I had a realization yesterday. I've been disturbed by the fact that my trouble thinking has not been occurring only when I have bad headaches. In fact, the past few days have seen me experiencing fewer severe headaches, and yet I'm still feeling quite stupid. (And that stupidity has been sparking a lot of anxiety, because I feel like I'm stumbling around in the cognitive dark.)
And then I remembered that the higher doses of Neurontin made me feel stupid. And then I remembered that I've been having some sleep disruption lately, and that's another Neurontin side effect I've had at higher doses. So now I'm thinking that the Neurontin may be causing me some difficulties that were previously masked by the severity of the headaches. We raised the dosage (from my longtime 300 mg/day to 500 mg/day) in hopes that it might help with the headaches, but I'm not sure that it ever did. But the Pain Doc didn't want to change the dosage, since we were changing other things (the Tylenol #3 dosage, and then the transition to the Butrans patch). The Neurontin just got put on the back burner & I sort of forgot about it.
Aside: Neurontin is used to treat many different conditions—including anxiety, mood disorders, and nerve pain—and I was taking it for the psychiatric purposes long before the headaches became such a problem. Then, more recently, when I went to see Pain Doc about the headaches, he recommended increasing the Neurontin dosage to see if it might help with the occipital neuralgia. I'm not sure it's ever really helped, but I was willing to try anything.
Now my headaches aren't so bad—at least these past few days—and I really don't enjoy feeling stupid. In fact, feeling stupid additionally results in me feeling anxious, because I have the constant feeling that I'm forgetting something, that I'm not understanding something, that I'm making mistakes. So I'm wanting to try reducing the Neurontin dosage. If the headaches become unbearable as a result, then we can increase the dosage again, but if I'm making myself stupid for no reason, well, then that's just stupid.
So I've phoned the Pain Doc & left him a message saying that I want to try reducing the Neurontin again to see if it helps (the stupidity) and/or hurts (the headaches). He hasn't gotten back to me yet, but I expect I'll most likely hear from him tomorrow. And I'm going to reduce the Neurontin dosage & see if my thinking improves over the next few days.
In the meantime, I'm going to try to avoid putting myself in situations where I need to think clearly in order to make decisions, make judgments, organize my thoughts, etc. So this is not the time to try to communicate effectively with a handyman about some work we need done on the house ... or the time to try to do the bits of sewing I was going to try on two of my sweaters (since sewing is something I TOTALLY do not know how to do & so would need to be figuring things out as I went along) ... or the time for me to work on my complaint to the Medical Board of CA ... or even the time to just finish the sort of complicated LJ entry I've been trying to write about some recent communication issues I've been having at CWC & with an individual friend.
I've been feeling better in the comparative absence of pain and illness, which has led me to do more, but I don't actually have enough brain to do a lot of the stuff I'm trying. So I'm going to try to hold back a bit, just until I've had a chance to experiment & see if reducing the Neurontin dosage might help.
Edited to Add: Watched "The Fault in Our Stars" tonight. Cried for at least an hour non-stop.