Saturday, February 26, 2011

How much does the Doctor's Office Matter?

There were a couple of reasons I had started another elimination diet last year. Of course I wanted to try to find any additional food triggers I might have, but I also wanted to feel like I had done everything I could so if I needed to take the next step for my Migraine treatments, I could justify it to myself.

Although I still have a long way to go on this elimination diet, I feel that I will not reduce the number of Migraines I am currently getting as I add back more foods. I may find more food triggers which will help me in the long run, but that won't reduce my Migraines further than they are now.

I have to say that both of my elimination diets have been successful as the first one decreased my headaches and Migraines almost in half while the second one reduced it by almost another third of this lowered number. However, I am still getting too many Migraines and am still in double digits per month.

Since I had already laid the ground work, I decided that I might as well get some of my other questions answered about my next step doctor. Just to set the record straight, I am not ready to move yet, but I need all of the information in order to make the best choice I need to make for me and my family next.

I called the next doctor's office I plan to go to if I decide to move on. I had already seen that this office is having some staffing issues so I was prepared for some disorder, but I'm not really sure I am ready to deal with a doctor's office like this either. I did not like the way I was treated and the abruptness of being thrown into an automated system the first time I called. Knowing their staffing issues and not looking to transfer there yet, I could easily overlook it and move on.

Even though it seemed like it was a long way off, the automated system set the expectation that it could be five days before I received a call back from the office. Since this was not an emergency, I was willing to live with this especially since I know I am not ready to move yet, but I also know that this is what I tend to do before I jump into doing something.

I realized the morning of a client visit that the doctor's office may call back on that day. I decided it was worth it to leave an extended message on my cell phone, which I left in my car. It seemed to work like a charm because of course they called in the middle of the client visit. The message they left really restored my faith in the doctor's office as they acknowledged my message left specifically for them and said they would try to call after the certain time I mentioned or the next morning.

They were really pleasant, but I never heard back from them again. Since I am so tentative about making any switch at this time, I find I am using it as an excuse to not call them back plus I need to be prepared for the coldness again. Here are the pros and cons that keep going through my head right now:

Pros: The doctor is a top notch doctor. He is only a couple of hours drive away. He would be a partner and a true Migraine specialist.

Cons: Scuttlebutt has it that the office is in total disarray at this time. The office is a couple of hours drive away. It would cost more to go to him; especially the first visit.

I know his office is going through a tough time right now, but I've heard of them going through hard times before too. My current doctor's office does not rate well on the doctor rating sites, but I have never experienced anything negative with them. They have always been very pleasant and most importantly, available for anything I may have needed.

Although I know the doctor is one of the best in the world, I don't like the taste the office left behind. What if I weren't just inquiring now? What if I needed to get through with an issue? I think I question it more right now because I have also seen where a couple of their patients have had issues trying to get in touch with their office. This was actually the reason I thought to leave the extended message to them on my cell phone in the first place.

Honestly, I never really thought about how important a doctor's office staff would be to me and how much I would be willing to put up with from an office no matter how good the doctor. I don't know that I like the feeling of not being able to get in touch with my doctor especially since I don't call into the office very often to begin with.

I question this more right now as I analyze my current doctor even closer and keep going back and forth as to what I should do. That's probably a big reason I reached out to this next doctor's office at this time too. I also had another visit with my doctor this week. I probably came out of that visit with more questions and quandaries than I have in a long time. Granted, I probably put myself in that position and she even told me that I will have a lot to contemplate, but I haven't had a chance to research anything since my visit. I can't seem to get rid of this cold where the coughing is wreaking total havoc on everything.

How much does a doctor's office matter to you? What do you look for from the office? What is important to you? What can you or can't you overlook?


Monday, February 21, 2011

Client Visit

My client visit started out awful. While driving there, I just couldn't take it anymore. The sun glare was worse than it had been in a long time and it did not help having all of the ice on the sides of the road which was also beaming into my eyes. After trying on three different sunglasses, I finally caved in and took one of my triptans.

I tried not to take a triptan because of the cognitive side effects it usually has on me, but having a Migraine wouldn't be any good when trying to think and come up with solutions for the client either. I still had a few hours before the visit and I was hoping that would keep my brain honest enough. I had to balance taking the triptan now or possibly needing it even more later when I was actually at the client's site as a last resort.

I always have a horrible fear when I go to one of our clients offices because I am terrified the lights in the room are going to be murderous. This is based on an actual experience I had a while back where a client visit triggered a multi-day, hard to treat Migraine that was tough to make go away all because it was triggered by the lighting the client had. I still don't know if there is anything I can do preventatively to help my Migraines when I find myself in a lighting situation that is going to turn bad quickly.

As it turned out, it was a good thing I took the triptan when I did. I met my boss near the client site for some coffee, where I got water, so we could discuss our visit before we headed over there. Considering we each had a couple of hours to drive from different directions, this worked out great. We found a table we could spread out on. After a few moments, I asked if he minded if we moved tables. He knew immediately why I needed to move without me having to say anything else. I couldn't take the lights at that table and would not have lasted there much longer let alone whatever was ahead of me light wise at the client site.

We found another table, with a different light setup that was a little better, but I still needed to adjust where I sat by sliding over a seat to make it as comfortable as I could while keeping the beast as quiet as possible. I would not have made it through this 'coffee' break if I did not take the triptan before this stop.

Do you want to know the kicker? We arrived at the client site a little early. We entered into the conference room way before the client was even there. They had all of these funky settings you could do with the lights and the person who turned the lights on, only turned the lights on which were along the outside walls. It was soooo nice! You would have thought I turned on these lights! I figured this would at least cool my head down until the client came in when I would deal with the lights as best I could.

After they arrived, they started to turn on all of the lights. Thank goodness for a menopausal woman who was there. She was having a hot flash and politely asked if they could keep the lights the way they were! She has a very good relationship with the people in the room and they were more than willing to accommodate her. Wooohooo!!! I wanted to dance on the tables, but that wouldn't have been very professional of me.

This whole meeting was held in a conference room with the most soothing lighting I have ever had in a business meeting. I couldn't believe it! It was exactly what my head needed especially considering I was going to have a couple of hours drive home in rush hour traffic with headlights to contend with. I want those lights in every meeting room!


Sunday, February 20, 2011

Migraine Research is in Danger: Take Action Now

I just took action on this issue and thought you might find it interesting too.

The House of Representatives is considering an immediate and unparalleled $1.6 billion cut to the budget of the National Institute of Health (NIH). These proposed reductions are a serious threat to our nation's health and the prospects for improved therapies for migraine and other disabling headache disorders. Please act now to protect Migraine research!

After all of the publicity around Serene Branson lately, I believe more people can see how different Migraine attacks are than they ever expected they could be; that Migraines are not just headaches. We are hearing how unusual it was to catch an episode, such as Serene's, on camera and how they want to use that footage for research purposes. How can they research the tape if there is not enough research money? You can read more about the action alert on the Alliance for Headache Disorders Advocacy (AHDA) website.

It is so easy to take action. It can take less than 10 minutes to send emails to your Congresspeople. All you need to do is to go to the AHDA website and follow the easy instructions. You can elect to add in your own comments, but it is not necessary. Please help and take action now by sending your email to stop these proposed cuts to the NIH today.


Saturday, February 12, 2011

Migraines, IIH and LP?

During my last doctor's visit, I had a Freudian slip. I have a few back burner items that I have not talked to my doctor about yet, but I think it may be time to move this item up to the forefront.

Last visit, I tried to say 'IHS' for International Headache Society. Instead, I said 'IIH' which is an acronym for Idiopathic Intracranial Hypertension that is also known as PTC, Psudotumor Ceribri. IIH is an increased level of spinal fluid which can contribute to Migraines. I quickly recovered from this Freudian slip, but it was interesting to see her reaction when she heard 'IIH'. First of all, it didn't belong in my sentence. Second of all, I could see that she knew it was on my mind especially by the way she tilted her head and the face she made. It wasn't necessarily in a bad way, just interesting to note.

I am always fearful of 'contracting' every aliment/trigger I read about, but I don't want to bypass a possible diagnosis that could help me either. Even though I am in the middle of the elimination diet, I still feel I am getting too many Migraines. Although they have gone down, I don't think it's enough and will still continue with the elimination diet as I feel I am finding 'good' foods on it which will help me in the long run.

While I have a hard time believing I have IIH, you never know until you take the test. The only definitive way to test for IIH is to have a lumbar puncture (LP) to test your opening spinal fluid pressure. I have read different articles written by Teri Robert about IIH that explain everything in an easy to read and easy to understand format: Headache Attributed to Idiopathic Intracranial Hypertension - The Basics and Idiopathic Intracranial Hypertension (IIH) - The Basics.

How many symptoms of IIH do you need to show before you really should consider being tested? Here are some of the symptoms of IIH:

> headache, sometimes daily, sometimes severe, not relieved by medication
> hearing loss
> impaired vision or eventual blindness
> memory problems
> Migraine attacks with unexplained triggers
> nausea
> pain behind the eyes
> pulsating intracranial noises
> shoulder and/or neck pain
> tinnitus
> vomiting

I would say I have six of the eleven IIH symptoms. Some doctors will say that you must have papilledema, which is the swelling of the optic nerve, in order to have IIH, but that's just not true. I have heard of at least three people who have had IIH without having papilledema. This is where I think my doctor is going to make me see a neuro ophthalmologist to test for papilledema anyway.

I'm not sure why I want to have another test that really has no bearing on whether or not you have IIH. I'm sure it would be nice to know if I have papilledema or not, but my eye doctor takes pictures of my optic nerve during every visit already. He also knows I have Migraines as I remind him every time I go. I guess I'm just not sure I want to spend the money on a neuro ophthalmologist if it really isn't worth it. What do you think?

I didn't bring up IIH on the last visit after I slipped and said it. I ran out of time and actually went way over my time with that visit plus I really wasn't ready to discuss it. I don't have every symptom for IIH, but I don't think it would hurt to be tested for IIH to at least rule it out as a contributory factor. I sense that she is going to be a little reluctant to go this route, but I am getting more ready to at least cross it off my list as something I've tried. The elimination diet has reduced some of my Migraines, but it really hasn't gotten rid of some of the everyday nuances I still experience.

If you had a lumbar puncture to test for IIH, how many symptoms did you exhibit before you had the test done? Were you diagnosed with IIH? Were you tested for papilledema? If you had a lumbar puncture, what tests and preparation did you need to do before you had the lumbar puncture done?


Sunday, February 6, 2011

Migraine Poetry Contest Time!

It's that time of the year again! It is time to enter the fun, annual poetry contest that Teri Robert has been holding since 2001.

This really is an exciting activity to go through. It can stretch your mind about things you never really took the time to stop and think about. Some people get very creative with their entries, but you don't need to and can be very straight forward with your poem.

You have nothing to lose by entering the contest and so much more to gain from looking inside of yourself or seeing what others have written and it's another way we have to support each other. I was also pleasantly surprised and touched last year when I received an honorable mention for my submission. If I can do it, so can you!

The official rules can be found on Putting our Heads Together Poetry Contest, 2011 rules. At the bottom of the rules page, you can find a link to the 2011 poetry contest entry form.

Why a poetry contest and what have others written about in the past? If you'd like to get the answers to these questions and see past entries and winning entries, they can be found on the Help for Headaches and Migraines site on the Poetry tab. Check it out!

I hope you get your entry in as I can't wait to see all of the entries. Have fun writing your poem, follow the rules and don't forget to submit your poem by midnight on the Ides of March; that's Tuesday, March 15th!

Good Luck!