Pain management and ADHD medication

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I seem to be stuck in an annoying situation.

Short recap: I have both ADHD and fibromyalgia. These two conditions tend to have a lot of overlap (they are both thought to essentially be dopamine dysregulation issues), and both of them have a “let’s try different things out” treatment regimen.

Because of ADHD I have great difficulty in focusing on my work.

Because of fibromyalgia I have great difficulty in focusing on anything other than pain.

The medications which help me with fibromyalgia preclude me from being prescribed medications which help me with ADHD.

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Various health updates

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Two and a half weeks ago I got a COVID-19 test, and it finally came back, negative for both PCR and antibodies. So, it’s pretty unlikely that I have or ever have had COVID-19, which means that’s probably not at the root of my recent health issues.

One and a half weeks ago I finally got a followup, proper sleep study, which found that while I do have occasional apnea events, it’s not to the extent that CPAP treatment is warranted or even beneficial. Which is unsurprising; even when I was using CPAP I never found it to be very helpful, and this diagnosis means that I do not have access to my current provider’s DME1 so I can’t, like, get my equipment refreshed.

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Support networking

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I’m in the midst of a really bad fibro flareup lately, and am burning through my sick days at work pretty quickly. It’s frustrating and I need a way out, and something else that I can do as sustainable income.

I’m in a bunch of differently-intersectional support circles, and I’ve noticed the following:

Disability circles: Doesn’t understand the impact of my disability on my profession (because they don’t understand what my profession entails)

Technology circles: Doesn’t understand the impact of my disability on my profession (because they don’t understand what my disability entails)

The thin segment of disability+technology together: Doesn’t have any answers either, just sympathy and relatable experiences with not knowing what the hell to do

I keep asking in technology circles to see if anyone knows other jobs that would use my brain without needing to use my body and I keep on having to grow the list longer and longer with preemptions. No, I can’t go into management; I’m not good at coordinating other peoples' moving parts and it’s not what satisfies me as an engineer, and the brain fog from the pain makes this not a thing I’m likely to be able to get good at. No, I can’t go into teaching or training; that has even more requirements and rigidity in terms of my scheduling and I cannot do anything that requires that I be available at precise times on specific days.

I ask in disability circles, and there’s another, different list; no, I can’t use voice recognition software to program (not while there’s shared open-plan workspaces or I’m working in languages which aren’t suited to it – and I usually don’t have a choice of language). I still can’t go into management; it’s a completely different set of skills and not a natural progression. I already have a good ergonomic setup, both at home and at work. And employers don’t look too kindly on me smoking weed all day.

And in the intersectional circle, the only response I ever get is: “I have no idea, let me know if you figure something out.”

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The ongoing MSG discourse

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It seems like the pro-MSG camp is really ramping up their Discourse again lately, and it’s getting really frustrating.

Yes, it is deeply unfortunate1 that MSG sensitivity was labeled “Chinese restaurant syndrome.” Yes, it is probably the case that a lot of supposed MSG sensitivity was psychosomatic and due specifically to that name. And yes, glutamic acid does exist in a lot of things naturally and does in fact contribute to the “umami” flavor. I don’t disagree with any of those things.

What I do disagree with, however, is the mischaracterization that everyone who has an MSG sensitivity is just faking it or being racist, with the same strawman “gotchas” like “Did you know it’s also in Pringles and Doritos?!” (Yes, I do. It was Doritos which first gave me a reaction, for that matter. Long before I’d ever heard of MSG or “Chinese restaurant syndrome.”)

It turns out that there’s a high correlation between MSG sensitivity and fibromyalgia. And like many things that cause fibro problems, it’s not a single isolated incident that causes problems, but an accumulation of issues. If I have something with a low-ish amount of MSG on its own, I probably won’t have a problem. But if I have something with a lot of it, or if I’ve had it several times over the course of a week, I will have a problem and it will ruin the rest of my day.

And yes, glutamic acid occurs in a lot of things, but (generally) not bound to sodium and not in the high quantities that it occurs in with processed foods!

Several studies have shown MSG to be safe for the general population. And I do not doubt that it is. But these studies don’t include people with nerve disorders like fibromyalgia or epilepsy, or with a general history of migraines or the like. MSG actively amplifies the action of the pleasure centers in the brain. Fibromyalgia’s main issue is an inability to downregulate nerve receptors. Can you possibly see how this might cause a problem for some?

These fucking thinkpieces completely ignore the very real problems that a lot of people encounter, and also encourage people to actively put MSG into their food and not disclose it to be a “gotcha” for people with problems.

It’s like putting gluten into the food of someone who has celiac disease because of the backlash against fad gluten-free diets.

It’s like giving someone sugar-based Coke when they ask for diet, because they think it’s funny. Or giving someone diet Coke when they ask for normal, because they think they should “lose some weight.” Both are disastrous for diabetics who have planned their glucose intake for the day. (And incidentally, artificial sweeteners are also a major migraine trigger for me.)

It’s like “testing” someone’s stated food allergy by putting that thing in on purpose. Or not worrying about cross-contamination, or thinking, “Oh, it’s only a little bit.” Which can cause people to die or at least have a very bad time.

Don’t FUCKING do that.

Generally: if someone has a food sensitivity, believe them. Even if you think it’s made up, there’s no harm in believing them, while pretending you know better than them for their own issue can be incredibly harmful. Even fatal.