Headache Log : Paula the PA

I knew I had a great feeling about the neurologist, even if I did pick him out of the phone book.   The first person I met with was his PA Paula.  She was great and incredibly thorough.  (And she was interested in my headache calendar. - BONUS!)  This wasn't 21 questions, this was 100 questions.  But some that stuck out in my mind were ....

"Have you experienced any tingling in any of your extremities?"
"Extremities, no.  Unless you count my nose."  Then I went on to explain the tingling I'd experienced in my nose and face.  And that I hadn't been concerned because I had read that migraine sufferers often experience tingling in their face. 
She explained to me that it was also a very common side effect of Topomax. 

"Have you lost any weight?"
Sadly, no.  This was also a common side effect of Topomax and one I was very aware of.  But one I did not benefit from.

Other questions and then ...

"Have you had trouble concentrating?"
Concentration?  Does it mean I have trouble concentrating if I try to say something and by the time I get to the middle of my sentence I can't remember the beginning of my sentence or what was supposed to be the end of my sentence?  Does it mean I have trouble concentrating if I can't study at Barnes & Noble because I get drawn into every single conversation around me and not into my text book?  Does it mean I have trouble concentrating if I go to the library to study, the quietest place I can imagine, and the noise of the pages turning by the guy two tables away from me is disruptive?  And if his page turning isn't bothering me then it's the lack of noise that's bothering me?  How about the babbling brook noise I downloaded to my iPod to drown out the page turning noise, but instead of focusing on my homework I keep trying to listen for the loop within the iTunes track.   That every movement that happens around me brings my eyes up to what's going on around me.
I had never thought about it before, but YES!!!! YES!!!! YES!!!! I have trouble concentrating.  I thought maybe I was just too old to go back to school.  Had forgotten how to study.  Or was just not smart enough to be a pre-med major.  Because that's what I've been contemplating now for years.

I explain that I've never really thought about it before, but yes.  I really believe I do.  School has never been this hard for me before.  Focus has never been this hard for me before.  Work has never been this hard for me before.

She tells me it's the most common and most complained about side effect of Topomax. 

"Have you ever been to physical therapy before?"
"Yes, twice.  Once for my knee and once actually for this very same issue.  The time I went for migraines was not a good experience." 
I tell her why I hated it.  She tells me she wants to try it again, but with a different focus this time.  And that she wants me to have an open mind about physical therapy this time.  I explain that I have a VERY different opinion of physical therapy and physical therapists now than I did 10 years ago.  This won't be a problem. 

Headache Log : The Young Doctor

Determined to find a new primary care physician so I didn't have to drive an hour to my previous one and so I didn't have to wait a month as a "new patient" to see one, I decided to be a little proactive.  Besides, if someone could please give me some sort of drug to help me - that would be AWESOME!  I still have 10 days I have to survive before I get to the neurologist.

I find a young doctor fresh out of medical school with an opening the very next day.  I'm naive enough to take it.  He's inexperienced enough to prescribe Almotrex - even after I tell him I can't take Imitrex or Zomig.

He also suggests I double my Topomax intake.

A very wise pharmacist instructs me that almotrex is a triptan - almotriptan - just like Imitrex and Zomig.  And he's very concerned about what will happen if I take it.
Whew!  What a relief!  I didn't want to spend $70 on pills that were just going to make my head hurt worse anyway.

Headache Log : Topomax

At some point around 2009 or 2010 the Verapamil stopped working.  Headaches and migraines came back on a daily basis.  Went into the doctor, he explained that Verapamil is actually one of the least effective migraine preventative medications on the market.  He prescribes Topomax.