Migraine

I saw Dr. Young for the first time this morning. He was very kind and encouraging, and also very thorough. The whole staff was very thorough. I saw the psychiatrist or psychologist first, Dr. Tramuta, I am not sure which he was. I was nervous about seeing him because I have a psychologist at home and it just seemed like it would be impossible to catch someone up on my life in an hour--but our conversation wasn't really like a regular psychology appointment. He asked me questions about what an average headache/migraine day was like, what an average week and month were like, and the difference between my lower-level headaches and the true migraine headaches. We talked about my current meds and my abortive and rescue medication use. This was very enlightening for me. He told me that they look at abortives and pain meds (like Vicodin, Percocet, Fiorict, etc) the same, and they want me taking a medication to treat a migraine no more than 10 days PER MONTH! I have always read and been told that I could look at the two classes of meds differently, and take an abortive on 2 days and a pain med on 2 other days--but they said only treat a migraine with either med on 10 days per month. That was very disheartening. BUT, they want me to come back and be in-patient in August, and during that apppointment I will stop the meds that are likely causing rebound and daily headache, and the hope is that after that, I won't need to treat headaches as often. So here's hoping about that. He also asked some basic questions about any co-morbid conditions, and family history, etc. It was a pretty painless and easy conversation.

After Dr. Tramuta, I saw a nurse and she went over the paperwork that I had filled out at home, detailing how many days I have headache/migraine, as well as meds I have been on and meds I am currently on. She was very also very nice.

In between visiting with all the different people I filled out a personality test that took quite a bit of time. I am not absolutely sure how that will be used, and I won't get the results until my next visit, but I am sure the results will be interesting to see.

Finally, I saw Dr. Young and we reviewed some of the info I shared with the other Dr. and nurse, and he asked some new questions and did a thorough neurological exam. He told me he would like me to come back as an in-patient, and that they would use IV infusions to learn what kinds of meds I respond to. He said they want me to have a 24 hour pain free period before coming home, and that it typically takes about a week. He also changed one of my meds, but didn't want to alter things too much until I come back for the hospital stay. I learned also that the hospital I will be at is about 10 miles away from the clinic, closer to the airport. My mother or husband will come with me, so we'll have to figure out what to do about transportation while they are here, but I think the subway system will work out fine.

I feel very hopeful about the experience and the potential progress that we can make. I am a bit worried about reducing the days I can treat a migraine, but if rebound really is causing the daily problems, then that's fairly easy to fix (I hope) and maybe that by itself will increase my quality of life dramatically.

I am still in Philadelphia, and I love the area around the hospital. I am staying at the hotel Jenny and Teri both recommended, Holiday Inn Express Midtown, and it's a very short walk to the clinic from here, plus the hotel is in the middle of lots of cool shopping, dining, and historic stuff. Where I live in Arkansas there isn't really a "walking city" and Philadelphia is. My husband is with me and we have enjoyed just walking around. It seems there is a gorgeous park on every block.

So, that's my update! I know others have asked recently about the Jefferson, and I will keep an eye on this thread and those and will try to be as helpful as I can after only one appointment.

Thanks to Teri and Jenny for all the info!
Julie

Hi Julie,

Thank you so much for the great update. I know our members will be very happy to read your detailed description. It takes some of the mystery out seeing this particular Migraine specialist.

I wish you continued good luck and look forward to more updates.

Yay, Julie!

Sounds like a great appointment. You're definitely in EXCELLENT hands there!

Thanks for writing such a long descriptive post. This is absolutely wonderful, and will be great for others who are tentative about going to Philly to read. It breaks it all down, and you talked about each part of the visit so that nothing is scary or left out, and a potential future patient would know what to expect. I thank you for writing this, and giving the gift of knowledge to someone who comes along here next!

Philly's a great city! If you can, enjoy as much of it as you're up to when you come into town. (I do that in Dallas when I go see Dr. K)

I'm thrilled for you, Julie!

Julie,

I'm so glad that things went well at the Jeff!

Did you have any trouble with finding your way around town? Did you take the train?

Your first appointment was just like mine, about two years later!

I think they use the MMPI (the personality test) to look for indications of extreme anxiety, depression, etc. In my case, my MMPI showed some tendencies toward depression (not full blown depression, but some leaning in that direction). Didn't surprise me--chronic, daily migraine will do that to a girl!

Please try not to feel too stressed about the psychiatrist's "treat only 10 days per month" statement. As I mentioned in the past, I found that my treatment became very individualized and more focused as I formed a relationship with my doctor. I think a doctor needs to really get to know you well before he truly understands what level of abortive/rescue you need to function! Give it time. They'll get to know you and the care you need!

I'm really happy for you! You're on the right path!

jenny

Julie I am so happy for you. I know this was a difficult decsion for you, but it sure sounds like it was the right one!!!

Cindy

Julie,
Thanks so much for sharing your experience, I am heading to Jefferson on the 22nd of this month for my 1st visit. I am a little scared and excited at the same time. I have been suffering from chronic daily headache, and migraines about 5-6 times a month. My medication regimine right now is terrible. I have preventative and abortive medications, but when they fail, I have nothing else to turn to! I end up in the ED, which I hate!

I am scheduled to see a fellow named Dr. Charleston, I hope they work closely with the attending physicians (like Dr. Young!) I am glad to hear that there are a couple of places nearby to eat and shop. I am traveling only about 3 1/2 hours, but we are going to be staying overnight the night before, because my appt. is for 8:30am.

I just pray that everything goes well, and for some new insight to my disabling condition.

Again, thanks for sharing...it is so reasurring!
~Megan

Julie,

I'm so glad things are going so well for you at Jefferson! That is such wonderful news to hear

Here's to continued success!

Thanks for the encouragement everyone. I knew how anxious I was about the visit and how much Teri's article on the Jefferson helped me, so I wanted to be as detailed as I could be to help others in the same situation.

Jenny, we ended up taking a shuttle from the airport to the hotel. We were trying not to check too many bags and ended up with a giant heavy suitcase and 2 big heavy carry-ons, and we didn't want to lug them around on the subway. After seeing the driving in the town though, I believe we will be giving the train a try! LOL. It really was a great appointment, and the scheduler who was kind of short with me on the phone ended up being very nice and helpful. They all loved my Arkansas accent too, which is funny, because of course I think I sound as normal as can be!

Megan, I hope you can relax and feel good about your decision to go there. I am not generally an anxious person, but I was stressed about the appointment, but it all turned out to be for no reason. I dread the in-patient stay a little bit, and hope they can keep me fairly sedated for a couple of days, but I know even that will be very helpful and be worth it. I am generally not a good hospital patient! And I just found out they don't have Wi-Fi at the hospital. So I may be getting that new iPhone that you can tether to your computer after all! LOL. I don't think I can live without my computer for that long!

If anyone has any info about being in-patient there, please let me know. I have no idea what to expect. Is it basically a regular hospital stay, with just IV's and the typical medication changes, jor is it more of a "migraine program" with coping classes and alternative therapies, etc. My stay at MHNI in Michigan was the whole migraine program. It all seemed redundant to me because I keep myself pretty up to date on migraines and treatments. Well, obviously except for the 10 day per month thing, which was total news to me. But as Jenny said, I expect there might be some wiggle room with that.

I hope everyone is pain free today! Thanks again for the encouragement, and if anyone has any info on what to expect from the in-patient stay, please let me know.

Thanks,
Julie

I forgot to mention how cool the area around the hotel is. If you walk to the left when you come out, there are really a lot of restaurants, and if you walk right, there is tons of shopping. It's all kind of high end though, and we weren't really there to spend $$ on shopping since the rest of the trip was expensive, but it was neat to look around. At the end of all the shopping, there is a gorgeous park on Rittenhouse Row, which is evidently a big deal around Philly. Major high end restaurants down there with Bentley's and Aston Martin's parked out front. Way different from my hometown in Arkansas!

It was a very enjoyable trip, especially once I could relax about the doctor's appointment.

Julie

When I lived in Philly my wife was treated at Jefferson and was hospitalized twice - once for five weeks and once for a week. She went in for infusion treatments four times as well. All this over a three year period.

Anyway - during her first hospitalization there I would take the train to the Market Street station when I went to visit her and would walk up 10th street to the hospital entrance on that side. As you walk up 10th street you will pass a large Episcopal church on the left side and there is a plack next to the entrance that designates the area where the church sits as the place where Ben Franklin flew his kite with the key when he discovered electricity. I got a kick out of that. It's only a block away from the hospital...

Good luck at Jefferson - am interested to know how it works out for you.