Headache Log : Dr Reichert

"How's your mood been?" Dr Reichert wants to know.  "Have you been depressed?" 

I've had a constant headache since February 14, my mood has not been good.  Of course I've been depressed at times.  It's pretty hard not to get depressed and discouraged. 

Dr. Reichert is just as thorough as his PA.  He has discussed with Paula everything that she and I spoke about and he wants to take me off of Topomax.  He wants to put me on Cymbalta instead.  Cymbalta is an anti-depressant, an SNRI (I actually know what this is!), that is also used to prevent migraines, to treat sufferers of chronic pain, musculoskeletal pain, fibromyalgia, and some forms of neuropathy.  Well, I see little wrong with that - so long as I can stand the side effects.  Paula explains that there are few complaints about the side effects of Cymbalta. 

He also wants to run some blood work to check my hormomes and to see if I have a vitamin D deficiency.  I explain that I just had blood work run by my GI doctor a month ago and my TSH levels were normal.  Ok, hormone level test out, but vitamin D test is still needed. 

And he wants to have an MRI done.  Unlike the MRI done 10 years ago he wants to look at the blood vessels in my head and check my blood flow.  Then he causually throws out a word like embolism.  Yes, EMBOLISM!!! He wants to see if I have an embolism!  Of course I remain as calm as he does. 

Finally, I ask him if he knows anything about occipital neuralgia.  He says he is aware of it.  He'd like to see how I respond to the medication first.  See what the MRI reveals.  And see if the physical therapy helps. 

I leave his office full of optimism.  Almost optimistic enough to cancel my date with the plastic surgeon and the Botox injections - ALMOST.