Migraine

I saw my neurologist, Dr. Young of Jefferson Headache Center, today. I was his first appointment of the day and he talked to me for appx. 40 minutes. I had written everything down I wanted to cover with him and we talked at great length about seemingly anything I wanted to. I've never seen him so relaxed. He is literally one of the top headache specialists in the country and having an appointment with him has always felt to me like an audience with the Pope. As I was leaving, I said to him, "Thank you so much for your time... I know it is valuable." He laughed and said, "It will be more valuable to you if we can help your headaches!" Before you see him, you talk to a nurse at length who updates all of your info so that Dr. Young doesn't have to ask all the questions like, "Are you on any new medications, etc." When I was done talking with her, she said, "I hope Dr. Young can come up with a good treatment plan because you are such a great patient." I laughed... she then clarified, "You are! You try so hard to do everything right and that is really admirable!" I think part of this is me keeping an anal-retentive journal of when I take pain meds, when I don't take any, what I take, when my headaches are worse, etc etc. The day before I see them I print out a calendar with blank boxes and then go through my day planner and write down everything that has transpired pain and headache-wise and any questions/concerns I have. I think this isn't the case with most of the people they see.
Dr. Young and I came up with a new plan of action for now. I'm in another bad headache cycle, so starting tomorrow I am going to do what is called a '4 Day Bridge' of a medication called DHE or Migrinal. What that means is that I'll be using this new medication for 4 days in a row to try to break the cycle of headaches and 'reset' my system. It is a nasal spray. The next level of 'breaking the cycle' would be outpatient 'infusion' which means I would go to the hospital 3-5 days in a row and spend the day hooked up to an IV with a cocktail of meds to stop the headache. The next level after that is hospitalization for 5 days so as to have a continuous IV of the drugs. I'm hoping the nasal spray works.
I talked him out of putting me on a new preventative medication as I just started Singulair last week. He said it is a very small % of people who Singulair helps migraine-wise, but agreed with me (after I quizzed and questioned him) to wait a month to start a new preventative, Lisinopril, an ace inhibitor. This also gives me time to have my Feb. 20th appointment with the Woodlands Center (an environmental/food allergy specialty clinic) and get allergy tested. So, we'll see. I am more and more realizing I have food triggers. I'm hopeful that the allergy testing will give me some insight in to what I can change in my diet to better the overall quality of my days... I'm not naive enough to wish for total headache remission... I'm pretty much at peace with the idea of this being a life long balancing act of diet/medications/exercise to improve my quality of life and to help keep the chronic daily migraine down to a dull roar. That I can handle.
Did I mention Dr. Young rocks? He does... he really does.
One step (or day) at a time.

I take that - that and Mobic did the trick for me.

quote:

to wait a month to start a new preventative, Lisinopril, an ace inhibitor.

Sounds like you had a good visit!

Don't you just love doctors with "plans"!!!

Congratulations on your part in a successful visit.

I do something similar with my headache diary. I just saw a new HA specialist a few weeks ago and she loved that I came so well prepared. It sounds like you were too! Good for you! And great to hear that your visit went so well.

I have Dr Young too
dont you just adore him !
I have never felt so respected and well taken care of :_)

bim

Hi Betsy that's great that your appointment went well and Dr Young's attitude about actually helping with your migraines. Also good on you for your preparation. It's often hard to know how to prepare as I've found providing too much detail leads to them thinking you have a health anxiety and therefore you get worse treatment.
It's interesting that nurses are used more in the US. There are suggestions of this in Aust, ie they can spend more time, ask questions, build up relationships, do blood tests and BP checks, get family histories down for doctor and other things and even could provide some referrals, draft care and mental health plans for docs addition and sign off plus liaise and identify community resources. Yet GP's in Aust are really resistant to using them (whilst whinging about their workloads) as they wish to maintain professional top dogness rather than looking at better care for the patient.