Back From the Neurologist

Knowing that some of you are in different timezones and might be looking for an update, I thought I would post this sooner, rather than later.

I had a very successful visit with the neurologist today. It’s amazing how much information you can cram into 15-20 minutes. He’s a small (one doctor) practice and I really like him a lot. You may wonder why I like him so much already? Well, I have to tell you that when we were winding down the discussion and I asked him about whether or not I should continue taking the Fioricet to combat the regular headaches, his response included the phrase “it’s what I take for my migraines” and I just about fell out of my chair! I naturally have a lot of faith in someone who has actually experienced the conditions he or she is treating as a physician. It’s one of the reasons that I prefer female gynecologists because, truly, I don’t care how much formal training you’ve had, you cannot truly understand until you’ve gone through these things yourself! I have an incredible amount of respect for him as a doctor and his skills, not just from that statement, but also his knowledge of what is happening in the prescription drug market. He knows what drugs have recently been released, are being worked on, are slated for development, etc.

Overall, a very positive experience and I give him an A+. He had a good bedside manner and I felt like he asked all the right questions, or at least as many as he could in the time allotted. We went (quickly) through my entire history from when I first started getting migraines, including the symptoms I used to have, what I have now, what drugs I’ve been on, what has been tried, what hasn’t, what I’m doing now, how that’s working for me, what I could do to improve my usage of some of the drugs available to me, etc. He seemed surprised that I’ve never been put on a preventative drug for the headaches before now. He also told me (which I’ve heard before, having the benefit of side knowledge due to my mother’s 30-year struggle with migraines and depression) that whether they are full-blown migraines or seemingly “just headaches” that they are all still related and in the same cycle, particularly this close together.

Anyway, I’ve been prescribed an anti-seizure medication called Neurontin to start taking as a preventative measure. It’s his first choice because it has the least side effects. The main side effect is sedation, so general sleepiness, grogginess and dopey-ness (though how you’d know that I’m dopier than usual is beyond me 😉 ). And in his experience, it works in about 6 out of 10 patients. The first thing he told me is that there are a lot of drugs available and that it may take a little while to find the right one because you never know what is going to work on each person. I appreciate his honesty and being upfront about that. In other words, “don’t get your hopes up, we may have to travel down this road a while before we get you some relief.” I expect that and can deal with it.

He seemed unwilling to change my anti-depressant, even though I’ve been on it since I was in high school. He mentioned that Wellbutrin is a fairly old drug and that there are newer generation drugs out and being worked on that might also work for me, but he never doubles up on anti-depressants that are in the same category. Plus, since I see a near-immediate effect on my migraines when I miss a pill (I’m on a 24-hour sustained release drug and when I miss a pill, I’m pretty much guaranteed one heck of a migraine within a few days), it’s probably not worth messing with it at this time. He also mentioned that depression and migraines often go hand-in-hand. I thought I would mention that for any of you out there who might suffer from migraines, but haven’t necessarily looked at the depression end. He’s found that when he puts someone on an anti-depressant, it can have the pleasant effect of also helping to control their headaches, as well. Just some food for thought. I never thought I suffered from depression, especially when I was a teenager, but you don’t have to be suicidal or severely depressed to suffer from depression. *Steps down off of her soapbox and tucks it away under the bed for another day.*

So, we went straight to the pharmacy and had the new prescription filled so that I can start it tonight. It will take a week or so until I’m up to the full dosage, so I want to start as soon as possible. I’ll take one before bed every night for 3 days, then twice a day for 3 days, then hit the full dose of 3 a day. Of course, he said I can stretch it out a little longer if I’m finding that I feel really tired while adjusting to the new drug.

Have I mentioned how much I like this guy? I have a followup appointment in 3 weeks, but he said that the timing isn’t set in stone. I can come in sooner if I need to, I can call and talk to him on the phone if I want, he can call in something else if I need it, etc. I almost fell out of my chair again when he said that I could talk to him on the phone. That’s the first time I’ve EVER heard a doctor say that to me. Usually, if you call up and say that you want to talk to the doctor, you’re told you need to make an appointment. Just goes to show that he’s not necessarily in this for the money. And based on the number of people in the waiting room, he has no shortage of clients!

So, I’ll cross my fingers over the next week and hope for some positive results from the new drug. I’ll be keeping a regular headache diary from now on (per his instructions), for which I already have a template that I downloaded from the internet a while ago, so that I can track my progress. Usually I track it in my head, but something more formal will specifically help to see if the drug is having any effect. In the meantime, at Terry’s strong recommendation, I’m going to schedule an appointment to see the company psychologist. It’s funny that Terry is pushing me in that direction, since I did the same exact thing to him a few months ago when he was having so many problems. It’s about time that I talked to someone about the stress I’m carrying inside of me, my type A, perfectionist personality and the high level of anxiety that I seem to experience so much of the time (and have since I was a kid).

I’ll attack this problem from every angle I can! That way, the headache monster has fewer places to hide. 😈 Come out, come out, wherever you are…