There is always a balance that needs to be found between treatment and the related harms or side-effects; I guess, this is another way of saying, there is no such thing as a free lunch; in a Newtonian world of cause and effect, none of us can have it all ways.
If things go well, and, we are lucky, for the patient and the clinician, the downsides to whatever intervention are small, compared with the benefits;
Headache – paracetamol and time and usually, most of us are OK. Migraine and Sumatriptan and with time, again, the migraineurs are sorted-out; occasionally side-effects might start to creep-in, with stronger medicine, but so long as the costs are outweighed by the benefits, we carry-on;
Notching things up a scale, to say, Temporal, or as it is sometimes called, Giant Cell Arteritis – that is, an auto-immune condition affecting the blood vessels around the temple and eye, which can lead to blindness, the treatment – usually, steroids, with their potential side-effects – diabetes, osteoporosis, high blood pressure, and, impaired wound-healing, are usually acceptable – after all, none of us want to go blind. And then there is the pain.
And what about another type of headache, such as, trigeminal neuralgia, which is an agonising condition affecting the trigeminal nerve that runs over the eyes, face and jaw; the treatments for this range from simple pain-killers e.g. the Paracetamol or Ibuprofen all the way through to the potent and potentially toxic neuromodulating agents which occasionally filter-through to the black market; (which are oddly, prolific in Doncaster), their addictive properties being significant and their cost-benefit analysis being occasionally difficult to unravel.
And then, to the real baddies – the cluster migraines – sometimes considered the worst pain imaginable – like a spike through the eye is a classic description, which requires even more complex levels of interventions –steroids, neuromodulators, opiates and high-flow oxygen.
How fragile we are, us humans, how easily we can be knocked-off our stride, sent into a free-fall that disrupts every aspect of our existence. If only, our robustness was less organic, if only we could withstand challenges and move-on without too much upset or distraction;
But that is not who we are, the balance, whether interpreted through homeostasis or Yin & Yang, reflects the up and down of who we are, that all beings no matter how big or small must accommodate.
Balance is the essence of nature; winter and summer, hot and cold, dead or alive, we constantly fluctuate between these extremes.
And it is knowledge of these extremes, understanding of the to and fro of life that is essential for any of us involved with the support or care of others.
We, like our patients, like our mothers and fathers, sons and daughters, must accept this state of flux, welcome it in to our purview, learn to live with the uncertainty of change, or growth, and perhaps, reach a point where we can celebrate the variation, the uncertainty, the continuous flux of not knowing whether tomorrow will ever come.