Migraine

I saw Dr. Jan Lewis Brandes earlier this week in Nashville, and she's adding several things to my treatment plan.

I'm to start a very slow increase of Lyrica. I read the prescribing information -- too much information! -- and it's indicated for neuropathy from diabetes and shingles, for fibromyalgia, and as a secondary anticonvulsant. I've seen several people here on the forum taking it for their migraines.

In a month, if it's OK with my psychiatrist, I'm to start Cymbalta. I'm already taking Effexor and Wellbutrin for my depression, so Cymbalta would be a third. I'm to keep on taking Lamictal, my current preventive. She says it's a good drug, and she suspects it's helping with my depression.

I'm going to continue to see my local neurologist. My internist wants me to have a local neurologist in case of an emergency or unforeseen difficulties, and I think it's a good idea, too. Dr. Brandes is a 7-hour drive or an all-day plane trip away, and she's only in the office on Tuesdays. My local guy is fairly conservative and probably wouldn't add the Lyrica and Cymbalta without stopping the Lamictal. He also wouldn't add the Cymbalta so quickly after starting the Lyrica. She's also starting me on a fairly high dose of magnesium.

New protocol for daily/acute pain. When I feel a 1 to 3 (a mere twinge for me, but she says it's important to treat early), I'm to take Skelaxin, a muscle relaxer. I can take that 3 times a day, every day if necessary. If it gets between 3 and 5 (what I'd currently consider minor pain), I'm to slam it with Imitrex, a whopping dose of Ibuprophen, and Skelaxin. To prevent medication overuse headache, I'm limited to three times per week on this treatment.

So far (since Wednesday), the Skelaxin has stopped the headache (1 to 3) from progressing.

She has a one-page monthly headache calendar that she wants me to keep. I'm not sure how I'll be able to write in the very small squares. I'll probably set it up in Word and use a small font. I may also keep using the same chart I've been using, which keeps track of stuff like my mood.

All of this is very encouraging.

Gretchen in Mississippi

There you are!

We've missed you around these parts. It's good to see you back, and it's way spiffy to see you come back with some good, hopeful news.

*smooshes Gretchen in a GINORMOUS dragon hug, which is, of course, MUCH bigger than a bear hug*

I have not been on any of those new meds, however it sounds as if you are taking some very proactive steps in treatment from your new doctor. It is always good to have a new set of eyes spread light on an old problem.

I really hope you get some help and it is great to see that the new med has stoped or prevented three headaches already. That seems fairly great to me.

Nancy W

Gretchen, it's great to hear that your visit went so well.

As for the small monthly calendar, I usually use that as a summary of my daily diary. I keep the diary for myself, then bring the single page in for office visits.