Long Covid Diaries: Miracle Cure (well not completely.)

You may recall that about five to six weeks ago, I got my first Botox shots in my neck in order to combat my long covid induced migraines. (For my official "covid diaries" see here; here; here; here; here; here; here; here; here; here; here; here; here; here;  here; here; here; here; here; here; here; here; here; here; here; here; here; here; here;  here;  here; here; here; here; here; here; here; here; here; here;  here; here; here; and here.) It's time for an update.

So, first the MIRACULOUS news. About two to three weeks after my first Botox shots, I started a rather ambitious stretch of keynoting at a conference, chairing a job search, a pub lecture to students, a visit to the Vermeer exhibit, and family responsibilities. During the past year, I would not have scheduled that, but (counterfactually if I had, then) I would also have stocked up on Naproxen often in anticipation of trouble. But I decided to try to do without as long as I could. Amazingly two weeks later I had not had a single migraine. Since then I have had more travel for workshops, a visit to the Globe to watch A Midsummer’s Night Dream with a bunch of (lovely) teenage boys, and performance of Monteverdi’s 1610 Vespers by the Queenes [sic] Chappell on London’s Strand followed by a trip to Leicester square for midnight mochi, and so on without any use of anti-inflammatories at all.

So, the pattern of migraines has been broken. (That was the concern of my neurologist, who worried that my use of Naproxen was masking an escalating migraine storm.) And it’s been amazing to be confident in social environments again. It’s also amazing to see the smiles on the faces of my long-time conference buddies when I am clearly myself again in professional contexts (long-winded questions, smug erudition, finding my own jokes hilarious, etc.)

I don’t want to claim I don’t have any long Covid symptoms left. I want to single out three. First, I do still get cognitive fatigue in complex social environments. But the symptoms are much easier to manage and they are not followed by debilitating headaches. (Also I get MUCH less cognitive fatigue in such cases and I continue to be able to function somewhat normally even when I do.)

Second, the weird tinnitus that I had before still is there. When I am cognitive fatigued, and then lie down, I have this weird buzzing ‘sound’ in my head as if there is a fridge or vacuum-cleaner not far off. (It comes in degrees.) If my sister hadn’t taught me how to meditate I probably would find it impossible to fall asleep.

Third, and this is probably connected to the second, the self-regulation of my brain to return to a kind of natural equilibrium after a cognitively exciting social evening (e.g., a dinner out, etc.) is not yet functioning properly. I still have trouble sleeping normally, despite continuing with heavy dosage of melatonin (as advised by the NHS). I will wake up in 90-120 minute increments throughout the night. And obviously, a few bad successive night’s sleep does undermine cognitive skill. I will probably avoid teaching in the evenings (which I used to adore) for the time being and at conferences I will generally avoid a lot of late socializing.

But otherwise, in many respects, I am back to normal in so far as that I have clearly aged a bit in all kinds of small ways that would probably have frustrated me immensely but that don’t bother me because of the overwhelming relief and gratitude that I feel that I have a chance to enjoy a very rich life-style. (I can also see this in the reactions of my immediate family.) But I clearly recover more slowly from minor mishaps and ailments.

I said ‘many respects’ because I have had to change my work habits. I used to be an incredible intellectual multitasker, but now I mostly avoid that. Because my work and family are in two different countries, I physically and temporally separate these aspects of my life much more rigorously than before. I travel much less and I don’t try to use virtual technology to be in two places at once.

Along these lines, I limit the number of simultaneous intellectual projects and I also recognize that I write less quickly. It takes me longer to write these digressions and, in turn, these are wordier than they used to be. (So, I am clearly less economic in my expressive capacity.) I have academic friends with brain trauma who have had far worse cognitive lapses (and who struggle with writing and other forms of linguistic expression), and I count myself lucky that the drop off is not catastrophic; but to me the difference between ‘before’ and ‘after’ is noticeable. I also work shorter days and fewer days.

I should wrap up. When I started this substack I was curious if I could generate sufficient paying subscribers that would allow me to either reduce my appointment at the university or pay for occasional mini-sabbaticals. The University of Amsterdam does not have a good program of research for senior faculty. While I am very pleased with the quality and number of my subscribers (as well as the new kind of engagement it has generated), in that sense the switch to Substack has been a failure.

I don’t want to end this update on a downer. I have lovely plans with my family lined up, many intellectually ambitious projects on the anvil, I am developing two new courses this Fall, and I am about to enter a period where I can return to my daily morning swim. I am even mulling a Seneca’s Letter’s post before I take my annual blogging break. Non exiguum temporis habemus…satis longa vita et in maximarum rerum consummationem