On My Last Nerve

Nurtec, it turns out, is very new.

So new that insurance companies mostly pretend it doesn’t exist.

Which means it costs about $250 for eight pills.

I declined.

Thankfully the gabapentin worked.

Not perfectly, but enough.

The pain dropped from a seven to nine down to a two to four. Occasionally it would spike back up to a six or seven, but those spikes passed faster and the light sensitivity faded after a few days.

Manageable.

Which is a word you start appreciating more when you’ve recently been living in the nine range.

Unfortunately the timing was… less manageable.

Because it was also time to visit the kids.

Which meant a week of solo parenting.

Now, children are delightful.

They are also loud.

And emotional.

And extremely invested in debates about vegetables and bedtime.

So I explained what was happening with my head in an age-appropriate way.

And then I bribed them.

Robux, specifically.

If they helped Mama by using soft voices that week.

It worked.

Remarkably well, actually.

Which is perhaps a small lesson in behavioral economics.

Or perhaps just parenting.

Around that time I had lunch in Detroit with a good friend who works as a physician assistant at a local hospital.

I told her the whole saga.

She frowned.

“Too bad you don’t live here,” she said. “I could get you in with a neurologist this week.”

Unfortunately Detroit was slightly out of network.

The next day, though, she ran into a colleague.

A neurologist.

They discussed my symptoms.

And then she texted me asking if I could call when I had a moment.

I called immediately.

She put me on speakerphone with the neurologist right there.

Which is how I learned two things.

First: I did not have a Very Specific Symptom that would have been Very Very Bad.

Second: the ER diagnosis of occipital neuralgia seemed correct.

They also suggested a few treatment options to discuss with my own doctor.

Which felt like progress.

Meanwhile a nurse from the second ER visit called to check in.

I praised the ER doctor who had started me on gabapentin.

And asked if I could meet with someone at my GP’s office to discuss dosage adjustments.

She scheduled an appointment for Thursday and put me on a cancellation list.

Then I flew back to San Diego.

And something interesting started happening.

The system began… working.

First there was a message asking if I wanted to move the appointment earlier.

Yes, please.

Then another message.

Would Tuesday work instead?

Yes, please.

Then on Monday at eleven in the morning I received a text:

There is an appointment available in thirty minutes.

Would you like it?

I ran.

That physician assistant turned out to be another small miracle.

She listened to everything.

Approved the Detroit neurologist’s recommendations.

Then did something even smarter.

She switched me to Lyrica.

Which is essentially slow-release gabapentin.

Instead of spikes between doses, the medication stays steady.

Which means fewer surprise visits to pain levels eight or nine.

She also wrote everything up and sent it to the neurologist’s office to see if they wanted to move my appointment sooner.

Two hours later I received a phone call.

“Can you come in Friday at eight?”

I just kept saying yes.

Over and over again.

After I hung up the phone I cried.

Which is sometimes what happens when relief arrives after a long stretch of uncertainty.

That night I started the full stack.

Muscle relaxant.

Aleve.

Lyrica.

I feel mildly drugged most of the time.

Like the sensation of being sleep deprived, except without the exhaustion.

When I drive I blast music or audiobooks and turn the air conditioning up.

Just to keep my brain alert.

I also requested a temporary work accommodation so I can work remotely for a couple weeks.

Driving right now feels… adventurous.

And not the fun kind.

But the pain itself?

It’s now mostly a one or two.

Sometimes a three.

Which feels miraculous compared to where things started.

All thanks to a chain of people.

A brilliant PA.

An ER doctor with a pinched nerve who became curious.

A friend in Detroit who happened to know a neurologist.

And a few lucky openings in appointment schedules.

The American healthcare system, it must be said, is an absolute mess.

Holy hell.

But sometimes, within that mess, the right humans appear at exactly the right moment.

Which makes you realize something strange.

The system might be broken.

But the people inside it?

Sometimes they bend the whole universe a little bit in your favor.

Tomorrow morning I meet the neurologist.

We’ll see what happens next.