A New Approach

 

Medicine pills

Yesterday not only marked a new month but also a new beginning for me in how I approach my treatment.

I had my new patient appointment with Dr. Colman and it was exciting but also scary. I worried that I may have put too much emphasis on this appointment and didn’t want to be let down. However, Dr. Colman and her team did not disappoint.

They spent over 2 hours with me going over my history, every concern and issue I have or have ever had and they made me feel so safe and comfortable and NORMAL. I didn’t feel rushed, like they needed to get to their next appointment. I never felt like any of my concerns were being minimized or anything that I had been through made me a freak or a medical marvel.

When it came time to discuss treatment going forward, everything was explained to me in a way that was easy to understand even if it was hard for me to swallow. In the past when I spoke about how nothing was working and my migraines were still so bad,  I was just prescribed more medication, had my doses adjusted and was sent on my way. I was in and out of the office in 15 minutes or less. If I had a migraine that lasted more than 4 days and I needed the cycle to be broken, I was told I could go to the emergency room for a DHE infusion, but first I had to get approval from my insurance so I’d have to wait 3-4 days for that. It literally made no sense. And the ER is absolute Hell for anyone going through a migraine.

Yesterday I was told that I’m too reliant on my medication. As someone who has had a stomach ulcer rupture due to NSAID overuse, I would agree. I’ll be the first one to say I never want to end up in that situation again, but I also need to be able to function on some level and my medicine allows me to do that on most days. But then I got schooled on rebound headaches. I’ve heard about them before but I never paid them too much attention, because I deal with migraines. Chronic ones. I was always in the mindset of, I can’t concern myself with the likes of mere ‘rebound headaches’. I’ve got bigger things I’m dealing with.

However, Dr. Colman and her team disagrees. Because of all the medication I take and all of the combinations of triptan cocktails I mix together when I’m in a pinch, I am hurting myself more than I realize. On top of all my preventative medication, I’m using triptans almost every day and I also end up using extra strength tylenol most days too. I am currently prescribed three different brands of triptan and use them at my own discretion depending on my mood, intensity of migraine, etc. At yesterday’s appointment, like Sophie’s choice, I was allowed to pick only one to continue using. I can use it just 3 times a week. No more than that. If I need to use something else, they prescribed me a muscle relaxer that can be used more frequently.  I’ve been instructed to start with only half of a dose before bed when needed.

If I need to use a triptan more than three times in a week I can reach out to Dr. Colman via email and either her or one of her fellows will get back to me about other ways to help me. Those can include prescribing a steroid, another prescription, coming into the office for a nerve block or possibly seeing the nurse practitioner for an IV infusion. All of these including the muscle relaxer are options I have never been offered before.

We also spoke about so much more than medication. I went for lab work, which I haven’t been asked to do in such a long time. I am still awaiting results. We spoke about my mood, anxiety, how it affects migraine and the vicious cycle of cause and effect. As a result, we discussed methods of coping including therapy, meditation, exercise and more. We spoke about my sleep habits (or lack therof) and some big changes I need to make to combat the insomnia I struggle with. She brought to my attention the fact that I have an increased risk of stroke since I experience migraine with aura and the brand of birth control pill that I am on increases that risk further.

This appointment was eye-opening for me. Not only in how many more doctor appointments I need to make immediately, but how doctors in the same field treat patients so differently. Don’t settle for a doctor who may not be giving you the best treatment, just because supposedly they are the “best” in their field. I always try and steer clear of dwelling on the past. No sense in harping on what I can’t change so I ‘m not going to sit here and think about what could have been during the 7ish years I was under my previous doctors’ care, but I’m grateful to now be under Dr. Colman’s.

Though this new way of treatment is overwhelming and letting go of all of 2/3 of my triptans is going to be difficult, I’m ready to embrace this new approach because while I know it may get worse before it gets better, as with anything that is hard I have a feeling it’ll be worth it.

 

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