Migraine

Well, here is the long version of my latest neurologist visit.

I told him Plan A (naproxen) didn't work and was giving me stomach problems. He REFUSES to let me even try Diamox on an as needed basis, much less as a preventive.

His big idea? Upping my Elavil from 20 to 30mg. Which, if it was going to work, probably won't do me any good in July and August when I have the worst problems with pressure shifts.

He's still giving me an attitude about using the occasional Vicoprofen for rescue. He thinks I should try Tylenol. I'll settle for rolling eyes now that frying pan guy is gone. It's bad enough he won't give me a rescue med, even though he knows I'm well aware of MOH/rebound and am extremely careful in the amount of meds I'm taking, but to give me a lecture about taking pain meds I get from another doc who actually takes my pain seriously? Not cool.

Besides, as I have explained to him a number of times, I do not get rebound headaches from narcotics. I know most people do, but I was pounding percoset for two straight weeks when I had my wisdom teeth out and in that time I got one migraine. And when I do take Vico as a rescue, I don't do it more than once a week.

He keeps talking about me eventually coming off preventives. I looked him dead in the eye and said "Until you can get me 30 pain free days in a row, we are NOT having this conversation." How can you even discuss the idea with me when I'm having 8-10 a month??? Considering the clinical guidelines are to consider preventives if you have more than 3 migraines a month.

So.... back to square one. I'm currently deciding between Eileen's Neuro or dragging myself down to Jefferson in Philly. But I'm done with this guy. I can't believe he wants to focus on Migraine treatment and can't think outside the box. Nice guy and all, just not for me. He isn't agressive enough in treating my migraines.

So, that's it. I'll be on my fourth neurologist now.

Hello Kelly,

From different posts I've read, I think I see Eileen's doctor in Wayne. Her name is Dr. M. I've seen her only a few times now and I still like her.

On my last visit with her, she said to me that we need to work on finding the right preventative combination since I have too many triggers. It made me feel so much better having a doctor tell me that rather than hearing the many other comments I have heard from previous doctors I have gone to.

On my first visit with her, I explained how a couple of my previous doctors had me retry a few of the medications I had already tried and that I really didn't want to go down that path again. She assured me that we wouldn't retry any of the old meds.

I am already collecting my list of questions for her for our next visit including my weather related Migraine ones. This NJ rain is getting to be too much lately.

If this is the same doctor, I find her to be very patient and listens to everything I have to say. She has even changed some treatments to my way of doing things as opposed to the way that she normally treats her Migraine patients after listening to what I had to say. It wasn't a big change, but she listened and changed her way of doing things. I really feel like she is a partner with me.

You should be able to get an appointment with her fairly quickly. I think she said that about eighty or ninety percent of her patients are headache or Migraine patients. You could always get an appointment with her and go on the Philly waiting list if you wanted to.

I'm sure you'll figure out what is best for you. I wish you the best in the decision you make. I truly understand your doctor dilemma.


MigrainePuppet
http://migrainepuppet.blogspot.com/

Kat,
I was thinking about your mention of shooting for 3 migraines a month. Does this include when I've had them for up to 12 days at a time? (stupid giggle)I had 6 in June. One lasted for 8 days, before I broke down and went to the ER.

Any idea how long the waiting list is for Philly? It's penciled on my list for after a few more tries locally.

Amy

Kat,

I don't know the geography there very well, but you may have several options for doctors. How far are you from Stamford, CT, or NYC? Dr. Sheftell in Stamford is wonderful. Dr. Richard Lipton is in the Bronx. Take a look at all your options. OK?

Kelly,

I'm sorry Dr. G wasn't "the one!" But remember, the right doc IS out there! You just have to keep searching til you find him/her.

As you know, my doc is at the Jeff and I'm really happy there! They never seem to run out of ideas--I always feel like there are options out there for me!

Sending you lots of !

jenny

I want to thank you all for your support!

Puppet: I think I'm going to make the appt w/ Dr M and get on the Jefferson list. Cover my bases right? I'm glad she has a flexible approach to treatment. The last 3 neuros I've see don't prescribe "off label" which doesn't do me any good.

Amy: I'm not shooting for 3 migs a month. That's just the guideline of being on preventives, as in if you get 3 or more migs a month you should consider preventive meds. I want 30 pain free days in a row. That is my goal right now. And If I hit that, It'll go to 60. Btw, I count Migraine DAYS. As in if I have one mig that lasts 3 days I count that for 3 in my "monthy" migraines. In June I had 10, but it was actually only 8 migs, but two lasted for 2 days each. Btw, if a migraine lasts more than 72 hours you should seek immediate medical treatment. Check out the article on Status Migrainous.

Teri: Thanks for the suggestions, but right now I have to stick with providers covered under my insurance. I have an HMO plan so I have no out of network benefits. Before I start paying entirely out of pocket I want to exhaust my covered options first. If I have to I will, but I already have trouble keeping up with my medical costs and that is just copays!

Jenny: Depending on how things go in Wayne, I might be seeing you down in Philly! I'm trying to look at it logically. I've seen 3 neuros and tried 4 preventives, so I've barely scratched the surface at this point. Each doc and med is a learning experience.

Maybe fourth time is the charm right?

That's bad the neuro is talking coming off preventatives when you are still getting so many per month. Yes I understand guidelines say consider preventatives if they occur 2 to 3 times per month or if they are troublesome (I assume that say applies to someone who may say get one that goes on for a few days less frequently than that). I was once told that I "shouldn't be reliant on medication" from a doctor that I later found out prescribed methadone to drug addicts (rather than give that speech to them). So nothing surprises me.
Anyhow good luck with seeking a new opinion with a new neurologist.