The pump breaks in a variety of ways. Sometimes you fix it. Sometimes you replace it.”

Mind.

Blown.

Of course.

The heart is a machine.

The brain is… something else entirely.

Which means neurology lives in this strange territory where the doctors are incredibly knowledgeable.

And yet still navigating mystery.

Which suddenly made the entire appointment make sense.

The calm confirmation.

The lack of dramatic testing.

The reliance on symptom patterns and treatment responses.

They aren’t being vague.

They’re working at the edge of what is known.

Which is both humbling and slightly terrifying.

So yes.

Part of me is still disappointed.

Because I want to know MORE MORE MORE.

I want diagrams.

Certainty.

A neat little explanation box.

But I also recognize the brilliance in my friend’s words.

And the reality that sometimes the best available answer is:

“We understand enough to help you.”

Which, honestly, is not nothing.

Right now I’m waiting for the neurology physical therapists to call and schedule those sessions.

Strengthen the neck.

Calm the nerve.

Prevent future chaos.

In the meantime I’m breathing.

Letting the medications do their thing.

Getting comfortable with the uncomfortable reality of not knowing everything.

Thanks, universe.

And, also, DAMNIT.

But also…

Seriously.

Thank you.