Lyrica

Went back to my neurologist again.  Had to schedule the appointment to get the Gabapentin refill, but it’s been a while since I’ve seen her and I’m 5 month post-op so it seems 15-20 headache days a month is going to be the standard. 
For someone who used to 30-31 headache days a month 20 feels like an improvement. 18 feels great and 15 feels like a new life! But it’s still too many. It’s still not normal. It’s still not ideal. 
I met with Dr Williams and she still has lots of ideas. How refreshing to be seeing a doctor for over 3 years and she’s still got plenty in her arsenal.
We were discussing what I have and haven’t tried and she asked, almost rhetorically, “And you’ve tried Lyrica?”  I said, “I haven’t.” She seemed a bit surprised. So I’m swapping out Gabapentin to try Lyrica. 
The effects? My sleep is better.  It's not nearly as difficult to come out of sleep on Lyrica then it was on Gabapentin.  But the headache frequency is the same.
We've known for a little while now that some of the headaches, or at least their severity, are effected by my menstrual cycle. Now that I'm closer to a 15 or so day headache month it's even more obvious that they are effected by my menstrual cycle so there has been some talk of stopping that.  Maybe that will be next on the list. 

4 Month Post Surgery

Month 4 had fewer debilitating migraines, but not fewer overall headaches.  One issue though was that I ran out of Gabapentin in the third week of January and so my quality and quantity of sleep really began to suffer.  And when I don’t get enough sleep or quality sleep, that’s a trigger.  Last weekend of the month I got back on it and started sleeping better immediately.  In a few days the headaches had calmed again. 

Splints

One week post-op I go back to see Dr. Rose and I'm so excited to get the splints out of my nose!  I can't breathe with them in there and they are so uncomfortable.  Imagine the worst congestion ever and nothing relieves it and you can't blow your nose at all!

Dr. Rose informs me that the bone spur had torn some of the tissue inside my sinuses and he had to use some of the cartilage he removed during the septoplasty to repair the tear.  Because of this, the splints have to stay in an extra week.  I nearly cried.

I go back in two weeks post-op and finally get the suckers removed.  Dr. Rose said it would feel like he was pulling my brains out through my nose when he pulled the splints out and he wasn't kidding!

And look at the size of those things!  I don't think I realized there was that much room inside my nose.

But oh my goodness I can breathe!

Septoplasty

September 9, 2016 I had my septum corrected and the bone spur removed.  I read that the first 24 hours are the worst and I can attest to how true that is.  I was also told that I'd probably feel fine enough to go back to work after 3 or 4 days, but that most people don't because of the bruising.  Since my time of was going to be unpaid I planned to swallow my pride and return to work as soon as I felt well enough - bruises be damned.
I googled what the bruising would look like and when I could expect to return.  And then I waited for the bruises to come on.

Ok, so I'm sort of drugged Day 1, as you can clearly see.  Day 2 I'm still fairly drugged.  Day 3 is good.  But where are the bruises?

I don't know if I'm an anomaly or if  it's because I went to a plastic surgeon instead of an ENT, but I never got a single bruise.

And I didn't feel better after 3 or 4 days.  While the first 24 hours were certainly the worst, I had a migraine every day for 6 days.  

The doctor said I won't experience any headache or migraine relief for 1-3 months because of the inflammation.   

Deviated Septum

The neurologist treating me for sleep apnea made the observation that I have a deviated septum (interesting that no one else has ever said anything about this).  I also have hypertrophy of the tonsils (EVERYONE mentions this to me).  She suggested I see an otolaryngologist (ear nose and throat or ENT) about it.  Which I do.  He suggests surgery, though not very strongly.  Because I can't take the 2 or more weeks of work necessary to have my tonsils removed and the 1 week for the septoplasty I decide not to pursue it at this time.  Besides, is getting my tonsils out going to cure my headaches?  If the CPAP isn't helping the headaches then how will getting my tonsils out help?

But the deviated septum, that gets me thinking .... remember the plastic surgeon? The one who does migraine surgery? One of the nerves that can cause migraines is deep in the nose.

Sleep Apnea

July 2015 - Tizanidine.  No effect.

September 2015 - Venlafaxine ER.  No effect.  Odd side effect though, I would wake in the morning or middle of the night and feel like I could barely breath, like my throat was thick and sort of numb. My doctor said this is a side effect people with sleep apnea experience so she recommended a consult with another neurologist who specializes in sleep disorders including sleep apnea.

January 2016 - Seroquel.  No effect.

Also in January I had my consult with the sleep disorder neurologist.  He said, based on the way I answered several questions, he was certain I didn't have sleep apnea.  However, because of all the scary health consequences of untreated sleep apnea, I decided to do the overnight test and be 100% certain I didn't have it.  Plus, I could check off that box as a possible contributor.

Well, turns out I DO have sleep apnea.  I woke, on average, 22 times per hour.  Geez!  No wonder I was exhausted all the time!


February 2016 - Hydroxyzine.  No effect and it had a side effect, it make me very depressed.  I stopped taking this in May 2016.

May 2016 I stopped taking Hydroxyzine and didn't go on anything new at this time.  Just pursuing the sleep apnea issue to see if it's the cause.

After I was put on a CPAP machine I began having so much more energy.  But after several months of using it and even adjusting the pressure, the headaches didn't get any better.

Ozone Injections

Went for my follow-up with the handsome D.O. yesterday.  Had a serious headache when I went in to his office so I asked for manipulation.  (Knowledge of and ability to do manipulation is the biggest reason I wanted to go to a D.O.)  Didn't get manipulated.  But I did get another form of treatment that was unexpected.

I could happily report to the doctor that most everything else was much better.  But the headaches - no go - maybe worse.  I mean, July was worse than June.  If this is a trend, I dread August and don't know how I'll live through September.  He said that headaches are the last symptom to go away.  And he wanted to give me a bit of a kickstart or something to try and break the headache cycle.  He wanted to try ozone shots into specific trigger points in the muscles of my neck and shoulders. 
(Now, for those of you completely opposed to me injecting toxins or poisons into my body, go ahead and freak out and get on your high horse or your soapbox or whatever and rant - because ozone is considered toxic or poisonous.)  My post right before this one is a copy & paste of an ozone therapy case study (or rather many) so feel free to puruse it if you want to know more.  It isn't specifically about migraines or headaches, just pain in general.  There's a lot of useful information. 

Let me say that I knew, before ever going to him, that he performed ozone treatments.  And I had done my research about ozone treatment.  While I couldn't find much information on how exactly it is used to treat headaches, I was able to find enough information to learn that it is not widely used in the United States, but is hugely popular in Europe and many other parts of the world.  I spoke with Dr. Porter a little about it's rarity here and he said that there are only 400 doctors in all of the U.S.A. that do ozone treatments.  (As I understand, Dr. Porter is the only doctor in Utah who performs this treatment.)  But in Germany alone there are over 4000 doctors.  He said that it will never be mainstream in the U.S.A. because it is not profitable.  A big pharma company cannot patent ozone and charge exorbitant amounts of money to the sick and suffering for this sometimes miraculous treatment.  (Ok, I'll get off my soapbox now.)

As he was giving me the shots he would tell me what I could expect to experience with each shot.  Then he said, "I know this, because I've had ozone shots, too.  I used to have horrible headaches."
"Used to?"  I asked
"Used to." he confirmed
"That's comforting to me," I told him
He told me he was on topomax for years. 

I've had a good feeling about him all along, but to think I just found a doctor who has experienced what I am experiencing and who has cured himself - well, like I told him, that's very comforting to me.

So about the ozone shots.  He finds trigger points within the muscles to do the injection.  In my case it was my occipital, levator, and trapezius muslces.  First he injected a solution full of all kinds of nutrients and vitamins and medicine, the few I remember him telling me are folic acid, vitamin B, lidocaine and another 'caine.  Then he injected the ozone gas.  The needle seemed huge.  I remember thinking when I saw it that it appeared to be the same size as a needle used to take blood.  As he pushed on my muscles he said he could feel where the botox had been injected and was working, but obviously there were many places where I did not get a botox injection and those points were painful when touched.  That's where the ozone was injected, deep into those muscles.  The sensation was strange.  Mildly painful, but mostly strange.  When he got to the occipital muscle – wow!  Weird!  First of all, the needle goes so far in that it hits my skull.  It’s not painful, but I can feel the needle scratching against that thin flat bone and I can hear it inside my head.  And when the gas goes in, I can hear the gas dissipating through my head.  I guess I’m a bit of an airhead now as a result of this procedure.  When he had finished he asked how I felt.  I said, “Everything feels tight”.  He said, “It should, we just inflated your muscles.” 
He had me move my head around and stretch my neck a little.  As I moved I could feel and hear the gas moving around.  It is truly wild.

The injection sites are very tender and the muscles that were injected are very sore and stiff.  In many places when I push on the muscles they feel almost spongy.  And I can feel the gas bubbles moving.  I had Justin push on one spot – it sort of grossed him out to feel it.  I think it’s all fascinating. 

The doc said that I can have more injections in as little as a week.  He said that sometimes we hit the big ones and then notice there are a bunch of others that weren’t as evident due to the bigger sites.  I’ll keep you all posted.


Side note:  The diet is going ok.  It's very difficult to stick to, but I definitely notice when I eat things I shouldn't - corn, wheat, & sugar primarily (I guess because those are the three I cheat with the most.)

Botox: 2 months in

I really do like my neurologist. He is a good doctor.  He is the only doctor I've ever had who has called me repeatedly to check on me.  I understand that as his first botox patient he may have a professional interest in how I am doing as much as anything else.  But regardless of his motives - I feel good that he calls me to check up.

I have been keeping track of not only the days I have headaches, but the severity.  My scale is 1-5 (I stole my scale from the book "Chocolate & Vicodin".)  5 is obviously the most severe.  The month prior to the botox shots I had 2 level 5 headaches, 7 level 4 headaches, 10 level 3 headaches, 7 level 2 headaches, and 1 level 1 headache.  Not a single day without any sort of headache at all.  The first month after the botox injections I had only 1 level 5, 8 level 4's, 10 level 3's, 8 level 2's, and 1 level 1 again.  Still a headache every single day, though.  Still it would seem like an improvement. 

I had told my neurologist I didn't think it was helping as I still was having headaches.  I knew that it didn't always make them go away completely, but should make them occur less frequently and with less inensity. 

Is it working?  I'm still not sure.  And month 2 tells a very different story than month 1.
6 level 5 headaches -four of those in a row :(  10 level 4 headaches, 9 level 3's, 3 level 2, and not a single level 1.  Also, a headache every single day for that month. 

(In case I didn't already point this out - these botox shots are into muscle and the botox shots the plastic surgeon does are into nerves - so the outcomes from the treatments could be very different.)

The Handsome DO

Sorry I have been away so much and haven't posted recently.  Between work, school, homework, and headaches I don't seem to have much time for anything - especially blogging.

My most recent blog-worthy experience involved Dr. Stuart Porter, DO.  (And a handsome DO at that!)  He was recommended to me by a very close friend and then another one of my very close friends went to see him and was quite impressed with him also.  So I decided it was time.  I need something different, a new perspective.  I'm not giving up on my neurologist and his cute PA.  I can't, they are doing their best, I truly believe they care, and they have incredible customer service.  But I want another opinion.  Enter the handsome DO.

Unlike an MD, Dr Porter spent about 1 hour with me.  You know all that paperwork they have you spend like 30 minutes filling out and then never even look at?  Not Dr Porter.  We went over that paperwork quite extensively.  He asked me more questions than I could care to count.   He has a very holistic approach and explained everything quite well.  He said he wanted to check for a vitamin D deficiency and I informed him I'd just a test done and was fine.  So he explained that he has a very different standard than most labs and would like to check it again.  He also wanted to check my thyroid and hormone levels - I wasn't about to tell him at this point that those have already been checked and are fine.
He looked over my medical file which I had sent to him from my neurologist.  It had the vitamin D test results and sure enough - I was deficient.  Certainly by his standards, but .5 points off from being deficient by anyone's standards. 
At the end of the appointment he took about 8 vials of blood and asked me to come back in 2 weeks.


2 weeks later I walk into his office, scared of all the foods he must have discovered I was allergic to.  Please, not corn and please not cows milk.  The nurse teased me and said that I was going to love my new diet - I'll be eating nothing but meat and leafy greens. 
Dr. Porter came in and again, we spent about an hour going over all of my test results.  He didn't just discuss what came back as bad, he also discussed what came back as good.  Soften the blow, right?  If I wrote about EVERYTHING he tested me for and the results as well, this would be a novel. 
My thyroid and pituitary glands are functioning properly.  They are releasing the proper amounts of hormones.  However, my T4 levels are low.  (My last hormone test was only for TSH.) 
Vitamin D test came back even lower than my last one now indicating and even greater deficiency than before.
I am insulin resistant.
Lots of other stuff that's not nearly as exciting and lead me to be on a huge amount of supplements.

Food allergies - this is where it is potentially exciting for you as a reader, but miserable for me.
Here is what I am NOT allergic to - according to his test:
Almonds
Rice
Chocolate  (before we say, Thank God for that one!)

What I cannot eat due to other problems and deficiencies  (which means I MAY, someday, be able to eat them - sparingly):
SUGAR (Not sure how to have chocolate without sugar, unless it's artificially sweetened)
Artificial sweeteners (see, no celebrating for me)
Soy
Starch (this includes virtually every vegetable that grows in the ground as well as legumes.  the exception - thank goodness - garlic)
Fruit (unless it's berries, apples, and grapefruit - low glycemic fruits)
Aged Cheeses
Vinegar
Mushrooms
Foods containing yeast
Caffeine
Alcohol - see, no celebrating of any kind!

Foods I AM allergic to:
Eggs (the white)
Cows Milk
Peanuts
Gluten
Wheat
Oats
Corn
....there are more, but that is all I can remember for now and those are the biggies :(

Needless to say - I am hungry a lot.  I also cheat on my diet a bit.  I try really hard to avoid all these things, but I give in to temptation, hunger, peer pressure, and simply - convenience.

This is going to take some serious getting used to :(

Botox : Information

I've received criticism from some regarding my desire to get medical botox and then having actually done it.  People can't understand why I would put "poison" in my body.  I have done my research and now I want to clear a few things up regarding "poisons" and most importantly, Botox.

There is a bacterium called Clostridium Botulinum that is most often found in spoiled food.  By consuming infected food this bacteria it is able to enter your blood stream and systemic systems and can virtually attack any part of your body.  Clostridium Botulinum, or Botulism, produces 7 different neurotoxins.  These 7 toxins attach themselves to the axon terminals of neurons preventing the synthesis and exocytosis of the chemical messenger acetylcholine.  Acetylcholine is used throughout the body, but is especially important in the innervation of muscle tissue.  Without the release of acetylcholine a muscle contraction cannot occur, which means paralysis of that muscle.  This is particularly troublesome if the neurons being attacked are those that innervate the muscles of respiration.  If you can't breathe, you will inevitably die.  This is also a serious problem if the neurons are those that innervate your heart.  

Could the prevention of muscle contraction possibly be a good thing? 

One cause of migraine headaches in some people is neuralgia or nerve pain.  A cause of occipital and trigeminal neuralgia is that a few of those nerves (or their branches) upon leaving the skull have to pass through very narrow passageways in bone, tissue, and between muscles.  If one or even many of the muscles surrounding that nerve contracts it can pinch or irritate that nerve causing nerve pain (neuralgia). 
Again, I ask, could the prevention of a muscle contraction be a good thing?  If those facial, cranial, and neck muscles can't contract, they can't pinch the nerve and will therefore prevent neuralgia (nerve pain).

As I said, the bacterium Clostridium Botulinum produces 7 different neurotoxins.  Those neurotoxins affect many different proteins necessary in the synthesis and release of acetylcholine.  Botulinum Toxin A is only ONE of those SEVEN toxins.  And it only affects ONE protein.  Botulinum Toxin A (Botox) is RELATED to the bacterium Clostridium Botulinum (known as botulism).  But it is not botulism.  It is a purified, sterilized, and diluted protein derived from Clostridium Botulinum. 

Second point - I do not ingest botulism or even Botox.  It is not put "IN" my body.  It is put on my body.  It does not enter the blood stream to then travel to other areas in my body.  It does not affect other systems in the body.  (Like any medicine that you might ingest.) 

The amount of Botox used in medicine and cosmetics is 50 units.  Because this is only one of 7 neurotoxins used by bacterium Clostridium Botulinum, and it has been diluted, purified, and sterilized, in order for Botox to be fatal a person would have to receive an injection of THOUSANDS of units DIRECTLY into the heart.

Curare is a toxin derived from a plant.  It has been used for thousands of years to make the often fatal "poison darts".  Curare is also used to relax muscles during anesthesia.
Purple foxglove is a poison that has been found to be a very effective heart medication.
Willow bark is toxic and causes fatal bleeding.  But it is also used to prevent or minimize the effects of a heart attack as well as to prevent strokes. And has been found to reduce inflammation, relieve pain, and reduce fever.  In fact, millions of people consciously ingest this poison every single day (it is called aspirin). 
The crocus flower is a very poisonous flower, but one of the most expensive spices in the world is derived from this flower.  If you have ever intentionally eaten saffron, you could be said to have consciously ingested a poison.

Let's also not forget that whenever you get a vaccination you are getting a small or inactive amount of a particular virus injected into your body.  You are getting "medicine" that has been derived from a very mean, nasty, and virulent virus.  (Viruses are some of the most potent, fast-evolving, fascinating, and beautiful creatures on this planet.  And they are amazing and efficient little killing machines.)

It would seem that the words "toxin or poison" and "medicine" can be synonymous.  What may be "medicine" to one person may be toxic to another.  And what may be toxic to one may be "medicine" to another.  Or what may be toxic when used in one way is actually medicine when used another.

When I went on Cymbalta no one said to me, "Why would you put that poison in your body?"  But from my personal experience ingesting Cymbalta was much more toxic to my entire body than Botox has been to the few tiny muscles it was applied to.

Also, interesting to note, studies have shown that Botox is safer than aspirin.  But I bet that many of you have taken aspirin and thought nothing of it.

So far....

I think the Cymbalta withdrawals are finally starting to subside a bit. I feel normal often.  Not necessarily more often than not, but, baby steps.  I'm very rarely nauseous anymore.  The vertigo or dizziness thing isn't quite gone.  I still experience it from time to time, but it seems to be happening much less often.
The Botox ..... I'm afraid that it may be too early to tell.  Friday night I had a migraine.  Saturday day and into the night I had a migraine.  Sunday I had a headache that turned into a migraine overnight. 
I know that in some people the Botox will make their migraines go away completely, but in others it just decreases severity or frequency.  At this point it's just too early to tell really.

Oh, and my cute neurologist (who doesn't seem to have much of a sense of humor) called me Monday to check on me.  When I told him about my weekend he said that unfortunately it does take from 24 hours to 2 weeks to start working.  But he asked about side-effects and I said that I hadn't experienced any.  However, I there was one side-effect that I was really hoping for.  He put one shot right in between my eyes and I still happen to have quite the little "crinkle" there from scowling so much.  (I'm ornery as hell, I can't help it. Those years of endless scowls and dirty looks are taking a toll on my face.)  Well, I was joking with him, but as I mentioned he doesn't have much of a sense of humor.  He said when you come back for your second injection in a few months remind me about that little crinkle and we'll put extra there. 
Really?
He said, yes, your insurance covers a certain number of treatments, and an over all amount, but that's all.  I'll have more than enough to cover your regular injections and still ut a little extra in that spot.   :)  He's great.                               

Injections

I got a very happy and welcome phone call on Wednesday, June 1.  My insurance company had accepted my appeal (or rather my neurologists) to be a candidate for Botox injections to relieve my migraines. 
When I went in for my appointment on Thursday I was given 31 injections of Botox.  7 in my forehead, 5 in each temple, 3 around each occipital nerve, and then 4 down each side of my trapezius muscles.  The needle was tiny and I could barely feel it go into my skin, but once the injection happened it got to be a bit painful.
It's not supposed to start working for about 24 hours so I didn't expect any immediate effect.  I do want to note that I was the first ever Botox patient of this neurologist and his entire neurological office.  But regardless of that, I think he was great. 
He told me about a few side-effects.  Redness, swelling at injection site, and droopy eyebrows. 
I can happily say that I experienced none of those side effects. 

Trazodone Side Effects

One of the side effects of Cymbalta is insomnia.  So to counter that the doctor prescribed another medicine that is a known migraine preventative that has the side effect of sleepiness (amitryptalin).  Unfortunately not only did the amitryptalin not make me the least bit tired, it seemed to have absolutely no effect on my insomnia.  So then the doctor had me try trazodol instead of amitryptalin.  Trazodone is also know to prevent migraines and has the side effect of making a person very sleepy,  Well, it seemed, at least initially, to be making me sleepy.  However, some of the other side effects of trazodone were not so pleasant.  It gave me horrible dry mouth and congestion (only when lying down).  And I'd only experience these side-effects the first 6-8 hours after taking the pill.  I couldn't breathe.  Yes, it would make me sleepy, but then because of my difficulty breathing I couldn't sleep.  It seemed to stop even making me tired after a few weeks and it wasn't preventing any migraines either. 
So I went off that one, too. 

P.S. The pharamcist told me that it only makes you tired for a few weeks and then your body seems to adjust to it.

Cymbalta Withdrawals

As a result of the chest pain I have stopped taking Cymbalta.  I know that one side effect is heartburn and I wanted to see if it was the Cymbalta causing it.  (I consulted with my neurologist about this first, I did NOT simply go off it all by myself.)  Friday, May 27 would technically be my second day off the stuff.  All day I just felt an overall "yuckiness".  Just "not well".  Hard to explain, hard to put my finger exactly on what it was.  If I exerted myself the feelings would get much worse and I'd also start to feel lightheaded.  Also a slight headache.  (I've never had the flu, but I imagine this is what it might feel like in its very early stages.)
Saturday, my third day off he stuff.  Much worse!  Nausea, dizziness, lightheadedness, headache, fatigue, and still that overall "yuckiness".  Saturday night the nausea hit it's peak.  I threw up 4 times in about 90 mins.  And I still had chest pains. 
In the middle of the night it occured to me, I know what histimine does to the body, it makes sense that an antihistimine would decrease my feelings of nausea (and also help me sleep!)  I did a little research online via my iPhone and sure enough - benadryl would help with my nausea.  So dug through Jody's medicine cabinet and was fortunate enough to find benadryl.  Now, let me be lucky enough to keep it down.
It worked!
Sunday morning I still felt yucky but remembered that the pharmacist had told me that I could take dramamine whenever I get nauseated from my migraines.  I looked at what dramamine helps with and it said - nausea and dizziness.  YAY!  So I took dramamine to help me get through that day.  It never made anything go away, but made it bearable.
Monday, more of the same.
Tuesday, more of the same.  But at this point I was so frustrated with feeling yucky in addition to the headaches and migraines (and who knows, maybe an additional withdrawal symptom of Cymbalta) depression.
I cried the entire drive to work.  I took several breaks during my work day to go to the bathroom and cry. I cried my entire lunch hour.  It took everything I had not to cry while sitting at my desk greeting clients and interacting with co-workers.
I finally called my neurologist.  She named off the list of known withdrawal symptoms of Cymbalta - check, check, check.  She said that I could go back on it and we could try to take me back off it even more slowly, but at this point I am nearly half way through the withdrawal period.  I elected to tough it out.
My drive home Tuesday afternoon was very scary, I'll be honest with you.  I was starting to experience the strange neurological withdrawals that I had read about.
Wednesday, in the shower I nearly passed out from the dizziness.  So I stopped midshower and went right to bed (with a towel around my head and everything).  Called in sick and slept nearly the whole day.  Felt yucky, yucky, yucky.
Today is Thursday and I am back at work.  Still feeling yucky.  Still very lightheaded and on the verge of passing out. :(  And still crying constantly (or at least fighting off the tears.)  I've never really suffered from depression - a few days this past winter.  And this is crap is ridiculous.  I don't even know why I'm sad and crying half the time. 
I've read that withdrawals can last 2 weeks.  I'm almost to the halfway point.

D.O.

I have always been a fan of the idea of going to a doctor of osteopathy.  (A DO takes a very whole body approach to medicine).  Two of my best friends recently went to Dr. Stuart Porter, DO and I heard great things from both of them about him.
Thursday, I got to visit with him.  What an amazing difference between virtually every MD I've visited with and this DO.
First of all, I'm not sure if I can call what I've done with MD's "visiting".  I see them for about 10 minutes and they ask few questions other than what are your symptoms.  Don't you care about the extensive medical history and list of medications I just spent 30 minutes filling out for you?  Didn't your nurse write down all my symptoms when she asked me 15 minutes ago what they were?  And didn't you hear me when that I told you that "triptans" don't work, in fact they make my migraines much worse? So why are you now prescribing me a triptan? 

I spent about 3 minutes with what I assume was his nurse - she took my weight, temperaure, and blood pressure.  Then I spent about 30 or 45 minutes with the doctor.  That's right - I had him all to myself for more than half an hour!  And that extensive family history and medical history form I filled out.  He looked at it.  Right in front of me.  Ask me questions about it.  Then he went through an even more extensive questionaire which included things like, "how are you sleeping?", "do you feel fatigued during the day?", "do you suffer from seasonal allergies?", "do you crave sweets?", "how often are you menstruating?" (not just what is the date of your last period).  With certain answers that I gave him, he would then explain how that may or may not help with the headaches. Finally, he wanted to perform an allergy test on 13 known and common food allergens.  And explained that sometimes you have a food allergy that goes unnoticed because it doesn't give you a stomach ache or make you feel the same way you do with other allergies.  Also, he wants to test all of my hormones and also my Vitamin D levels.
This is where I stop him - oh, I've already had a Vitamin D test ran and the results came back that I am fine.
He says that he's going to run it again because headaches are a result of low Vitamin D levels.  And what the lab says are "fine" are not fine to him.  The lab will approve Vitamin D levels above 32, but he considers anything lower than 50 as too low.  And for someone suffering from headaches it best to have them closer to 100. 
Just as we're about to wrap up he sees the paperwork I had my neurologist send over.  What's this?  I tell him what it is and he says, "let's see if your Vitamin D test results are in here."
Sure enough.  And you know what my "fine" level is?  32.5 
So I'm taking Vitamin D, but he also recomended a few others. 
Follow-up in two weeks when we'll have the results back of my hormone and food allergy tests.

Falling Apart? Or Bad Week?

It all started with the wonderful, and yet painful, massage on Tuesday.  I was sore for several days after that.  Then the severe chest pains on Wednesday morning that had me thinking I may need to run to the hospital. 
To make matters worse, I had a little fall Thursday morning.  (I lost my balance while sitting on the counter in the bathroom.  Are you finished laughing yet?)  The fall hurt my hip (where I landed), my shoulder (which hit a small cabinet I have in my bathroom), my foot (which hit against the side of the door on my way down), my lower back, (I guess from the jarring landing I made), and my wrist (which I can only assume I tweaked while trying to catch myself and soften the blow). 
I'm off the Cymbalta, which was making me sick and is now REALLY making me sick - I'll discuss that in a minute. 
The Trazodone which is supposed to help me sleep is not really working any longer.  And besides that, the side effects of the trazodone add to my inability to sleep.  The side effects are congestion and dry mouth.  So as soon as I lay down I begin to feel congested so I can't breathe through my nose anymore.  And then it causes dry mouth which is exponentially worsened by the fact that I have to breathe through my mouth.  The final and most exciting side effect is the blurred vision.  So when I can't sleep, I can't do anything else, because I can't really see.
Then to top it all off - I think I sprained my pinky toe Monday night.
So now I hurt everywhere and feel like I am just falling apart!

Cymbalta Side Effect?

Sometimes I worry about reading the potential side effects of a medication because then I may experience them simply because I expect them.   Like a placebo - sort of.
But I looked up the side effects of Cymbalta anyway and I saw insomnia.  Well, as you know, my faithful blog reader(s), I am suffering from insomnia.
I have never had heartburn in my life until about a year ago.  And then ONLY when I took a peppermint pill for my tummy.  But for the last two months I've had heartburn quite often.  I tried to identify what it was - was it caffeine, was it chocolate, was it spicy foods?  It almost didn't seem to matter.  I'd get it on an empty stomach.  Everything but water gave me heartburn.
I learned in physiology the difference between all the heartburn medications and which was the weakest and which was the strongest.  So I went to the pharmacy and picked up the strongest heartburn medication available.  It was even a time release one so that it would work all day.  It didn't help.
When I had I looked up side effects of Cymbalta, there it was - heartburn. 

I've been having a most interesting issue with my stomach and esophogus and chest the past month or so.  Whenever I eat (it doesn't matter what, it doesn't matter how much) I get that feeling like something is stuck at the bottom of my esophogus and top of my stomach.  Each swallow - stuck.  I knew that it wasn't, but it was that sort of feeling.  Only this was painful and would radiate up my esophogus giving me pain in my chest.  It would only last a few seconds, but it was very irritating.  Then when I finished eating I'd have this pain that would start at what I imagine to be my esophogeal sphincter and would radiate up my esophogus.  It came in waves and could be quite painful.  It would last 10 or 15 mins after I finished eating.
This weekend I experienced it a few times and my chest hurt so bad I thought for a second - what if this is a heart attack?

This morning, after I ate breakfast, that pain was back - and with a vengeance!  I doubled over, I saw stars, it was hard to breathe, I was in tears and swearing like a sailor!  Each wave just a minute or two apart was excrutiating!  I thought I was going to have to go to the emergency room.  And it lasted nearly two hours!  It slowly subsided after about an hour and fifteen minutes - enough so that I was no longer constantly thinking about where the nearest hospital was. 
I decided that since Cymbalta is quite possibly giving me heartburn, I'd look up the other side effects.  I saw "abdominal (stomach) pain" listed.  Well, that's not exactly informative.  What KIND of stomach pain?  What did it feel like?
I continued my search - this time turning to websites that were not drug specific - and I found a blog that's meant to be a support to those suffering from depression.  It had postings about antidepressant medications and the side effects people had suffered.  One woman posted "Ever since starting Cymbalta several weeks ago I have had horrible heartburn.... There are times when the pain in my chest is just a huge pain in the center of my chest. It gets so bad that I take the Extra Strength Vicodin that is prescribed for my disk degeneration". 
YIKES!
So I called my neurologists PA and told her about my experience and that I wonder if maybe it's from the Cymbalta.  Well, I'm going off Cymbalta immediately to see if this stomach/esophogus problem goes away.

Potentially Great News

Spoke with my neurologists PA today and it turns out I may qualify for Botox injections to treat my migraines.  The best thing about this (versus the plastic surgeon who suggested Botox injections) is that it is quite possibly covered by my insurance.
The FDA has approved Botox as an acceptable treatment for migraines in certain circumstances and Paula, my cute PA, has said that I am an excellent candidate.  To be a candidate I have to:
1) have more than 15 headaches a month - CHECK
2) not respond to several preventative medications - CHECK
so she's working now with my insurance company to get it covered for me.

Massage

Let me tell you about the  most professional, most caring, most amazing massage therapist I've ever been to.  His name is Garret Sueltz at Studio 603 in Draper (801-571-5331).  Yes he was so good that I am going to give him a plug.  If you live near Draper or don't mind driving to Draper for a massage, he is well worth the drive and well worth the money.
I had a Groupon for a 60 min massage at Studio 603 which is how I came across Garret.  I was the last client of the day.  When I went in Garret asked me why I had come to see him.  I explained that I have chronic headaches and frequent migraines.  He asked if I wanted him to focus on my back, neck and shoulders and I said yes.  If he could get that worked out then he'd move on.  Otherwise he'd spend all of his time there, he explained.  He asked if he could do a deep tissue massage to which I gave him a very affirmative yes.  I love deep tissue massage (I'm not one for the nice relaxing Swedish style massages - I want it to "hurt so good"). 
Garret began to explain what he was going to do, where he would massage, and warn me that it will hurt.  The muscles that need the most work are very deep, but also, they sit right on top of a bunch of nerve bundles.  And then the usual - let me know if it hurts too much.  I think only one time have I ever told anyone it hurts too much.  You can have me in tears (and some have) and I won't tell you it hurts too much.  I know pain - I deal with it all the time.  A deep painful massage is the type of pain that I know will come to an end in just a few minutes when the therapist moves on to another muscle or body part so I will just take it.  Also, I know that it's a healing pain. 
So Garret works and works and works; knots in my muscles are popping, I am cringing, pain is shooting all the way down my arms when he works on my shoulders.  But Garret keeps plugging away.  Knot after knot after knot gets massaged and pushed on and stretched out.  He was determined to get everyone of those knots out and those muscles relaxed. 
I am laying there thinking - this is the longest massage I've ever had!  Or does it just feel that way because of how much pain it's causing me?  Or is it because we're working on only a portion of my body and I can usually gauge how much time I have left by what body part they've moved on to or if they've asked me to roll over?
In the end it was the longest massage I've ever had.  When I looked at the clock I noticed that Garret had given me a 90 min massage for about the price of a 30 minute massage.  He didn't charge me extra, didn't even say anything about going over the time.  He was so determined to help me, to relax my muscles, to remove those "toxins" from my body, to get those painful knots out that he just kept going.  That's why I say he was the most caring and most amazing massage therapist I've ever been to.  I don't think he ever looked at the clock and he certainly never had a timer going. 
He's also the first massage therapist to ever massage my stomach and my face.  Incredible!
When I took a massage course at the age of 18 from the college of massage therapy they taught me to massage the stomach.  But I've never actually had anyone do it until Garret.  Another reason I think he's amazing.
And then in the end when it was finished he showed me stretches to do for the muscles that were massaged and for complimentary muscles.  This is why I think he is the most professional massage therapist I've ever been to.  It wasn't just a massage to him, it was a therapy session. 
He told me that I'd need a follow-up massage in about 3 weeks when those knots and muscles would be more pliable and gave me a coupon for 50% off my next one in case I wanted to return to him for that follow-up.

So, again, Garret Sueltz at Studio 603 in Draper (801-571-5331). 

Occipital Nerve Block : Day 5

I have a headache again.  I know this comes as no surprise.  But what is a surprise (although it probably shouldn't be) is that the nerve block appears to have worn off already.  My neck hurts - and not just in the injection sites, but all over.  And there is pain again in the back of my head.

I took excedrin in the late morning - I don't know why I even try anymore.  I guess because I haven't completely given up hope that SOMETHING will help.