Wednesday, August 30, 2017

Today, I Had to Beg for Migraine Control

B&W photo of a hand holding three pills (two capsules and one tablet); underneath is a yellow-cream bar with black text "Today, I Had to Beg for Migraine Control" and under this a black bar with white text "not standing still's disease"

Today was my follow-up with neurology, which also happened to be for an EMG and nerve conduction study.

Over the last few days, I've been doing research around what might be potential differential diagnoses for what I'm facing. I did research, read research others sent me, and bounced ideas off other smart people. I put together a list of tests I'd like ordered, possible diagnoses, concerns, symptoms (new and old), etc.

And didn't get to do a goddamn thing with it.

The EMG was uncomfortable. Essentially, they're sending electricity up and down certain nerves in order to gauge how 'normal' nerves are functioning. Obviously, this results in the movement of limbs without trying to move. Both the test and the reactions are uncomfortable and not fun.

The nerve conduction study, also called the needle test, consists of sticking a needle where a nerve and muscle meet. Then, they have you move in a way that would stimulate these nerves while the needle gauges how well the nerve and muscle are communicating. For me, this was far more uncomfortable - maybe in part because some of this was done near my bulging disc and middle of my back.

All of this is done with no medication. The needle test winds up leaving blood spots all over, resulting in interesting looks if you go out afterward.

While this all was uncomfortable and even painful, this wasn't what bothered me the most about my appointment.

After going through these tests and them not finding anything, I asked my neuro if the bulging disc could be causing/exacerbating symptoms. He flatly dismissed this. 

He then returned to my chart and began to look at my medication list. He said he was leery of putting me on anything to control my migraines because I was already on 'too many medications.' I explained that I have multiple diagnoses, so obviously I'm on meds for these. He countered with concerns on contraindications and interactions. 

He literally didn't want to do the work to check which medications I could take. I had to make a case for getting my migraines treated. I literally had to beg for pain relief.

I explained that nothing I've been using to treat my migraines is helping anymore. I'm having them more often as well. This is what I was referred here for, after all, to control my migraines.

He relented, asked if I've been on a tricyclic antidepressant before, and said he would add one and then check the contraindications and interactions to make sure it was safe for me to take.

Yes, the antidepressant he prescribed can be useful in preventing migraines for people. However, I also wonder if this is some way to get a young femme out of his office and to stop annoying him. When doctors don't know what to do - or don't believe the patient is in pain - antidepressants are often the go-to drugs.

I find it odd, too, that he would prefer sticking me on a second antidepressant daily to working with a relief medication for when I do get migraines I can't control through other means. There is a higher chance that I could deal with a severe mental health issue here compared to other, lesser side effects with heavy hitters.

All of that, and I don't go back until December 1st. I'm supposed to call in a month to report back how the medication is doing, but that's it. No further tests around my nerve shit, and no more working down that path to a diagnosis for that.

I walked back to my car and cried. I'm very upset. It's just like my initial illness stuff in 1993/4 and getting a fibro diagnosis between 2010-2012. The whole thing just screams old white cishet abled paternalistic doctor dismissing young femme(ish) patient's invisible pain, and I can't live like this for too much longer.

I shot my GP/GYN a note and explained about the bulging disc. I also explained that I do acupuncture - a common first-line in reducing pain, according to this med system's website - and I wanted to see what else we need to/can do to deal with this. I've barely been able to sleep and, when I do, I usually wake up around either midnight or 5 am to move to the couch because of pain.

This whole day went to shit. I should not have had to beg for control of my migraines, especially when it's because a doctor couldn't pull up a goddamned color-coded alert in the MyChart system. It's not like he even had to look on Drugs.com like a normal fucking person.

UGH.

I cried, drove to Target to get my new script (fawning at the gorgeous pharmacist like the queer newbie I am), and rage ate a large frozen custard with peanut butter cups. No, not the best decision, but something I needed to do for me right then.

And so was pizza because fuck cooking tonight.

No one should have to beg for pain relief, especially when it takes so long to even get in front of a doctor who can help. Period.





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