New Isn’t Always Better

Thirty years ago, in my 20s, I moved to a new state, which involved finding new doctors in my new hometown. Looking at the list of neurologists in the area, I decided to switch up my search and start at the bottom of the list instead of the top. This one random, minor decision changed my life.

My first appointment with my new neurologist

His last name started with Y, and he accepted new patients. Good enough. I scheduled a meet-and-greet appointment with him. Two weeks later, after the initial neurological exam, ever the gentleman, Dr. Y, ushered me out of the exam room and into his office. An actual office with a desk full-size desk, a large sunny window, bookshelves, and comfortable visitor chairs. I took the chair he indicated and declined his offer of something to drink. When was the last time you had your physician offer to get you a refreshment?

A different type of conversation

I decided to overlook the fact that he had to be in his 80s – 82, to be exact, he advised a few minutes later as he took pen to paper and started a conversation with me that was his courtly way of taking a full medical history. He probably also asked questions to help determine my overall neurological fitness. Still, it was done so naturally I couldn't tell you which questions were diagnostic in nature and which were, well, just questions.

It was a real conversation during which he first told me about himself and invited me to ask him questions. Having been practicing medicine since 1939, Dr. Y had probably forgotten more than they were currently teaching in medical school. Although he hadn't forgotten any of the manners his grandmother taught him.

I was charmed. And then he changed my life, putting me forever in his debt.

How he reacted to my migraine symptoms

He was still taking notes on fabulously thick cream-colored paper with a fountain pen when I mentioned occasionally that my right arm went numb before any traditional migraine head pain started (and at that time, I didn't know to call it an aura). As he put down his pen, I assumed he wasn't interested and immediately qualified my concern, saying the other doctors I had told about this didn't think it important. He tsked. Actually tsked! Ever polite, he didn't disagree with my vague mention of "other neurologist," but he did disagree with the importance.

He explained that limbs going numb, particularly arms, is often a precursor to stroke, regardless of age, and he didn't know why young people were dismissed when it happened to them. Not that he thought I was an imminent stroke candidate, but one couldn't be too careful when migraines were involved as they are very much a mystery.

His treatment recommendations

Better safe than sorry; he asked if I would please start taking an adult aspirin every day. He also explained that the gold standard for migraine treatment in the '60s had been using anti-seizure medication, which no one in the five years since my official diagnosis had ever mentioned to me. He didn't know why it had fallen out of favor as a course of treatment but would like to try it with me. He advised of all the side effects, explaining the primary concern was getting some sort of handle on the migraines so I could get on with my life, not the side effects. Once that happened, we could revisit any side effect issues.

A prescription and a new routine

I left his office with a prescription for an anti-seizure medication that had been on the market since the early '60s, instructions about taking aspirin, and the suggestion to get up at the same time every day. Something about circadian rhythm patterns and stabilization of these patterns by waking at the same time every day to help stabilize my brain's migraine reaction – it didn't matter what time I went to bed; it only mattered what time I got up. I also had an appointment to see him again the next month.

Did it work?

Within three months of the initial visit, my right arm stopped going numb. Come to think of it, my arm never went numb again. I started getting up at the same time every day, seven days a week, and within six months, my morning migraines largely stopped. Once I was able to wake before the alarm clock, the dreaded morning migraines stopped almost completely. It was a miracle of epic proportions.

The anti-seizure medication, although immediately successful, came with side effects, including weight gain and hair loss that I found very challenging in my 20s. Sitting behind his desk in his office, he politely agreed it was difficult and then scratched his bald head and said it was up to me - I could come off the medication and have a thick, full head of hair, or I could stay on the medication and continue to find ways to manage the migraines that were never going to be cured. Nothing is more annoying than having one's vanity concerns oh-so-politely beaten by reasonable logic and facts.

Trying something old, but new to me

I stayed on as his patient for the next five years until he finally retired, seeing him about once a quarter and always coming away with something old but new to me to try.

With more than 50 years of private practice, medical knowledge that started in the 1930s, medications from the 1960s, and living in the 1990s, my life was forever changed for the better. This may just prove that new isn't always better; sometimes, tried and true is the way to go.