Complementary Treatments for Migraine

I’ve written here before about migraines.  Grace was plagued by migraines during the prodromal phase of the disease onset (that feels like a redundancy).  Migraines are the bane of my existence.  My neurologist jumps through whatever hoops neurologists jump through in order to try to keep mine in check.  I have a “migraineur’s brain” meaning that I have T2 lesions on my brain that show up on an MRI.  Migraines cause lesions on the brain.  Scary thought.  Neurologists call it “scar tissue”.  I don’t know about you, but I don’t want scar tissue on my brain.  I don’t want Grace having scar tissue on her brain.

What can we migraineurs do about it?

I’m on a shit ton of medication which works prophylactically to prevent migraines, and, even though I still get them, it works 50% of the time in a bad month when stress is sky high and 75% when life is holding.  That’s not bad.

200_s.gif

Could it be better? Sh’yeah!

I have reached a somewhat desperate state.  I went to the emergency room at 2 AM this morning because my migraine was beyond self-help.  It was at a 9 or 10 on the pain scale, and, once the barfing starts, it won’t stop.  The good people of my local ER were on it, and I was home by 5:30 AM sans any pain at all.

This is no way to live.  So, if you live with chronic migraine disease, what can you do? My neurologist puts me on prednisone from time to time in an attempt to arrest a migraine that might feel like sticking around.  That didn’t work this time.  I’m on prednisone now, and that is not a drug one wants to be on.  Side effects, anyone?

Let’s talk about an alternative treatment.  Butterbur and feverfew.

In 2012, the American Academy of Neurology (AAN) updated its guidelines on migraine prevention to include complementary treatments. Based on reviews of clinical studies, the AAN recommends:

  • Butterbur (Petasites hybridus). Butterbur is a traditional herbal remedy used for many types of ailments, including migraine. The AAN considers butterbur “effective” and recommends it be offered for migraine prevention. Butterbur was the only non-drug treatment ranked by the AAN as having the highest proof of evidence (Level A) for effectiveness. Butterbur may cause an allergic reaction in people who are sensitive to ragweed and related plants.
  • Feverfew. Feverfew is another well-studied herbal remedy for headaches. The AAN ranks feverfew as “probably effective” (Level B evidence) and recommends that it be considered for migraine prevention. Pregnant women should not take this herb as it may potentially harm the fetus.
  • Riboflavin (Vitamin B2) and Magnesium. Riboflavin and magnesium are the two vitamin and mineral supplments ranked by the AAN as “probably effective”. Vitamin B2 is generally safe, although some people taking high doses develop diarrhea. Magnesium helps relax blood vessels. Some studies have reported a higher rate of magnesium deficiencies in some patients with migraine..

German doctors have been using butterbur as a prophylactic treatment for migraine with great success since the 1980s.  It is a widely recommended and known treatment in Germany and other European countries.  My neurologist may not know about this nor has she recommended magnesium to me.  She has recommended vitamin D due to low vitamin D levels being linked to inflammation.

The thing to note about butterbur is a pesky alkaloid that is toxic to your liver–pyrrolizidine alkaloids.  They are indicated on butterbur supplements as PA, and all butterbur supplements should say “PA-free”.  I note this because there was a change in a German company’s manufacturing process a few years ago, and their butterbur supplement, Petadolex, suddenly became contaminated with those pesky alkaloids.  A review and subsequent testing of the supplement revealed that the hepatoxic alkaloid compounds were still present in the supplement, and Germany removed the supplement from the market; Switzerland banned the sale of all butterbur supplements altogether.  There are, however, other companies that produce butterbur supplements other than Weber and Weber, the German-based company who failed the investigation.  Oddly enough, you can still buy Weber and Weber’s butterbur supplement on Amazon, so beware.

This is a case of throwing out the baby with the bathwater (Switzerland, I am talking to you).  Everyone in the know is aware of hepatoxic alkaloids in butterbur.  Why the American Headache Society is attempting to formulate a stance on it is beyond me unless it just doesn’t want anyone taking butterbur at all to prevent litigious action.  In the end, you need to be smart.  If our doctors have us taking a plethora of drugs in an attempt to manage our pain, then why not look at butterbur as well? Have you read the side effects of these anticonvulsants, steroids, and triptans? Nothing is very good here.

In the meantime, here is an excellent butterbur supplement that is PA-free and also contains feverfew and magnesium.  It’s wheat-free, gluten-free, and even vegetarian.

Do some research for yourself if you struggle with migraines.  There are complementary treatments.  Sometimes we have to be the ones to find them.

Further Reading:

Preventing Migraine Pain with Butterbur (great article)

Migraine Preventative Butterbur has Safety Concerns

 

Random Thoughts during A Spring Blizzard

In which MJ has a problem keeping her thoughts to herself

It has been a long week.  We are under a winter storm advisory during spring break.  Typical.

The girls have been little super heroes this week.  I have zero complaints about them.  In fact, I figured something out, y’all.  I figured out that I could delegate.  I could ask a few of them to sort the laundry and ask another one of them to start a load of laundry.  And, you know what? They did it! Milly likes to help me fold laundry so I actually conquered the mountain range in the basement.  Laundry is my nemesis.  I hate it.  Truly.  I would rather shave the cat or stick my tongue on a frozen flagpole than do laundry.  In fact, I have actually shaved a cat in lieu of doing laundry.  No lie.

I had my MRI and EEG on Monday, and I saw an eye doctor today.  The MRI was fine, and Gene did a good job injecting the dye into my arm.  It didn’t hurt at all.  Good job, Gene.  As I predicted, my EEG was clean.  They always are.  I haven’t had a seizure in ages.  My MRI was weird, and I’m irritated with my awesome neurologist.  While there was no visible inflammation of the optic nerve, there were white matter lesions.  She didn’t say how many.  Huh.  She then said that the lesions hadn’t changed since my 2009 scan.  I don’t recall her telling me in 2009 that I had lesions.  What the heck, awesome neurologist? She told me that my chronic migraines were the cause of my white matter lesions.  Great.  I now understand why she’s adamant that I keep them under control as if I don’t try to do that.  I get about twelve migraines a month.  In a good month, I’ll get about seven.  Without the Topamax, I’d get about twenty a month so the drug does something for me.  She told me that I had to see an eye doctor as soon as possible because she couldn’t rule out optic neuritis.

Fine.  Sigh.

I saw him this afternoon.  My favorite eye doctor retired.  He was great.  The dude I saw today was just…limp.  He had zero personality and a terrible bedside manner.  He should not be allowed to interact with humans.  He should be a neurologist.

I tried my best to be charming and charismatic which just really means that I unintentionally acted like a dumb housewife.  My left eye was throbbing so I was squinting and twitching a bit.  I had a migraine earlier in the day because, you know, the odds are about 50/50 that I will have one.  Zomig, the abortive drug used to stop migraines, gives me a bit of a slur.  My hair was braided, and I was wearing my retro grape Crush shirt with pink Converse.  I think I looked and acted like a stoner.  He didn’t say one word during the entire exam.  Normally, I don’t mind the silence, but this was really awkward.  He was holding my eye open with his fingers! To be honest, I am so glad that this man wasn’t a gynecologist.  Can you imagine?

“Scoot down.  A little more.  A little more.  A little more please.”

This man must be the caller at a spelling bee in his spare time.  He must make children cry.  He calls out the words with his stony voice and then stares the children down silently when they ask, “Could you use that in a sentence please?”

Anyway, after he thoroughly molested both my eyeballs, he declared that my eyes looked healthy.  He also said that I most likely had a bout of optic neuritis.  He then very directly said, “You know that optic neuritis is strongly associated with MS.”  I immediately thought to myself that this man was in the wrong field.  He should have been a process server! I really wanted to roll my eyes, but, unfortunately, I can’t.  My left eye won’t roll up right now.  What kind of justice is that? I’ve lost the ability to roll my eyes! Here, I’ll let Tina Fey do it for me:

I told him that I already knew that.  My mother has MS, and my awesome neurologist informed me of the risks associated with optic neuritis.  It’s why she sent me to see him.  She wanted his opinion.  Optic neuritis won’t necessarily show up on an MRI particularly after a run of prednisone.  He told me that the prednisone most likely calmed the inflammation down which is why it didn’t show up on the scan.  I have to go back in two weeks for a field vision test to see how much damage has been done to my nerve by the inflammation.  So far, color is a bit desaturated in my left eye.  Red is more orange, and I still can’t focus as well as I could before the inflammation occurred.  Apparently, this is normal after ON.  ON is often a recurring condition.  I had to ask him directly what to do should I wake up one morning with an exacerbation.  He flatly said, “Call your neurologist and get an MRI.”

I don’t like him.  He isn’t very helpful.  I had to drag the information out of him.  Thank God for the Internet.  I read up on ON a ton before I even saw him so I knew what to ask.  What if I didn’t know what to ask? What if I was scared or nervous or had no access to the Internet or had little experience with uptight doctors?

Can I just say this: I do NOT have time for this!!!! I need a working eye.  I don’t need or want trigeminal nerve pain.  I don’t need or want an inflamed optic nerve.

So, I’m going to see a functional internist.  She’s the one that diagnosed my celiac disease.  She looks at the why behind the symptoms.  She’ll know what to do.  She won’t just throw steroids at me.

In the meantime, I’m starting the Paleo diet.  It’s anti-inflammatory.  Good-bye, dairy and sugar (insert pouting face).  Hopefully, I’ll feel better so that I can get back to, you know, rolling my eyes and other important things.

Cheese and Whine

In which MJ might whine a little or a lot

I like to process my life through humor.  If I didn’t, then I would turn into a mushpile.  It’s just too intense.  So, we laugh a lot around here.  Laughter and humor are probably one of the best ways to process intensity.  There are only three ways to rid your body of stress hormones: tears, sweat, and laughter.  I choose laughter every time.  Crying ruins your make-up, and sweating ruins your hair.  I kid.  Sort of.  Besides laughing is just more fun.

I’ve been judged by a few people because I don’t see the intensely moving films at the cinema anymore.  I don’t go see the documentaries like “Waiting for Superman”.  Why would I? I’ve already had to testify in front of a judge in the case of a dismissal of a school principal.  I’ve taken on the school board.  I don’t want to sit in a theatre and relive it! It’s hard for me to read intense fiction as well because real life is over the top around here.  I don’t want to enter into more fictional intensity in my free time unless it’s going to be truly meaningful.

So, yesterday I watched the first episode of “The X Files” with Doireann.  She was home sick, and I was on the couch feeling very weird.  I had to see my neurologist yesterday for my six month check-in, and I predicted before I went that I wasn’t going to leave her office unscathed.  I’ve had some weirder than my normally weird symptoms for the past few months.  I am a known under-utilizer.  I don’t call my doctor if I’m ill.  I won’t even go to the ER if I’m having an anaphylactic reaction.  I just stab myself in the leg with my Epi-pen, down two Benadryl, and keep going.  I don’t know why I’m like this.  It annoys my family to no end.  It may be that it’s because I have a family of already very needy kids who need a lot from the healthcare system.  I don’t want to be another reason that we’re paying more medical bills, and I just finished paying off that surgery and hospital stay associated with that “idiopathic” kidney stone! (Psst…it was caused by a 6-week vitamin D blast prescribed by my PCP) I also don’t like the attention.  I was sick for most of my childhood and adolescence.  I hate seeing doctors.  HATE.

So, when I had to tell my neurologist yesterday that I suddenly can’t see very well out of my left eye, I’ve had two weird phantosmia events wherein I’ve smelled something burning accompanied by extreme vertigo, and last fall I had about three weeks of searing pain and tearing in my left eye going into my jaw all occurring at 3:45 AM, I knew that she was going to make her annoyed face.  I was right.  She looked irked.

“It’s stress, right?”

“No, your chronic migraines are stress.  You are not describing migraines.  This is different.”

Well, fine.  I tried to roll my eyes, but my left eye won’t quite roll.  It sort of gets stuck if that’s possible.

images

It doesn’t matter that my face will freeze like this. I look fine, right?

She mentioned the words “seizure”, “optic neuritis”, “cluster headaches”, “MRI with contrast”, “EEG”, “prednisone” and some other medication that was entirely new to me.  I whined a lot.

“Not another MRI! I hate them! With contrast this time? NO!”

“You knew coming in with all these symptoms that you weren’t leaving without an MRI and an EEG, didn’t you? It’s been a few years since you’ve had a scan.  An EEG is easy.  I want to be sure you’re not having breakthrough seizures.  That burning smell you’re smelling is neurological.  I need to be sure I don’t need to tweak your meds.”

I whined some more.

“I’m putting you on a coarse of prednisone and verapamil to stop these cluster headaches.  You’ll come back in six weeks to wean off the verapamil.  Side effects aren’t too bad.  Nausea, dizziness…constipation.”

More whining.

“I want that MRI ASAP.  I need to make sure that you don’t have optic neuritis.  Your symptoms are bothersome.  I’ve got to rule out MS.”

“Aw, come on!”

What can I say? I am a horrible patient.  She smiled at me.  I did all the neurological testing like heel-toeing it for her, touching my nose and her finger, and all the rest of it.  I did well.  No drunk walking here!

I am, however, not enjoying my prednisone and verapamil.  I feel WEIRD.  Sort of wired, hot, and tired at the same time.  My eye still feels funny, but the good news is that the trigeminal nerve that was causing those cluster headaches does not hurt this morning.  I can directly press on it, and I don’t feel a thing.  Thank you, prednisone! For the past week, it has been throbbing and keeping me up at night! Okay, okay, so my neurologist knows what she’s doing.

Now it’s just a matter of showing up for the testing.  Ode to joy.  I really don’t like EEGs.  At least it won’t be a sleep-deprived EEG.  At least I don’t think it will be.

Okay.  I’ve whined.  I’ve complained.  I’ve taken my morning prednisone dose.  Hey, it’s Buy One Get One Free at Caribou today in celebration of spring.  I think I’ll get a coffee involving lots of whipped cream! It’s not cheese, but it’s dairy.  That counts, right?

images-1

Yes. Yes, I would!

The Migraine Treatment Plan

I think we’ve got a winning treatment plan for Grace’s migraines! Her neurologist started her on Topamax prophylactically, and she is to receive a Toradol injection at the onset of a migraine cycle.  Grace is only on 25 mg of Topamax currently, but the goal is 100 mg.

Grace’s migraines have never responded to OTC medications; they have been intractable.  So, when we were at the hospital awaiting the injection, we were both a little dubious.  Lo, the Toradol was effective within 20 minutes.  It was an intramuscular injection, and it did sting quite a bit.  Grace has, however, not experienced a return of any migraine symptoms in a week.  I would say that the use of Toradol is akin to a steroid burst used to treat migraines in adults.  Toradol is an NSAID used to treat moderate to severe pain often in place of opioids.  I have used it post-surgery in pill form, and it was a very effective analgesic.  I can’t tell you how relieved I am to see Grace pain-free.

Speaking of migraines, I had to take the bull by the horns, so to speak, where my own migraines were concerned and make a decision.  Coffee or no coffee.  I was getting severe migraines every 48 hours, and I figured coffee was exacerbating them.  I don’t drink that much coffee–maybe 2 cups a day.  Three if I’m really jonesin’.  But, for the Migraine Brain, caffeine is either friend or foe.  In my case, I think it became Enemy #1.  I cut myself off last Sunday.  I didn’t anticipate that it was going to be as horrible as it was.  Why do we do this to ourselves? It was agony! Oh the pain!! I wanted to die.

I thought Monday was going to be better, but it was worse than Sunday.  Yesterday I got a cluster headache.  I kept wondering if coffee could cause all this pain and suffering.  Today, I feel better.  I feel more alert than I have in a long time, and my head doesn’t hurt.  Seriously…I love coffee, but I may never drink another caffeinated cup of coffee again after what I’ve just been through.  I’m very hopeful that some of the rebound headaches and various kinds of migraines I’ve been getting will stop now.  Apparently, caffeine makes medication more bioavailable.  That’s why it’s often partnered with pain relieving drugs.  It has nothing to do with our vascular system.  It acts as another drug.  It enhances the analgesic effect.  This is why acetaminophen is used with certain narcotics.  It enhances their effect.  No wonder caffeine can cause rebound headaches! That and the fact that caffeine sits perfectly in our adenosine receptors, thus, becoming an adenosine-receptor antagonist as well as causing increases in dopamine.  I wish someone had some real answers about caffeine and headaches, but the more I read the more I see that everyone is postulating.

In the end, I do see that I have to give up the coffee if I want to be free of the headaches.  I guess its tisanes and rooibos now.  Sheesh…

I like rooibos.  I like tisanes.  I wonder if I should get into flavored oxygen….

images

Attitudes, Migraines, and Melatonin

I am amazed at the things that will cause a 13 year-old girl to cop an attitude.  For Grace, it’s this:

imgres-4

Grace struggles with maintaining her blood sugar, or, at least, she thinks she does.  We’re not sure.  Abilify affects the pancreas.  We do know this.  Well, if Grace doesn’t eat something every two hours, her mood tanks.  She becomes irritable, unreasonable, shaky, and then she starts crying.  If she eats candy, then you can forget the rest of your day.  Skittles will send her into a tailspin.  So, I’ve started packing thinkThin bars in her backpack as an afternoon snack.  With 20 grams of protein, a low glycemic index, and no sugar, it is the perfect thing for her to eat at midday.  For the record, they taste good.  They are not your mother’s 1970s weight-loss bar.  I would eat this if they didn’t have soy.  Sometimes I still sneak one.

Grace, however, almost has a fit over having to eat these bars! It’s like I’m making her eat alfalfa sprouts, raw mushrooms, and barley grass.  She tried to have a showdown with me this morning when I insisted she bring one to school.  She wanted to eat popcorn.  How is popcorn going to maintain her blood sugar? She stood in the living room and glared at me, as if I could’t sense that.  I’m sorry, I do live with two other teenaged girls, thank you very much.  They do, on occasion, glare at me from that same spot.  I’m not your friend, sugar pie.  I’m your mom! I’m trying to help you so holster that attitude before you shoot yourself in the foot!

In other news, I came across a meta-study regarding migraine and cluster headaches.  This is important so hear me out.  If you struggle with migraines or the dreaded cluster headache, then you will want to read this study or, at least, find out the results of my trial.  I have just come off a three month run of migraines/cluster headaches.  Yes, I do take Topamax to prevent migraines, but when I’m stuck in a period of clustering it doesn’t seem to do much good.  I take that back.  I’ll get 12 headaches a month as opposed to 20 which was the case pre-Topamax.  My neurologist finally prescribed prednisone in an attempt to stop the headaches altogether.  It worked for a week.  For months, I was awakened at around 3:30 AM every other night either with an aura or in the middle of some sort of headache–migraine or cluster.  I was starting to go crazy.  I started looking for alternative treatments.

According to this study, the use of melatonin before bedtime helped almost every migraineur in some way.  Blood tests revealed low levels of melatonin in migraineurs.  I gave it a shot.  I took 5 mg of time-released melatonin just as I was going to bed.  The first night I slept like a rock.  I could barely get up in the morning, and I was very disoriented the next day.  It was suggested to me that my state was caused by sleep deprivation.  That’s possible.  i, however, did not get a migraine.  The next night I slept well, and I woke up feeling more refreshed and less disoriented.  Once again, I did not get a migraine.  Last night, I took melatonin, and I did not get a migraine.  This morning, I feel a bit better.  One thing to note, melatonin can give you weird dreams.  This has been true for me.  I dreamed that I was surrounded by giant rabbits the size of Irish Wolf Hounds, and they were all trying to kiss me.  Weird…

Needless to say, if you struggle with migraines or cluster headaches, think about taking melatonin.  I was very dubious, but I was also desperate.  So far, it has provided me with three days of relief.  That’s the longest I’ve gone without a headache since July.

Resources:

The Therapeutic Potential of Melatonin in Migraines and Other Headache Types

Taking Care of Yourself

Self-care is an essential topic particularly in the context of parenting or even caring for special needs people.  You could have a spouse with a chronic health condition, or you could be an adult child caring for an aging, ailing parent.  Or, like me, you could have one or more children with special needs.  I’ve named this blog “Empowered Grace” after my daughter Grace who has childhood-onset schizophrenia, but, in reality, I have four daughters three of whom have special needs.  My youngest has an autism spectrum disorder, and my second daughter was diagnosed with cyclothymia last Friday–a bipolar spectrum disorder.  Clearly, my husband’s and my genetics have combined in a most interesting way.  We won the genetic lottery.

It seems counterintuitive to put yourself first if you are the primary caregiver, and, at times, it’s damn near impossible.  I have learned through experience, however, that it is crucial to take care of yourself–to nurture yourself–or you will be useless to the people in your life depending upon you to nurture and care for them.

A few months ago I noticed that my hair was falling out.  I also noticed that I was getting gray hair.  I had to go to the dermatologist as well because my skin had transformed into that of my 17 year-old self.  Gray hair, hair loss, and acne? What curse had befallen me? My nails had become brittle, and I was chronically exhausted.  I also had a terrible taste in my mouth that no amount of teeth brushing and gargling would eradicate.  My libido had vanished, and within 6 months I had lost fifteen pounds.  The problem with the weight loss is that I didn’t need to lose fifteen pounds.  I don’t need to be 6 feet tall and size 4, but I was well on my way.  As it turns out, I was anemic, my vitamin D levels were in the toilet, my thyroid was sluggish, and I had a zinc deficiency.  This was all due to my not taking care of myself.  To getting lost in Grace’s multiple and relentless crises. I was no longer able to manage the stress in my life so I made some kind of tacit agreement with what circumstances seemed to only confirm: “I don’t matter.  Just keep calm and carry on even if that comes at my expense.”  I stopped sleeping and eating with any kind of consistency.  I stopped exercising because I couldn’t leave Grace alone or with anyone other than myself or my husband.  I just…eroded into a state of existential transparency.

I see a lot of people take this road because they feel forced onto it, almost cut off from the world of the living by horrible circumstances and a lack of resources.  It doesn’t take a lot in our present economy to tip a family over the edge into financial uncertainty or even crisis.  I know the statistics.  There are many families dealing with pediatric mental illness who are under or even uninsured.  They struggle to make rent and even feed their families.  I’ve been told more than once that I’m one of the lucky ones because we are insured, and I’m able to make the necessary sacrifices in my schedule to be home should a child need me.  Alas, the finger wagging, and “shoulding on” and “Oh, aren’t you lucky that you can stay home and take care of your children,” doesn’t make it better because those aren’t really supportive statements at all.  They are minimizing statements that cause suffering people to internalize their pain lest they sound “whiny” or “ungrateful” because they start to think that it could always be worse.  “I guess I shouldn’t share how I feel about my schizophrenic daughter and my autistic daughter and my bipolar daughter ( or fill in the blank with your circumstances) and my struggles to be a good mom.  I mean, I’m not homeless WITH these children in tow.  My husband isn’t beating us.  We have insurance although the deductible is high.  I guess I should just be quiet about it.  I can stay home, but I have to stay there.  I’m landlocked.  Oh, but that’s fine.  It’s all good.  Some people don’t have insurance at all.  I suppose I really should just swallow it and cope.”

So, Step 1 in taking care of yourself is: Find a supportive community where your circumstances won’t be minimized or normalized.  While I want to know the truth of other people’s circumstances so that I can offer support and keep a clear perspective on my own situation, I don’t want my life to be compared to someone else’s nor should we compare our pain, struggles, and issues with those of others.  It will never be a valid comparison because no two people are alike.  For example, The National Alliance on Mental Illness offers support groups for parents and siblings of those suffering with mental illness.  There are ‘Moms’ Night Out’ opportunities and other similar offerings.  To find your local NAMI, go here.  A note: Beware of what I call The Professional Victims.  I’ve run into quite a few women who compete with one another in the area of “I feel worse than you do” when it comes to taking care of their special needs children.  It seems that many of these caregivers will deliberately neglect themselves for the sake of playing the martyr.  I know I’m making a bold statement here, but it’s very important to listen to their language and then watch how they interact with their children and with others.  They are very loud and draw a lot of attention to themselves about their fatigue and lack of sleep, sighing loudly all the time.  They carry on about how little time they have for themselves casting contemptuous glances at their children.  They emanate bitterness and anger, and they are one of the primary groups who will minimize your pain because they are always suffering more than you.  If you’ve managed to shower and comb your hair as well as match your socks? Beware.  Clearly, your child must not really have a legitimate problem because YOU look relatively presentable.  I was actually told once that I was not being taken seriously in our IEP process because I didn’t look exhausted and sick enough.  This comment reflects the aforementioned toxic attitude so prevalent among this group of people.

Step 2 in taking care of yourself is: Pay attention to how you feel about yourself.  When I was in the thick of Grace’s psychosis last summer, I felt absolutely adrift and, well, ugly.  I’m a Southern gal at heart when it comes to my appearance, and I love being a girl.  I love hair, make-up, and mani/pedis, but I had lost all motivation to care for myself not to mention the time and money.  Most of our extra money had been usurped by medical bills.  I felt discouraged, uncomfortable in my skin, and ashamed.  I wanted nothing to do with my husband in the bedroom.  I was honest with myself about what it would take to feel better.  I just wanted a cut and color.  I could give myself a mani/pedi.  I found a local cosmetology school that offered cuts and color at a substantially reduced price, and I got my cut and color for $40.  I felt like a new woman, and that boost to my self-esteem energized me enough to get me through the rest of the summer.  So, do what enhances your self-esteem be that finding time to exercise, giving yourself a mani/pedi, or finding affordable ways to make yourself feel better by getting back to your hobbies or the like.  Some of those cosmetology schools also offer massage.  When we nurture ourselves in this way we tend to nurture those around us, too, not to mention we are modeling self-care.  A suggestion for reduced price self-care opportunities: The Aveda Institute.

Step 3 in taking care of yourself is individual counseling.  I did and continue to see a therapist.  I have found it extremely helpful in checking my reality and getting support as a mother, wife, friend, and woman.  It’s the one place I can go and just be myself.  My therapist is a wonderful woman who is immensely supportive, and she is like a cheerleader for me.  People like this can be few and far between in our lives, and I recommend that everyone find time to develop a relationship with a therapist.  Many fantastic therapists have sliding fee scales so be persistent when searching.

Step 4 in taking care of yourself is addressing one’s diet.  In my case, eating.  Period.  I stopped eating for days at a time during Grace’s crisis.  I was nauseated much of the time, and I had no desire to eat.  This was a huge contributor to my nutritional deficiencies and unnecessary weight loss.  I have Fibromyalgia, Celiac Disease, and Chronic Migraine Disease.  Not eating is only going to exacerbate the migraines and cause “fibro flares”, but, at that time, it just felt that everyone else’s needs surpassed mine.  I felt lost in the maelstrom.  I still have a problem eating due to the side effects of medication, but I have since learned to fill in the gap with supplements.  Supplements can eat away at a budget but figuring out what gaps need filling in has changed things drastically.  I follow a gluten-free diet religiously due to the Celiac Disease, but the GF diet can cause certain deficiencies.  I do not drink soda–ever.  Because I struggle to maintain caloric intake I can’t include empty calories in my diet.  I do drink tea and coffee, but both have noted health benefits.  I make my own GF breads so I can choose which flours to use and what to add to enhance their nutrition.  After visiting my doctor, I have a list of supplements recommended for inflammation (Turmeric, Vitamin D, and Fish Oil) and stress (Rhodiola and Schizandra).  I take a few others (zinc, L-Arginine, B-12 due to longterm anticonvulsant use, Vitamin C, multi-vitamin, Elderberry, Milk Thistle for liver support, and Calcium-Magnesium).  After adding the turmeric whose active component is curcumin, I have cut my NSAID usage by 80%.  That’s substantial.  My migraines have improved as have the Fibromyalgia symptoms.

Step 5 in taking care of yourself is remembering who you are as a person outside of your family and whatever troubling or trying circumstances envelop you.  After years of dealing with crisis after crisis, I began to feel like I only existed to meet the needs of my family and my ill or needy children.  If it wasn’t autism, then it was something else.  Now, it’s schizophrenia and a bipolar spectrum disorder.  What will it be tomorrow? I needed an attitude adjustment, and I needed to find myself again.  I needed to remember who I was.  I started going to the local museums that I so loved, having tea in the afternoon in my pretty tea cups, listening to music I like, dancing in my room, and doing little things here and there that awakened me to, well, myself.  Don’t miss this.  Gracie was still around.  She was still skulking around the house in either a manic or depressed state.  She was still hallucinating.  Milly was still banging on my bedroom door claiming to need something, (“The cheese is broken!“)  I just chose to finish dancing to my favorite song or calmly drink my Monkey Picked Oolong in the midst of the latest psychiatric crisis.  This is my life.  It’s not going anywhere so I needed to learn to find the beauty and the joy in it.  I needed to remember that I was so much more than just Grace’s mother or a homeschooler or a…  I am me, and I was me long before I was Grace’s mother or my husband’s wife.  To me, that’s the best thing you can do to take care of yourself.

Hold onto yourself because YOU are what everyone around you loves, needs, and leans on.  And, YOU are still your best advocate.