Before I go, I have something to say

What A Pill

Every Friday, I sit down at my kitchen table and perform The Pill Ritual, filling five pill boxes for the coming week. Each box represents the five times each day I take my migraine cocktail. Each box has seven sections. Sounds like a nightmare story problem, doesn’t it? Sometimes it goes quickly, dumping this capsule or pill into this box and that box but not this other box, and so on with the others. I sort them out, shut each compartment, put them away (but not too far away), basking in the applause of my invisible audience.

Other times, I get annoyed with all these drugs I have to take, and I either mutter in anger or sit there whimpering, surreptitiously reading a section of the New York Times. I’d rather see what’s showing on Broadway, or happening in Syria, than deal with these not-so-magical potions.

I used to be the woman who prided herself on taking hardly any pills at all. I even gave up daily multivitamins when I realized my meals provided sufficient amounts of every vitamin and mineral on the label. Just an occasional pain pill for the occasional pain, or the migraine pills my son’s pediatrician prescribed and I then begged my own doctor for. Once or twice a month, maybe, I downed one of those. And they weren’t even migraines. Just “bad headaches.”

The irony is that I’ve never been good at swallowing any kind of pill. If only everything was chewable, like those gummy bear multivitamins for adults. Yum. But not for me. Instead, I have the giant green magnesium bullet, the pink anti-anxiety pill that has to be sliced in half, and the tiny baby aspirin, which at least has an enteric coating so it slides down my throat, once I summon the will to swallow. And there are more, many more, in all colors of the rainbow. One capsule has to be compounded by my pharmacy staff, summoning visions of barefoot techs stomping grapes in the back room.

Another comes as sprinkles, allowing me, should I desire, to empty the tiny little balls inside the capsule into a dish of applesauce, then swallow without actually chewing. This is why I have trouble with oysters. I love them, but I prefer masticating to just flinging them down my gullet. I mean, otherwise, what’s the point? Where’s the taste?

The sprinkles remind me of my two children, both cursed with asthma. They used to take a drug every morning that they never could have swallowed at so young an age. Instead of applesauce, I would squirt some pancake syrup into a spoon, then empty the capsule’s contents into the stickiness and mix it with a toothpick. (Mothers learn to be creative, when it comes to their children’s health.) They would then happily lick the spoon, after which I’d inspect their teeth for lurking, unswallowed sprinkles. This made the tune “A Spoonful of Sugar Makes the Medicine Go Down” my pretty much permanent earworm back then.

Eventually, they mastered the art of tablet and capsule swallowing, although at first they had to ask me – Do I put my head up, or down? Pills go down faster if you tilt your head back, while doing that with a lightweight capsule will only let it float near the top of your palate, nowhere near your throat.

Some people hate the idea of Western medicine, especially its prescription (or over-the-counter) drugs. Me, I’m all for Indian Ayurvedic herbs and techniques – I’d love to have someone pour warm oil onto my forehead for half an hour – and I’m not opposed to Chinese medicine or acupuncture. But I’ve learned the hard way that no matter how many massages I enjoy, no matter how often I fall asleep actively listening to guided imagery designed to prevent pain or banish insomnia, sometimes you just have to take the pills.

That said, I know all about Medication Overuse Headache. This phenomenon means that the more pain killers you toss down, the more your body likes it, and the more it creates the conditions that make you take them. In other words, feed a headache too much of the wrong thing, and you’ll become, not addicted, but acclimated to the drugs’ effects. So your headaches will occur more and more often, and you’ll need to take more and more drugs to fight them.

It’s a fight you can’t win. I know; I’ve been there. I believed that if a doctor prescribed something to ease my headaches, and it worked, but I got more and more headaches, I should take more pills. Foolish me. I also discovered that drugs you would least suspect – for instance, Sudafed – cause horrible rebound headaches. Remember, you read it here first!

So I depend upon a neurologist who specializes in head pain, and who knows an amazing amount of stuff about pills originally manufactured for other uses – soothing depression, or stopping epileptic seizures – that work, in small doses, to keep the Headache Monster away.

Don’t even ask me about side effects. I get them all. Why must side effects be adverse? Why can’t the warning say, instead, “Caution: May cause sudden happiness, the ability to fly, and/or heightened IQ”?

The other day, I saw an online ad for an intriguing Indian supplement. It contained three herbs, at least one of them promoted by integrative medicine proponent Andrew Weil, M.D. Even though the last thing I need in my life is another pill, I ordered a bottle. It’s supposed to “uplift mood.” And with a name like “Joy!” (exclamation point included), how could it not? My pill boxes are getting full, but I hope I can find room for a little joy.

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