Try, Try Again with Migraine Medication
After a long wait to get an appointment, I finally got back into the office with my neurologist. They didn’t lay a hand on me, though, the entire appointment. No blood pressure. No vitals of any kind. Nothing. So, we really could have gone virtual, guys.
What does my doctor include in my post-appointment notes?
Have you noticed on your after visit notes that they say things about your appearance and demeanor? Mine said I was, “Attentive, appropriately oriented and engaged, and with good hygiene. In no acute distress. Mood appropriate, affect appropriate.” I suppose I was taking a test I didn’t know I was taking. I’m glad they thought I had good hygiene, wasn’t distressed, and that I was, as always, appropriate. Part of me wonders if I should have wandered into the appointment in my PJs with my headache hat on so they know what kind of disaster I feel like on the inside, no matter what my mask says.
What was my disability assessment score?
After chatting with the new fellow about my various medication fails and my current status — I scored pretty high on the disability assessment, up from “moderate” to “severe” — he used a lot of science words and made some suggestions. At this point in my life, there’s a fair bit of medical chat I can follow. I’m not a doctor, I just play one on TV…or, more accurately, I’ve been to enough doctor appointments to usually know what they’re talking about as it relates to me. However, he got a little too technical and I found myself distracted, glancing up at the fluorescent lights, annoyed by the seemingly obvious problem of having bright lights in a migraine clinic.
How was migraine impacting my life?
While the test said I was disabled, no one suggested I pursue disability, maybe because I’m a freelancer, or maybe because they’re optimistic I can be made more functional. The attending came in and went over the fellow’s suggestions. She wanted to know why I had an increase in migraines. “Are you working more?” she asked. “No! I’m working much less because I can’t look at screens!” I said, a quaver in my voice. I thought I’d made myself clear. I can’t do ANYTHING lately. I can’t drink, I can’t stay up late, I can’t look at screens, I can’t think of the word I want to use, and I can’t parent without getting a headache.
What new treatments was I prescribed?
I walked out of there with four, count ‘em, four new prescriptions. A new triptan, a new pain killer, a muscle relaxer, and a “breaker.” I expressed worry about sedation and they told me what to take at what time to avoid being totally knocked out. The first night I took the breaker, 50mg of Seroquel, and the muscle relaxer, I had to literally crawl into bed within half an hour. I still had my older kid awake! But I was OUT. The next morning, I felt like my blood was made of solid metal. My stomach didn’t feel great. And I still got an aura in the afternoon. I tried just the Seroquel that night, since I blamed my sluggishness on the muscle relaxer. Again, I had to put myself to bed right away. I kept waking up because of stomach issues and then plunging back into drugged sleep, plus each of my kids came in once and the dog threw up at 4:30am. Suffice to say, in the morning I felt worse than the day before.
What was my doctor's solution for the Seroquel?
Fortunately, emailing the doctor produced a swift reply to take half of the Seroquel. I didn’t, though, and we’ll have to see if I regret it. I needed a night off of the roller coaster of sedation. Tonight, I’ll try the half dose and hope for normal-ish sleep. Meanwhile, I’m so behind on work that I think I won’t recover, my kids need attention, and I’d love to walk the dogs but I’m still so, so tired. I’d love to say I feel hopeful that the whole situation is going to reset itself and I’ll feel back to whatever my normal is, but right now, I kinda just want a nap.
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