Beautiful but sad

Not the most cheerful of poems, but I accidentally came across this today and it really spoke to me. I'll have to read more by the author.

'The world is a beautiful place' from A Coney Island of the Mind, copyright © 1955 by Lawrence Ferlinghetti.

 The world is a beautiful place 
                                                           to be born into 
if you don’t mind happiness 
                                             not always being 
                                                                        so very much fun 
       if you don’t mind a touch of hell
                                                       now and then
                just when everything is fine
                                                             because even in heaven
                                they don’t sing 
                                                        all the time

             The world is a beautiful place
                                                           to be born into
       if you don’t mind some people dying
                                                                  all the time
                        or maybe only starving
                                                           some of the time
                 which isn’t half so bad
                                                      if it isn’t you

      Oh the world is a beautiful place
                                                          to be born into
               if you don’t much mind
                                                   a few dead minds
                    in the higher places
                                                    or a bomb or two
                            now and then
                                                  in your upturned faces
         or such other improprieties
                                                    as our Name Brand society
                                  is prey to
                                              with its men of distinction
             and its men of extinction
                                                   and its priests
                         and other patrolmen
                                                         and its various segregations
         and congressional investigations
                                                             and other constipations
                        that our fool flesh
                                                     is heir to

Yes the world is the best place of all
                                                           for a lot of such things as
         making the fun scene
                                                and making the love scene
and making the sad scene
                                         and singing low songs of having 
                                                                                      inspirations
and walking around 
                                looking at everything
                                                                  and smelling flowers
and goosing statues
                              and even thinking 
                                                         and kissing people and
     making babies and wearing pants
                                                         and waving hats and
                                     dancing
                                                and going swimming in rivers
                              on picnics
                                       in the middle of the summer
and just generally
                            ‘living it up’

Yes
   but then right in the middle of it
                                                    comes the smiling
                                                                                 mortician

I stayed home today to get some rest

I just woke up after sleeping three-and-a-half-hours. I needed it. I'd hoped to follow up with my primary care provider, but he didn't have anything till Thursday afternoon.

Long day in the emergency room

So I had to go to the University of Kentucky emergency department today.

I felt fine this morning, drove to work with no problem, blood sugar was normal, everything was fine. I got to the stadium lot and felt fuzzy in my head, and when I tried walking I was uncoordinated and listed to the side. I was carrying a small orchid and nearly dropped it repeatedly, even jerking at one point without meaning too, like those jerks you have when you're falling asleep, but I wasn't.

It continued when I went into work, and I nearly fell over, even with the cane, several times. Once I got to work I dropped an open drink twice on my keyboard (good I have an overlay), I was still fuzzy, and really slow in making the computer work. I went down to the employee health nurse. My blood pressure has been all over the place today, first high with her, then at one point really low. She got me in a wheelchair and she and my supervisor took me over to UK's ED, because some of my symptoms matched a TIA like I had in July.

So after the CT and EKG and other tests, there was no sign of a TIA (although they don't necessarily do that, being transient, after all). I spent a lot of time sitting and lying in bed and the fuzziness finally cleared for the most part. I'm dehydrated, but I wasn't enough to get fluids. I have orthostatic hypotension, but I'd figured that out some time ago (I am a medical librarian, after all, and I once knew someone who had it and they were the same symptoms, such as getting dizzy when standing up). But this wasn't really that...I was a little dizzy in the beginning but it was more unsteady, groggy, disoriented, that sort of thing.

Last night between 9 and 10 PM I'd taken a small dose, smaller than usual, of a muscle relaxant, tinzanidine. I've used it occasionally for years for neck and back spasms. I usually take 14 mg, again, PRN, just as needed, but I just took 8, thank goodness. It was over 12 hours by the time I went to the ED since I'd taken the medicine, which usually is short-lived.

I was still having unsteadiness almost 24 hours afterwards. My brain's just not in the same fuzzy mode it was before. Now (11:30 PM) I feel tired and overly-wrung out.

The doctor thinks I may have a hypersensitivity or allergy to tizanidine and I shouldn't take it, but she never said it definitely caused the symptoms today. I also found in my own research that despite having a relatively short half-life, it is heavily metabolised by the liver, and since I have fatty liver disease, I wonder if that affected things.

The nurse brought me home (thank you Kathryn) just before 5 PM, and I went straight to bed for a rest. She's going to come get me in the morning as my car is at the stadium.

So it was a big maybe on what all happened, but I'm just hoping I'm back to my normal self tomorrow.

UPDATE: Thinking back through things, I find it interesting that I didn't have symptoms for about two hours when I woke up, before I to to work. If it were some strange carryover from the tizanidine, you would expect me to be impaired from the moment I woke up. The only reason I even thought of the tizanidine was before I also had some, and the last time I had some, the night before my TIA in July, (and none of them thought it should be it either time, as it does clear fairly quickly out of the body, but it seemed oddly beyond coincidental not to mention). All the symptoms I had today were symptoms I had that morning in July as well.

It also reminded me of a time I went to another hospital for weakness on one side, headache, and chest pains. They decided it was a hemiplegic migraine with a panic attack because nothing showed up on the scans. But I'm beginning to wonder if that was also a transient ischemic issue as well. The chest pains may have been a panic attack, I do get them. I rarely get migraines, but I have not had a hemiplegic migraine, either before or since.

I think I'm going to talk to my PCP. In addition to being an expert with decades of experience in internal medicine, he has worked in both neurology and emergency medicine. He's also Canadian, and so maybe the training he received might give him another perspective.