Thursday, November 18, 2010

Neurologists rock! (Or mine do...)

I promised you another migraine update after I saw my neurologist, which I did yesterday. My brains aren't behaving as they should (more here) and so we talked about medications and possible solutions. These are pretty much what we always talk about. I also brought her my new headache calendar.

Her first remark? "Wow. You get a headache everyday. We need to fix that." Yes. Yes we do. But how? First, we're upping my dose of zonegran to a level that's more consistant with stopping migraines. That should kick in in about 3 - 5 weeks. Next, she asked me about jaw and neck pain. Apparently if someone has headaches everyday, they usually have jaw or neck pain. I mentioned that I have a very tight neck, which isn't painful per se, and that I've been having some weird jaw stuff lately. Many people, when they're getting a migraine, get an aura. This is a visual disturbance that signifies that a migraine is coming. Other than a handful of times, I don't get these. Instead, recently with bad migraines, I've been getting aching jaw pain. Just a bit, but enough to let me know I need to get some meds in me and go to sleep before the pain kicks in.

So these things made her suspicious and she started doing a bit of an exam. It was kindof weird, because usually neurologists don't touch you, but she was having me move my head around, feeling my jaw, and feeling my shoulders. The result? My neck movement is slightly limited due to tight muscles. My jaw freaks out when I fully open my mouth (it audibly clicks into place and shifts around and is generally weird). And then she felt my shoulders. Apparently my traps are so tight that my left one feels like it has an egg in it. A HUGE ball of muscle mayham. So all this combined with something my dentist said and my posture, means two things: intense physical therapy with someone who specializes in headaches as well as myofascial therapy (2 times a week for six weeks!) and an appointment with the UMN Oralfacial Pain Clinic.

The final part of our plan is figuring out what I'll do if I have a migraine that my normal meds (imitrex or relpax) can't beat. If I get one during business hours, my neurology office has an "infusion center" where I could go to get medication that is approved by my doctor. This would let me avoid the ER and the random (yet excellent) treatment in the urgent care. And since they're used to treating migraines, they know what they're doing. BUT if the migraine strikes outside of business hours, I have a percocet prescription to take to try and bust the migraine up.

So...that's the current plan. I see the neurologist again in mid-December. (Well, that is the Dr. neurologist. This was the CNP neurologist, who is AWESOME as well.) Hopefully I'll have made progress by then.


tatgeer said...

Woo-hoo! I love that they have such a detailed plan in place for you! You should try to get them to add massage to the list. :)

Simon said...

Good news! I'm glad they're committed to helping you out. A headache a day is NO FUN.

Katie said...

tatgeer - I already get massages once a month and they know this. Sadly, if they get deep enough to get the knots out, they cause pain... Hopefully PT will be more successful!

Simon - I know. So far, things are going pretty well...