Time

I bought a Groupon for a massage and as is often the case, there are strings attached, the massage comes with a sales pitch.  Only it wasn't a pushy sales pitch at all.  The massage is at a chiropractors clinic.  I began thinking about my insurance (it only pays for 12 sessions a year) and when it ran out and when it reset and then it hit me ...
It was over a year ago that I was seeing Dr. Nate. How long had I been suffering before I decided to go to Nate?  And I've just had another anniversary.  It was sort of demoralizing to realize how long I've been suffering with no solution in sight.

Keppra

The Verapamil was a no go.  Perhaps I was being overly optimistic that it would work.  Perhaps I am still overly optimistic that anything will work.  Not ready to give up hope yet (although I do have my days).

Tried Keppra for 8 weeks.  I experienced virtually no change.  I look back on my journal and I see a week where I was headache free, but I think that it may have been a reporting error more than anything else.  I was transitioning into a new job, while still working at my old job and I think I just forgot to always log when I had a headache and it's severity.  (It's hard enough to remember when I don't have life changes happening.)

Called the doctor last week to report that the Keppra wasn't working and I was ready for something else.  When he prescribed the Keppra 9 or so weeks ago he wanted me to know that we hadn't quite exhausted all of our options.  But that he completely understood if I chose to pursue another avenue with another doctor.  I thought that was nice of him.  When he found out I had visited the horrible doctor at the University (the so-called "expert") I felt a little like I'd betrayed him so this was nice to hear.  I know, it's silly of me, but when I've been seeing someone for over a year - even in a professional manner like this - I feel some sort of loyalty to him/her.

Keppra dosage has been upped.  I guess that was his next plan of attack.  Will it work?  I'm not one bit optimistic about it (although I admittedly refilled the prescription anyway).  Looks like I'm doctor shopping again.  What avenue to try next?

Verapamil Take 2

Went back on Verapamil.  Felt like, at this point, I was running out of options, and since it had been years since I was on Verapamil and of everything I had ever taken it had worked the best, the longest, and with the fewest side effects, maybe I had been off it long enough it would work again.
So I am now 5 weeks in and ...No luck.
My neurologist was kind enough, when I went in 5 weeks ago to ask for Verapamil, to tell me that we really aren't out of options and to give me some hope.
Monday, I was back to the doctors.  It was my regularly scheduled Botox injection which I opted not to have.  Sure the reduced wrinkles are nice, but it's not working (and I miss being able to look surprised). :)
So my newest experiment is Keppra.  Another anti-convulsant.  This one doesn't have the side effect of ADD like Topomax did (thank goodness!).  It has a much more pleasant side-effect - it may make me ornery.  Some of you may not be able to comprehend how I can possibly be any more ornery.  This is going to be an exciting discovery for all of us! I have horrible nightmarish memories of my days on the Nuvra Ring still fresh in my mind and how much I hated the entire world and nearly everyone in it.  So honestly, the thought of a mood change as a side-effect is not appealing to me.  But I thought of it this way, if I continue to have headaches and migraines every day I'm going to be miserable and that is going to make me ornery and hate the entire world and nearly everyone in it anyway.
The appeal to me when the doctor mentioned Keppra is that it is believed to act on the nervous system and bring it back to balance.  Since migraines are now believed to be the result of an over-active or over-sensitive nervous system I have been considering treatments and medications that are more in tune with regulating my nervous system. We'll see if I'm back on here in a month or two complaining about Keppra or signing it's praises.

Ultracet

Trying out another abortive since I can't take triptans and Fioricet didn't seem to be working.
Took my first dose of ultracet on Monday.  Took another one yesterday.  So far, I'm not impressed :(
Need something today, but I see no point in taking ultracet and I am trying to figure out what has been making me feel nauseous, dizzy, and "yucky" the past 3 days

DHE Injection

The middle of June brought on a new cycle - a two week migraine.  Since nothing was touching it we decided to try a new medication, but this one was a little tricky.  An injection of dihydroergotamine or D.H.E.  Often used to treat migraines and chronic headaches.  Google it, the side effects sound scary.  If taken within 24 hours of a triptan it can cause coronary artery vasospasm.  (Good thing I avoid triptans like the plague).  It can also cause a severe rise in blood pressure and a racing heart rate.  So my first injection had to be closely monitored and administered over time.  And because of the potential for vomiting, I had to be given benadryl before the shot which would make me sleepy.
It was unpleasant to say the least. The benadryl didn't stop the vomiting and the injection gave me a very similar sensation to triptans - a headache of a different kind.  The best way to describe it is to say that I felt like my brain had been poisoned.
I ended up sleeping most of that day and just feeling "yucky" all day, for lack of a better word.
But did it work?  That's the most important question of all .... I guess it did.  I didn't have a migraine that evening or the next.  (Although I did on day 3)
I'd do it again if the migraines were bad enough and the cycle was long enough.  But I'm still looking for another alternative.

Update - 6/20/2012

I haven't been on here in quite a while and that's because I really have nothing new to report.  Still having headaches on a nearly daily basis (with a smattering of good days every once in a great while).  And still have my "cycles" where I have a severe migraine for several days in a row.

No one really seems to know what to do.

Trying out one more option with Dr Reichert and then my next option may be a new doctor with a new perspective :(

Strike Three

After a few days of some fairly minor headaches I had the audacity to start to think that maybe I was getting better!  Then the weekend hit.  Two of the worst migraines I've ever had in my life and they lasted nearly all day long.  (Saturday I made the mistake of trying the Amerge.) Monday was another pretty bad one.  So I called Dr. Digre's office and left a message for her or her nurse.  "Please give me something other than a triptan.  The Amerge was awful."
Dr. Digre seems to have no interest in returning my call.   I guess if I'm not in her office where she can take more money from me she doesn't want to help me.
Oh, but she doesn't really want to see me anymore either.
I received a copy of the letter she sent to each of my current doctors regarding her findings, diagnoses, recommendations, etc.  It was pretty thorough, I'll give her that.  But I found it interesting that when she's listing the things that make my headaches worse or trigger my headaches she keeps leaving out smells - even though I told her and her PA REPEATEDLY that smells bother me even more than lights.
Also, one of the meds that she recommended I try in the future is an anti-nausea medication - even though I told her and her PA repeatedly that I do not experience nausea with my migraines.

I guess its pretty obvious that I am not at all impressed.