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Between a Rock and a Hard Place - How do We Choose?

September 19th, 2008

The first in a series of posts on Migraineurs making choices for our health care and our lives.

How do we choose? We are faced with choices on a daily basis. We lose sleep over them; they feel momentous, life-changing.  Rarely are they an Indiana Jones moment:

1. if I step on the wrong step it will crumble below me and hurl me into the rat/snake/cockroach infested pit, or
2. if I stake all on drinking from the gold cup my eyeballs will melt and I will desiccate into a human husk, so that the 2000 year-old crusader can say “he chose unwisely.”

Most of our choices change our lives more gradually!

For those of us with Migraine disease and chronic illness, choices often revolve around

1. what treatments to try, and
2. how to manage to make our living.

Most choices in life are reversible; we can change our minds, have a chance to learn from our mistakes.  Usually there is no one clear right choice.  In medical situations we often wish there was one.  How about the doctor coming to us and saying, “Well, Ms. So and So, here’s the choice

1. If you take this course of treatment it will cost you $2500 and you will feel worse for 2 months, 3 days and 16 hours, but then you will lose 30 pounds, become a natural blond, your Migraines will cease forever and you will never age another day.

2. On the other hand if you don’t take the course of treatment your fingers will gradually turn to pretzel sticks and crumble away, your brain will become a giant chicken heart and eat Philadelphia, your best friend will never speak to you again, and you will have a Migraine every day forever.”

I don’t know about you, but I’d go for the treatment.  And I don’t even want to be a blond!

Okay, I’m being extreme.  I hope I didn’t lose you there in all my silliness; there really is a point.  It is rarely given to us to know whether we are making the right choice, before, during, or after.  We have to weigh our options, but then we just have to choose.

Before I had my first child I fell and herniated a disk in my low back, causing two years of back pain.  Then I had a difficult labor with an erratic pattern of contractions, wearing me out without making progress.  After 18 hours of labor, I chose to use pitocin, a synthetic hormone, to stimulate the labor, and the pitocin made the contractions strong and painful enough that I felt I needed anesthesia.  I had to choose between taking pain-killers and having an epidural (where anesthetic would be injected into the dura, or sack, around my spine).  With an epidural there was a chance that my disk problem could become worse, even to the point of permanent back pain.  With pain-killers, if I ended up with a cesarian section, I would need general anesthesia.  The choice was to be awake for my daughter’s birth and risk disabling back pain, or to risk being knocked out for her birth with no back complications.  I chose the epidural.  I did have a cesarian; I was awake; and I did not develop any back problems from it.

My husband and I will never forget when I was lying in the birthing chair, pitocin-induced contractions sending me into ever higher spikes of pain and exertion, trying to make a choice in the panting moments between.  We were 31 years old, and we felt like we became adults in that moment.  If I had ended up with disabling back pain, I don’t know if I would have said it was the right choice.  To be awake and hold Rachel in the moment after she came into the world was a joy I did not want to miss.  That was what I chose.  But who can say if it was the right choice?

The choice I made recently was to start on Migraine preventive medication.  I spent at least 6 months making that choice.  It was a choice I was considering for at least 4 years.  Sometimes a choice needs to stew on the back burner of our minds.  In that 6 months I:
•    Found a doctor I could trust (which took several tries and months of waiting for appointments);
•    Did a lot of on-line research, and read about other’s experiences with preventives;
•    Recommitted to my meditation and relaxation program;
•    Tried magnesium and B2 supplements;
•    Tracked my Migraine numbers; and
•    Talked about the decision with my friends on and off line, my husband, my family.

Eventually, the choice just felt clear.

I will be returning to this subject of choosing in several more posts in the near future – if you’ve read all the way down here I’ve kept you too long already!  What I’ll leave you with today is to say that those times when you must make that life-changing decision right now are rare.  We usually have some time to make our choices.  Use that time.  Let things simmer on the back burner.  Let your subconscious mind do its job.  Will you make the right choice?  Nobody knows.  But you can make the choice with much less anxiety in the meantime.

- Megan Oltman

Pretzel sticks image coutesy of Windell Oskay; image of window at Mesa Verde is by me to illustrate being between a rock and a hard place - Mesa Verde is all rocks & hard places.  And amazing.

Tags: childbirth, chronic illness, Indiana Jones, making choices, Migraine disease, Migraine treatment, pitocin
Posted in Managing, Medicine, Silliness | Comments (7)

7 Responses to “Between a Rock and a Hard Place - How do We Choose?”

1. Anna Says:
   September 19th, 2008 at 8:16 pm

   Wow, I never looked at it as the Indiana Jones way. You make me smile.
   Have a beautiful weekend.
   Anna

2. Sara Says:
   September 19th, 2008 at 10:45 pm

   I hope your decision gives you the relief from pain you’re looking for! I too went on a preventative, but I resisted it for a while because I was on other daily meds and didn’t want to be on yet another one. Luckily, after I started taking it, I did notice a positive change. I still get migraines, but the severity and frequency is MUCH less. Here’s hoping you have the same positive results, if not even better!

3. Joseph Says:
   September 20th, 2008 at 9:05 am

   Just drop by to say hello. Hope you get well soon. Will drinking more water help? I read from a book that some migraine is due to lack of water. Your job nature may deprive you of drinking enough water, may be. God bless.

4. Megan Oltman Says:
   September 20th, 2008 at 9:52 am

   Joseph thanks for the reminder on the water! Migraine is a neurological disease with attacks which can be triggered by many things, one of them is dehydration. So lack of water doesn’t cause the Migraines, and water can’t cure them, but it’s very important for Migraineurs to stay well hydrated. I drink about a gallon of water per day (nearly 4 liters) so it would be hard for me to drink any more! Thanks for coming by - I do appreciate the well wishes!

   Sara I’m so glad your preventives are working for you - it’s too early to tell for me but I’ll come give a report here soon, you can bet.

   Anna I’ve been enjoying getting to know your blog. Thanks for coming by!

5. Kendall Says:
   September 22nd, 2008 at 2:06 pm

   Just got really bad news: the ESCAPE migraine trial has just been cancelled. No PFO Closures for migraineurs. Bummer. It was my only hope left. Everything else has failed, and I’m getting 8 migraines a month. I now wonder if all the triggers I’ve avoided the past 30 years were for naught–it was the PFO that was the problem. I’m on my way to buy an espresso to sip on the way to a liquor store, and after that I’m going to stop off and buy myself a box of chocolates. Grrrrr.

6. Amy Says:
   September 22nd, 2008 at 3:22 pm

   I love your comparison to Indiana Jones! I have so much trouble making decisions about medication for my headaches that I have gone without medication for some time now. In a way it really is that dangerous to try a new one. They can impact your your daily life so severely. At least with my headaches I know what to expect. Eventually, I will choose. Thanks for making me smile about it all.

7. MaxJerz Says:
   September 24th, 2008 at 3:51 pm

   Megs, thanks for this post. Very timely, as I’m coming up to some choices about where to go next with my treatment. I appreciate the reminder that I can take as much time as I need to make a decision.

   Be well,
   MJ

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