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ehygon

saw a neurologist for the first time

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I've been having more migraines than usual lately. It used to be 1 or 2 a month, and imitrex worked and the relief was glorious. Now it's like 3 a week with a constant headache in between from the minute i wake up, to the minute i fall asleep.

My gp referred me to a neurologist because he didnt know what else to do for me. I'd taken pretty much every otc drug in various combinations as well as some prescriptions to no avail. I saw this neuro yesterday.

He started by asking some questions about how things started (how old, symptoms, drugs that worked or didnt work) and then he did some reflex testing and other things i kinda expected. Then suddenly he was writing me a prescription and said he'd be in touch with my gp. This would not be a problem if...

-we talked about the problems i was having NOW and not 5 years ago

-he gave me an idea of what to do when i actually had pain because nothing works (he gave me a prophylactic)

-what to do if i do not find this drug helpful

I am incredibly skeptical that this man could spend so little time with me and know exactly what to prescribe to help me. I was sitting in my car, in and out of his office, and back in my car in exactly ten minutes. worse than any psychiatrist i ever had.

very discouraged. Im not sure what i'm looking for, i guess i just wanted to vent

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I guess he is not it. I would go to a different neurologist as soon as possible. And I would tell my GP how unhappy you were with the treatment from this dude.

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I'd say try the prophylactic, but if it were me, I would not be hesitant to find a new neurologist.

Based on the wild and wonderful stories I've heard here, neuros tend to vary wildly in both their bedside manner and abilities, heh. The only contact I've ever had with a neuro was for my son, when for some reason his pdoc was suspecting he might have seizures.

The first appt lasted about 1.5 hours, included a vast array of questions, and a full neuro exam (including the walk backwards and whatnot thing) and the neuro was pretty sure kid didn't have a seizure disorder, but he offered to test him anyway, but left it up to me. We decided to do it for pdoc's peace of mind, more than anything, because she was refusing to prescribe him a stimulant, after a trial of strattera that didn't work out so well. So we did the test, and kid indeed not have a seizure disorder, which allowed us to get him back on concerta.

Anyway, I'm rambling But I think my main point is: an initial neuro consult should really last at least an hour. I really liked my son's neuro, he was knowledgeable and easy to work with.

Anna

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thanks for the replies :)

I am taking the drug he gave me (sibelium, a calcium channel blocker) with no success so far. This could be, however, because the papers the pharmacy gave me say it takes 6 to 8 weeks to see the full effect (the box also says the dose should be twice what i take, but that's neither here nor there). In the meantime, I will see my pdoc next week, and explain the situation to her and see if she thinks I should ask for another referral to someone else.

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You did have the option of voicing your concerns during the appointment. And you could certainly call to ask what to do about pain mamagement until the prophylactic has a chancemto kick in.

Not saying he doesn't suck, just that you aren't entirely powerless in the situation.

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In my experience I would expect a first visit with a neuro to approach an hour, varying with the problem and severity.

I agree, that a more detailed discussion and direction would seem appropriate.

I guess his expectation is for you to keep doing what you have been doing to get along until you see how the calcium pills kick in. If you have a problem, call him.

Hope you feel better. a.m.

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I would jump in here too and say fid a new neuro.

My paindoc sent me to an old friend and highly regarded neuro for my 2+ years of 6 attacks of cluster migraines.

He did do the full neuro work up, history and exam, but more or less acted like yours did. Take this prophylactic and let's keep you out of the ER with Dilaudid injections.

Well, the pills did nothing except make me jittery and creepy crawly out of my skin and once the next attack happened I had been given a nasal spray (not Imitrex) and that ended me by ambulance in the ER.

I brought these issues up at my next appointment and neuro agreed that ok, this didn't work. Duh!

And after he had been teh one to tell my paindoc to prescribe the injectable Dilaudid, now he wanted nothing to do with it. (becasue y dad is a alcoholic... ergo, I should be kept away from anything addictive)

So I stood up and said you didn't take a good enough history since I have been on and off so many opiates in my life and I have never had a single issue to get off anything, so the risk for that is wee small. and I said that we would never see each other again. Brought that news back to my pain doc who actually KNOWS me who got on the phone during my visit and dressed this neuro down to nothing.

Felt a bit bad about their friendship going into the dump, but I have to look out for myself... plus I was very happy to see that my paindoc that I see every 28 days was so in my corner that he would make this call in my presence.

As said above, you can and should always voice your concern while with the doctor... but I say go with your gut feeling. It is rarely wrong.

Best of luck

Lin

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My last neuro thought he didn't need to change my pain med after prescribing me a new preventative. Hello, I told him it wasn't working on the pain (at the same time I told him the preventative didn't prevent anything.)

That's why I went to go pay out of pocket and get a second opinion. Now I have a new plan and a new pain management plan. I just wished I didn't spend a whole year on that neuro that would never talk to me on the phone. UGH!

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update:

i've been taking the sibelium (calcium channnel blocker) like he prescribed, with no real effect. I have been to the ER a few times and they give me toradol + maxeran, which makes it more tolerable for the time being, but the pain is back the next day. I went to my GP, who offered no options aside from sending out another referral for a new neurologist which will take months. I told him I want something for pain, he offered nothing, not even to try another prophylactic. I asked what the neuro's report said and it was basically everything which was in the referral plus 'i tried him on sibelium' with no recommendations aside from asking my shrink to help me cope. My gp offered to admit me to the hospital and call this new neuro on an emergency consult and stupidly i said no, but i am going to ask shrink tomorrow if it's still an option. I'm still seething though that my gp had nothing to tell me other than to put my life on hold for months and wait for the possibility that i will find relief. I'm sick of this shit.

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time for a new GP, plus a good neurologist, I am sorry you are suffering through this. I hope you get some relief soon.

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I've been having more migraines than usual lately. It used to be 1 or 2 a month, and imitrex worked and the relief was glorious. Now it's like 3 a week with a constant headache in between from the minute i wake up, to the minute i fall asleep.

My gp referred me to a neurologist because he didnt know what else to do for me. I'd taken pretty much every otc drug in various combinations as well as some prescriptions to no avail. I saw this neuro yesterday.

He started by asking some questions about how things started (how old, symptoms, drugs that worked or didnt work) and then he did some reflex testing and other things i kinda expected. Then suddenly he was writing me a prescription and said he'd be in touch with my gp. This would not be a problem if...

-we talked about the problems i was having NOW and not 5 years ago

-he gave me an idea of what to do when i actually had pain because nothing works (he gave me a prophylactic)

-what to do if i do not find this drug helpful

I am incredibly skeptical that this man could spend so little time with me and know exactly what to prescribe to help me. I was sitting in my car, in and out of his office, and back in my car in exactly ten minutes. worse than any psychiatrist i ever had.

very discouraged. Im not sure what i'm looking for, i guess i just wanted to vent

Add migraines to my laundry list of issues too. I have been in your situation and got so frustrated. i ended up going to a pain management specialist and had occipital nerve blocks done. When it comes to migraines, I feel like I'm the poster child. I've had DHE, pain meds, etc. and the nerve blocks, which helped a lot. if you're in the midst of a bad one, a propofol treatment can break it too, but that's also a pain management thing.

Good luck and keep me posted on how you're doing.

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I had my first acupuncture session today. the woman who poked me said "you've got the tension of a man twice your age with four jobs and a dozen kids and doing a course on the side. I don't know what it is, you don't have to tell me, but you have to get rid of it" LOL

She helped me relax like a real person for a little while (which is not the same as my version) and put some needles in, and god was it nice hahaha! Even if this does nothing but help me deal with stress, I'm going to continue there for sure.

I also saw my pdoc and she offered some psych meds to assist me in coping to see a new specialist. Like, benzos for anxiety about the intense pain of saturday, something to help me just sleep etc. She is not impressed with the neuro i saw and assures me the one i'm waiting to see is much nicer and well respected.

I feel validated that neither my GP or Pdoc are blaming this on me, because I didn't do anything wrong. Still in a shitty state, but today i have hope which i didn't yesterday. I could cry with joy with the fact that somebody is on my side.

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Ehygon, that's good news. I haven't tried acupuncture and I have a stupid question: did it hurt?

I am so glad you have some supportive doctors who are helping you through this. Neuros can have lousy bedside manner sometimes.

Keep us posted on how you're doing.

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Ehygon, that's good news. I haven't tried acupuncture and I have a stupid question: did it hurt?

the needles are smaller than the ones used for drawing blood even, so they don't hurt too much. I have only had one session, and while i did feel them going in, it was kinda like when you learn to sew, a little prick but not even remotely serious. after she put the needles in, she left me for about 15 mins to just relax and there was only one needle i could even still feel. I was afraid to move too much in fact, because i couldn't feel the rest and didn't want to try and see where they were. Some spots were a bit sore for a few hours after, but by bedtime i was perfect. They don't even leave marks like bloodwork can. I am going again on thursday and very much looking forward to it :)

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That's awesome, ehygon. I may have to look into something like acupuncture after your experience. Thanks for the feedback.

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I'm glad you have a pain management specialist who helps you.

I like shiatsu therapy and acupuncture before of after. I'd get free acupuncture (sometimes) with a shiatsu because my heart rate would be so high - like always (?) and the man felt bad leaving that untreated. He's a gem. Anyways, it's been a long time since those days.

The needles don't hurt, but one might twitch a little so you try not to move it. You can always ask to have any removed. The person stays close by just in case you call out. Sometimes they are in for so short that it really is nothing.

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Most accupunture needles can fit in a normal pore, that is how thin they are.

I have had it done for general headaches (does not work on my clusters). If you have never had it before, try to get someone to drive you to your first couple of appointments. I knew that once teh last needle was out, I had 20 minutes before I was so jacked up on endophines, that I was high (only time in my life).

Be patient, it can take a few tries before you get effect. I used to get them in sets of 10 at the time.

Good luck

Lin

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Update: I had my second session, this time face down on the table (last time was face up with them in my face/feet/hands mainly). No pain at all from those ones, probably due to the skin on your back being different than your feet or face. It was good, I was having some pain in the morning before i went in and i left feeling much better. It's not like a massage, where you can feel how someone was working your body with their hands long after, but it certainly is nice when you finally get up and go back to your day. I'm going to keep on doing it, because I feel like it's helping at least somewhat. I'm glad to hear from you guys on both knowing what it's like to try and deal with horrible headaches, and words of support :)

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