Short Term Gain, Long Term Pain

Think about where you are right now in your life. Maybe think about your job, your relationships, friends and hobbies. Think about your health.


Now think about where you'll be in 5 years time. Whether you'll be in the same job, be with the same person. Whether your health will still be the same. 


My acupuncturist today talked about how, 5 years into the future, my headache won't be such an important part of my life. 


But how can he know that? How can anyone know that? How can I dare to hope that? 


When you have chronic pain, you forget what life was like before it. You forget what it feels like to move without things aching, to wake up and spring out of bed. You can't remember the last week you went without trying some sort of pain relief, whether it be conventional medicine or otherwise. It still feels like regardless of any improvements over the last year, I still cannot envision a day without my headache. Without at least once a day going "ooof that hurts" or "urgh that aches". 


But my headache HAS improved in the last year. I've gone from needing deep heat on everyday, to every so often. I take painkillers less than once a week, when it used to be a miracle if I went a few days without them. 


I still crack and rub and generally wish away the pain, but I can't deny that there's been some change.

But some change doesn't feel like anything when you've been putting up with this for 8 years. And when a general improvement is punctuated with moments so dark, so distressing and so deeply agonising that you can barely gasp for breath, it doesn't feel like anything has gotten better really. 


As I write this, my head aches and my neck is so sore. When you've read this, and you go back to whatever you were doing, my head will still ache, my neck will still be sore, and I will still be thinking about 5 years time. 


Maybe, in 5 years time, I will be free.

Hello headache, my old friend

For more than eight years now I've woken up every day and had a headache. Eight years is a long time for my paltry memory to reach back, so I can't remember if it would be there when I opened my eyes right at the beginning. But in the last 5 or 6 years, it generally has.For a few bleary moments, approximately a second and a half, when I first open my eyes, my mind adjusts to the situation, and the context in which I base myself. This context of young woman with constant headache. Often, unless I am instantly hit with an inescapable thud of pain, those few bleary moments are a few bleary moments of freedom. It's as though my headache is waiting in the wings, a Pantomime villain, and my temples, my neck, my skull, my nerves and blood vessels are all about to join in a chorus of "he's behind you!"

And then out from the wings he leaps, cackling evilly and all the pain arrives trailing behind him like small minions. The headache orchestrates the minions, directing them to where he needs them most - lying across my forehead like a wet flannel, resting in my temple like mini Buddhas, ohming a tingle of agony. 
All this in those few bleary moments. 

I thought my headache was getting better. But this morning, as with yesterday too, my pantomime villain was barely containing himself to the wings before I opened my eyes.

And at 2am he snuck his new favourite pal in too: hello nausea, you sneaky bastard. I thought I'd had enough of you. 

When my alarm went at 7am, they were both there. Picnicking. Dining out on my nerves and blood vessels and pushing on certain bits and pressing on others. Feeling nausea lying in my throat; my headache lolling around above my eyebrows.

Dine away, villain. Push and press away. The context into which I awake everyday might include you, but it isn't solely about you. I am more than my pain. Good always defeats evil. Go back to the shadows with a boo and a hiss. You won't be missed. 

Deserving

At the first consultation of a new treatment Tuesday, after turning me into a human pin-cushion and hearing my life story, the acupuncturist said he didn't believe there was anything psychological to my headache. The solid mass that pretends to be my muscles gives him the hint that it's physiological. 

But at last weekend's hypnotherapy session I was asked about focusing on why my headache started. I spoke about how I often feel that I did something to cause this headache. The medication overuse, stress and anxiety, going on too many roller coasters. 

When you walk into a room for a Chiropractic appointment with someone who is not your usual chiropractor and they say that you're giving yourself mini-whiplash every time you flick your fringe out of your eyes and that's probably the cause of all your problems, you're inclined to believe them. They are the expert after all.

Except I didn't have a fringe when my headache started. Sure my mini-whiplash probably doesn't help, but it didn't cause my headache in the first place.

And the cause, the why my headache started, is likely to always be a mystery. Yes it could have been the stress of moving schools. Yes it could have been the roller coasters. 

Yes it could have been the medication overuse. And whilst I know that biologically medication overuse comes from taking pain killers too often, and not from huge quantities in one sitting, there is part of me that will always think I am to blame for this headache because of the things I have done, and because of the pain I have caused. It's karma. Except I can't cross it off a list like Earl. 

Trance on Saturday focused on emotions, and how they can cause pain. And how pain can manifest itself as an emotion. 

When I try to describe how my headache makes me feel, it's along the lines of frustrated, powerless. When I try to describe how my headache feels, if it were emotion, it would usually be anger. An anger that assaults my muscles, my skeleton, my senses, my organs. An anger that courses its way through my veins, pools in the temples, strikes behind the eyes, lies at the base of my skull, coiled like a snake waiting to spot its prey. 

When treatments don't work, I usually think it's because I haven't tried hard enough to make it work. When my head gets worse it is easy to point to the things I'm doing wrong, and not the things I'm doing right. The eating pastries as a snack, not the 2 litres of water I drink every day. The times I sit on my Xbox for hours not the runs I go for, the walking I do or the daily stretches. 

We only have one life, and sometimes it can be too short. I need to let go of this feeling that I did something in this life or lives past that mean I deserve this pain. I need to focus on making the best of the life I have, and make sure that I get the right balance to enjoy the life I deserve. 

The Problem With No Cure?

I haven't blogged here for a while not because my head has been good, but because I get so bored about talking about my headache, and I imagine so many people get tired of hearing about it.

What I would really like is a clean slate. For someone to take all my muscles out and replace them with new ones. To give me fresh blood vessels. To straighten out or curve up my spine so that's normal again. 

How much difference can you make to damaged goods? 

I can't see a future with this headache. Or is that my headache can't see a future with me? 

Waking Nightmare (aka 2nd migraine in 10 days)

I can't stress to you how much I know I could be worse off. 

But headaches, they affect your mind, and your perspective. 

Even as I cried in my dad's arms last night, there was a guy on the news who had been on the organ donor list for years. He's really sick. He's worse off.

I'm not dying, but sometimes it feels like I am. And sometimes it feels like it would be better if I did. 

Headaches are underestimated. You can't see them. If you don't suffer from headaches you can't understand the pain. If you've never experienced a migraine, then be grateful and pray you never do. 

The pain that can sometimes be a waking nightmare. A pain that stops you from moving, because every movement feels like the searing of flesh. 

It encourages a state of mind where nothing exists but the pain. Where you can't get to sleep because it hurts. Where you wake up early from the pain. Where you could be eating cat food for all you know, because your taste is dulled and the repetitive chewing motion you're putting yourself through feels like it'll go on forever. You're not in control of it, you're on autopilot. 

This headache, the constant dull tension headache and the throbbing migraines alike, they rob me of my control. Control over my movements, my actions. Control of my head. 

And especially control over who I am.

I emerge from my dark bedroom and my sick day still in pain. The remnants of yesterday's migraine linger on. 

And I soldier on. 8 years of pain. 

But I think I might be beaten. 

There's only so much a person can take.

Sour Patch

I have a spot on my neck, at the base of my skull, that gives me a lot of grief. 

From now on I'm going to call it my sour patch.

It hurts. It aches. It burns. It stings. It weighs me down. It feels like a pool of poison that spreads through the veins into my head. 

I woke up with a strong pain in this sour patch yesterday morning, and I knew it would be a bad day.

And it was. It was unpleasant, but anything that isn't a migraine I'm getting better disposed to cope with.

But I find my commitment to my treatment suffers when my head is worse. I stretch less. I'm more inclined to try and crack out the pain. And cracking my neck (and back and knuckles) is something I've been banned from doing. 
But still do. And I do it especially when I have a bad head because I feel like surely cracking that horrible area will release the tension and therefore the pain.

It doesn't work like that. I know it doesn't work like that.

I really wish it did.

But instead, I carry on. I try to remember to do my stretches and my breathing. 

And I'll try to remember not to crack.

And the most important thing, and the hardest thing to remember when you have a bad headache, like yesterday or like Friday's migraine, is that not every day is like this. Not everyday is this bad. Yes I still have a headache today, but it's a different headache. It's like tomorrow won't be as bad. 

Unless of course I'm brewing a menstrual migraine. Then it'll be 3 days til tomorrow won't be as bad.

Wearing Sunglasses Inside

Because lights make you feel sick.

And every noise is a sonic boom.

And you feel like your brain is burning up inside. 

No, that doesn't even begin to describe it. Is there ever any way to describe hell? 

Amitrip-down memory lane

I'm back on medication for my headache.


I haven't been on prescription medication of any sort for my headache for 3 years or more. The only regular medication I was taking was painkillers, Paracetamol mainly because years of abusing Ibuprofen had led to a sort of immunity to it. I'd gone back to it recently, since sometimes all the body needs is a break.  

But that abuse of pain killers could have been the root cause of my headache. Medication overuse. My body just stopped responding to all the painkillers I was chucking down my throat. Or just stopped responding in the right way.

I have tried to go cold turkey, but it's hard. Whilst I would never classify it as an addiction, it works in a similar way. When my body notices a withdrawal, it suffers. Like a caffeine lover, not having your morning latte can give you a headache. It's a rebound headache. And it's dependence. 

And quite frankly, I really can't be depending on anyone or anything other than myself. Friends, family, medical practitioners, I can't depend on them to get rid of my headache. Not unless I can depend on myself to fight the good fight against it.  

Knowing that I could have caused one element of this headache is painful. It brings up sad, bad memories. It's hard to think that there were times that I could only cope if I took painkillers. And it crushes my soul slightly to realise that actually when I take painkillers to cope with my headache, it's the same solution.  

So, no more. I have a battle plan, and this is part of it. 

Yes I have mental issues that could be contributing to my headache.
Yes, I'm sure as hell struggling because all my muscles are knots and that causes my headache too. 

But one size does not fit all, and the painkillers I've been taking are only one size. And that size is too small for me. 

So I'm back on a medication that I first took in 2008. It's called Amitriptyline, and it's an anti-depressant. But in taking 10mg once a day, I'm actually on it to help treat chronic pain, and prevent pain that could be caused by the rebound headaches. This way - whilst maybe not the best way - I can get off painkillers and I can break that cycle.  

And it's not the easiest way either. Looking back at the hospital notes from 2008, I struggled with sedation and a dry mouth on this drug. By the end of the 6-month period, I was on 30mg a day, three times what I'm on now. And I've only been on it 9 days, and the same side effects are back. I am so tired! Often, I just feel foggy. Yesterday I felt so spaced out and sedated I had to grab a can of coke.

Not a clever move, my head said. Here, feel the consequences!!

The pain that emerged as I dredged the can of remaining caffeine-filled drops was unpleasant, obviously. But actually, I was grateful. Because if I wasn't on the meds, I wouldn't have noticed the effect coke had on my head like that. Usually my head is so rooted in pain already that it doesn't affect it in the slightest. This I would gloriously cry as I washed down all the meals of the day with it. "It makes no difference to my head!" I would shout triumphantly. 

And granted, when I cut it out for 3 months in 2006, my headache persisted, so I was pleased that my favourite fizzy drink wasn't the culprit. And neither was chocolate. Chocolate, by the way, continues to make no difference. I should know - I consumed a whole bag of Wispa bites today.  

The sedation should settle soon: it can take about 4 weeks for the side effects to settle down when you start a new medication, sometimes longer. And I have only been given a month’s supply, so I will be returning to the GP at the beginning of July to discuss where we go from here. I have really noticed a difference in the last 9 days – so much so that only 4 days in, I actually noticed that my head was bad for the whole day, when I’d only been bothered by it in the evenings.

So we shall see. I see this not as a failure. Resorting to medication to get off…medication. It just has to be done. I need to break the cycle. I need to eliminate this aspect of my headache, so I can focus on the other aspects: the tension muscular and emotional; the health physical and mental.

The biggest difference between me now, and me a year ago, my Hypnotherapist said, was my attitude. I’m taking control. I’m not a victim anymore. This headache doesn’t own me. And I’ll fight tooth and nail until I own it.

The Spoon Theory

...finally, a sort of way to explain my headache.

The Spoon Theory

Got the doctors tomorrow, for another attempt at getting some help. Yet another new perspective.

Bingo.

Headaches can be caused by tension, stress, and anxiety. Emotional stress and anxiety can lead to an increase in tension in the large muscle of the neck and shoulders, this can, in turn, cause a headache.

 

http://ichphypnosis.blogspot.co.uk/2011/05/migraine-headaches-hypnotherapeutic.html 

Today was just one of those days...

...when I wished I could do that thing the Egyptians practiced on their mummies. Y'know, where they took the brain out through the nose.

Ow. Just ow.

Must remember not to cry. Crying does not relieve the pain. Not head pain anyway.

Up to eleven...and then some.

Yesterday I got a migraine so bad I have rated it a 12 on my tracking app.

And all I can say is I am really freakin' fed up on this.

I don't know what caused it. Something I ate? Something I drank? The sun? Not enough water?


Maybe it is time to subject myself to that headache prevention diet.

Sob.

Deep Tissue Massage Saturday 13th April

Yesterday I had the pleasure (and in some ways the pain!) of a deep tissue massage by Cindy Mollineau, a mobile massage therapist that I found in the Sutton Complementary Health Register.

Cindy came to my house with her own massage table, aromatherapy oils and music. (I was glad for the music - the only chillout music I have are acoustic versions of rock songs it seems!)

Cindy has been practicing deep tissue massage for 6 years. She started training in 2005, and she did course after course - and got hooked on it. (This is something I have heard many alternative therapists say - sometimes they are originally a patient themselves and they are converted.)

In many ways the massage was what I was expecting - Cindy got into the tightest areas of muscles, and worked to ease out some of knots. Needless to say that I felt a lot freer when she had finished, but I continue to have knots the size of golf balls in my shoulders (at least that's what they feel like to me). This is not because Cindy didn't do enough - she did more than enough. It is simply a consequence of having left these knots to form of their own accord for so long that they seem rooted in their place, and really I think the best way to eliminate them would be a week's worth of 2 hour massages.
Maybe I will treat myself to that at sometime.

You can find Cindy's website here.

A Miserable Morning

This morning I woke up with a bad, bad headache.
I struggled all day yesterday with one, and managed not to take any pain killers.
But as soon as I woke up I knew I would need to take some in order to get on with my day.

It is a miserable morning as the rain trickles down. And it's a miserable morning as I drag myself out of bed, with a head full of lead.

I can't even appreciate the sun pushing its way through the clouds, because this is the kind of headache that favours dark rooms, not sunshine and fluorescent lighting.

And the nausea that accompanies it is making my breakfast repeat on me. I don't want noodles a second time. And then my stomach is struggling with all this action and the upset has given me a stitch.

But it's the anger and frustration that makes this hardest to deal with. What did I do this time? Did I sleep funny? Did I not drink enough water? Did I eat too much fruit?!

I'm intent on making more positive changes to my lifestyle, and I am rewarded with a headache that to me resembles a melon expanding inside my skull.

And I am ashamed to say that it's mornings like this which make life so miserable that I question the point of even bothering.

Silent Enemy

There lives a silent enemy inside
That destroys the good of a heart.

This silent enemy that lives inside
Seems so reluctant to leave.

My silent enemy that stays inside
Twists and turns, stabs and burns.

This silent enemy that lies inside
Is breaking down my soul.

But I can scream and shout, bellow and yell.
I will laugh and sing, giggle and smile.

Because my silent enemy has no voice.
And I do.

A Headache Bible

Last night I spent some time gathering together all my medical notes, articles and information that I have about my headache and headaches in general. Finally putting them together in a folder makes them easier to get to and look at, which hopefully will encourage me to refer to and use these treatments more frequently.

Want to go on a tour?

Welcome to my headache bible!

I have many different fact sheets on all the different types of headaches there are.

A fact sheet on lifestyle changes that can help reduce or prevent headaches.

I have 2 sides of A4 dedicated to alternative treatments for migraines and tension headaches, cut out from magazines and newspapers

This cheery fellow is demonstrating how to do the Bowen Massage technique on yourself.

And this is the science behind what could possibly be the reason for my perpetual pain.

Just a selection of all the different drugs I've been prescribed.

I've also got medical notes from York Hospital, Parkside Hospital, and St Anthony's.

I've blue-tacked a sheet of exercises to my wall so I have quick access to them, and I have rediscovered a whole load of personal notes on treating my headache through relaxation and psychological treatment. Those will be interesting to read through more thoroughly.


**

This week I had a mild migraine attack. I should have seen it coming, because I had been struggling with my head for two days. I just couldn't get comfortable in the pain, and it was originating in my neck and base of my skull on the right hand side. I had some rather nasty and sharp pains inside my right eye on Thursday - the day of the migraine - and although I took 3 tablets (1 ibuprofen and 2 paracetamol), even as I walked home that evening I wanted to hack out that side of my face.


I finally got round to looking at a cookbook I bought for treating my headache.

Unfortunately, it wants me to follow a prevention diet for 2 months that means I can only eat 1/2 a banana a day.
What do you do with the other half??

I'll be considering that option more carefully, and might not follow it strictly, but there may be something I've not noticed before that might trigger headaches in my diet. It would be useful to know.

Unless it's chocolate. If it's chocolate, I don't want to know.

Chiropractic sessions

At my first Chiropractic session, my practitioner started by beginning to address the muscle imbalance in my body, i.e. all the knots, tightness and weak spots.

Starting on my front, he inserted an acupuncture needle into each shoulder, towards the end of the shoulder, at the apex of my arm, in places where he could find the sorest knot (and he had plenty of knots to choose from).
Acupuncture needles are used to stimulate groups of muscles or knots to move, to release into the correct position.
When he was locating a knot to place the acupuncture needle into, the knot on my right shoulder was very sore to the touch. But when the needles were inserted, and left to do their work, it was the left shoulder that began to ache around the needle. Which is just the reaction we're looking for, my practitioner said.

Whilst these needles were doing their magic, he also used a Tens machine on the rest of my back, placing four paddles in a rectangular shape (from what i could feel) from in line with my armpits to lower down on my ribs. The Tens machine itself made a lot of noise, a bit like a vaccum, but I've used a Tens machine before (when I was a kid, and played around with my mum's) so I knew what to expect. At first the machine was programmed to gradually increase the strength of a pins and needles type sensation through the paddle, and then it oscillated across the paddles in waves, diagonally from lower to upper, and across and then down again.

After the Tens machine had been turned off, and the acupuncture needles removed, he massaged my shoulder area, to "increase the muscle tone" I think he said. After some massage, he placed a towel over my shoulders, and made an adjustment to my back. An adjustment being cracking a joint that needed cracking. Ok, that is the simple way of putting it. I took a deep breath in, and when I exhaled, he adjusted my back.
Craaack.
Ahhh.

Turning onto my back, he made some adjustments to my neck. He turns my head gently, and then makes a little "impulse", which is a quick turn to that side, designed to help make adjustments. He said it doesn't always crack, because the joints don't always need to crack, but the impulses are designed to make the joints move. He did an impulse on a joint on my left side of my neck, and then on the right, and then when he went back to my left side, to a different joint.
Craaaaaaack-craaack-craaack.
Owwwwww.

It hurt a lot more, as I commented to him, than when I crack my neck. But that is because he actually cracked a joint that was stiff, and needed cracking.

Then he used his fingers hold specific areas under my skull.  I have learned that this is the "suboccipital" area, named so because it is below the "occipitus" area.
Whoever knew this would be educational as well?

As I lay there and surrendered to the pressure of his fingers, the right side began to get very sore. I lay there for a while, thinking I could put up with it, but eventually I told him, and he released some of the pressure. Ahh, I relaxed.
He repeated that for normal people, the initial pressure is quite intense, and then it tends to dissipate. Whereas mine just got worse on the right side, and did nothing on the left.
But it was when he took his fingers away, that the muscles reacted so strangely, and the sharp pain that radiated in that area made me cry out.
Argh!

"All I did was take my fingers away!"
"I knoww, but it hurt!"


Something tells me this is going to take a while...

***

Session 2 - see above, but less pain. Except for when the Tens Machine was duly making the muscles work, and the area in the left shoulder with the acupuncture needle started aching a hell of a lot, and the pain started spreading up my neck and into my head.


***

Session 3 - see Session 2, but less pain spreading up my neck whilst the Tens Machine worked with the acupuncture needle.

He also taught me how to do a "scapular retraction". Which is a fancy term for squeezing my shoulder blades together.

***
 Session 4 - see sessions 2 & 3 except this time, agony. At first, the left shoulder area had a few sharp twinges shortly after he had set the Tens machine up. He turned down the intensity, which helped hugely. But then my right started hurting, sharp stabbing pains inside my shoulder, and the left one joined in, and I almost cried. The pain seemed to come from inside my muscle and around the needle and began to spread up my neck. Oh the relief when he turned the machine off and took the needles out, especially the left one.

***

P.S Scapular retractions hurt. He said he is not surprised it hurts when I do them, but the important thing is that I keep doing them. If I didn't think this would help, I would take the same view of eating meat - I don't like it, therefore why should I do it?

***

Session 5 - no bad pain this time, hooray! Lying on my back, with his fingers on pressure points at the base of my skull, the intensity I felt at the pressure point on my right lessened. This, as my chiropractor has said before, is what happens to normal people with this treatment. I let him know how it was feeling, and how I relaxed I felt.
And right on cue, it reacted and as he took his fingers I yelped in pain.
Typical.

***

Sessions 6 & 7 - no pain, just relaxation

***

I now have a week without seeing my chiropractor, as he is away skiing. He says that we shall see how my head neck and back cope without what has up until now been a weekly session, and see if we need to continue having sessions weekly, or if we can have sessions fortnightly and then continue to space them out.

Trying to be NICE

The Chiltern Health Centre, where I have been most recently for a chiropractic consultation, and at the beginning of last year for hypnotherapy, drew my attention to a recent report from NICE, regarding medication overuse headaches. This blog, written by one of the practitioners at the clinic, talks about the report's findings and looks at it from a Chiropractic and Osteopathic perspective (the author is herself an Osteopath).

Medication Overuse headache is caused, put simply, by taking too many painkillers. This amounts to taking over the counter medicines such as aspirin, paracetamol and ibuprofen (which is an NSAID - non-steroidal anti-inflammatory drug) on more than 15 days a month, or opioids, ergots, triptans for more than 10 days a month. These latter three are anti-migraine medicines. I have in fact been prescribed with Triptans, to help fight any migraine attacks. I got a prescription of 6 tablets about 3 or 4 years ago, and am now down to my last tablet.

Taking painkillers for a headache can result in a withdrawal headache if you rely too much on the drugs to eliminate the pain. The "vicious cycle" as it so often described is accurate. My head hurts, and I want it to stop. So I take a pill. But taking the pill makes my head hurt, and because my head still hurts, I take another pill. My head still hurts. And so the cycle continues.

NICE's recommendation, according to the blog & the report, is cease taking the medication immediately, and stay off them for a month. Unfortunately, as is pointed out by the blog and many other sources, "Headache symptoms are likely to get worse in the short term before they improve and there may be associated withdrawal symptoms"

So. My head hurts. I take a pill. The pill makes my head hurt. I take another pill. Cycle.
My head hurts. I stop taking pills. My still hurts, and in fact, almost like a nicotine craving in the brain when you quit smoking, the head goes ballistic with pain because it's not getting any pills, and because you can't take any pills, the pain doesn't go away or decrease when you need or want it to. Slowly, this pain does subside, and the dependence dissipates. Eventually, hopefully, cycle broken.

I am hopelessly reliant on painkillers. It used to be ibuprofen, but more recently it is paracetamol, because (inevitably, really) ibuprofen wasn't really doing the trick. And at first, paracetamol did too. And to some extent, paracetamol still works because it often takes the edge off the worst headaches (and I now reserve painkiller usage to when I can't move without my head or face searing with pain).

The chiropractor I saw for my second opinion reminded me of these findings/recommendations, and after I saw him, I decided to give two weeks a go. I had already accidentally managed a week, so I decided to try for another week. Needless to say, this second week has not been as breezy (because my headache is self-aware and resists any attempts to remove it?) From Sunday through to Tuesday, I was in quite a lot of pain. Alcohol dulled the pain, but left me open to dehydration related agony the following day, so I kept that at a glass or two in the evening.
By Tuesday (1st Jan) I couldn't do it. I couldn't move without my head being in agony, and I couldn't get to sleep to try and make it go away. So I gave in and took a triptan tablet. This isn't strictly forbidden, from my understanding, since my dependence is on regular painkillers. And it certainly helped take most of the headache away, and I was able to actually get stuff done and be myself again. As I commented to a friend, Monday was "just one of those days that no matter what, I am my headache. There's no happiness, sadness, excitement, nothing." And that was only day two. So by day three, even though I was willing myself to be strong, I'm not made of stone, and I took a pill.

But today is the last day of two weeks without paracetamol, ibuprofen or aspirin.  Tomorrow, I'll embark on another two weeks and hopefully be able to negotiate any agony with resistance.
The end goal is freedom. If I keep that in mind, I think I'll be able to do it.

But I reserve the right to have a duvet day if I feel like my head is expanding from the inside out.