it's time to take action - TODAY!

As I posted earlier, the AHDA lobbied Washington DC last week to raise awareness of the lack of funding for Migraine and headache disorders. The time has come for us to email our representatives.

I just finished sending my email. Including writing my personal story, it took less than 10 minutes for me to advocate on behalf of the millions of us suffering with head pain.

This is what I wrote:

At only 25 years old, I am both a chronic daily headache and chronic migraine sufferer. I have head pain every moment of every day. This constant, continual pain has made it indescribably difficult to function in the world for the past several years. Because of various migraine triggers, I am unable to shop in most stores, eat at most restaurants and work at many types of jobs. In fact, having recently lost my steady job at an architecture firm due to the economy, I've been having incredible difficulty not only finding any job, but finding one I am physically capable of performing.

I am only one of 36 million migraine sufferers, but I am one of the more severe cases. I, along with millions of other Americans, desperately need an effective treatment so we can continue to contribute to our country. I have already tried almost a dozen different migraine preventives available on the market. None of these medications were specifically developed for migraine; all are "hand-me-downs" developed for other diseases. None of these drugs have worked. Without NIH-funded research, I have no hope of ever trying a treatment developed specifically for my condition. Instead, I will rely on anti-seizure, anti-depressant, blood pressure or anti-psychotic drugs, hoping one will work for me.

Now it's your turn. Go to the AHDA's website and follow the links to email your own representative of the House. It's free, it's easy and it will help the millions of us who will benefit from increased NIH funding.

Just remember, if we don't speak up for ourselves, who will?

More information about the AHDA.
More information about Headache on the Hill from Teri Robert.
Email your representative here.

Be well,
MJ

a long-overdue update

I'm ba-ack!

It's been a truly difficult few weeks for me and I hadn't felt up to posting. But it feels like maybe things have leveled out a bit, so here I am.

I posted a few weeks ago about needing to recover after a combination of Botox and family visiting. I thought I was in the clear, but the past few weeks brought worse.

The Botox reaction lasted longer than a week, and combined with a bit of withdrawal from the Lyrica to make me pretty miserable. I started having some weird symptoms, namely irregular heartbeat and tremors, which prompted my headache specialist to send me back to my PCP. I saw the NP at my PCP's office, who ran a full panel of bloodwork and had me wear a 24-hour holter heart monitor to see if we could discover anything. The bloodwork came back normal, and the holter didn't find any "documentable correlation" between my symptoms and my (very regular) heartbeat.

All of the testing and results took about 2 weeks. During those 2 weeks, the Depression and Anxiety that have been creeping up on me started to take over my life. I hardly posted on the MMC forums. I withdrew from DBF. I became very moody and irritable. And I felt horribly sick the whole time.

This past week it all came to a head. My insomnia came back full force. I left work early on Monday to come home and rest. We've had company staying with us this week, friends from college, who don't know much about what's been going on with my health. DBF has been unusually stressed at work. I asked for accommodations at work when a better desk opened up on my team, and my boss gave the desk to someone else. I felt like no matter what I tried to do, nothing was helping me to get or even feel better. I did have an appointment with my new therapist on Wednesday, but having to go through my family history was painful and only made me feel worse. (Though, in the long run, talking about some past issues will undoubtedly help me.)

Once I got the results from the holter on Thursday, I gave my headache specialist a phone call yesterday to let him know everything turned out normal, and my irregular heartbeat had disappeared. The tremors seem to be a holdover from the Lyrica and come on when I've overexerted myself. He returned my call yesterday but I missed it; fortunately he was on-call this weekend and called me first thing this morning.

What a difference a 20-minute phone call can make!

A big part of my Anxiety was my contradictory feelings that one, I am not ready to try any new preventive medications because of my awful side effects with them; but two, I couldn't face sitting around and doing nothing. So therefore (I thought) I had to try a new preventive. Faulty logic, I know. Medication isn't the only treatment available for Migraine Disease.

When I called my doctor on Friday and spoke with his NP, I told her that I'm not ready to try the propranolol he prescribed for me, and wanted to talk about alternatives. When Dr E called me this morning, we went over the symptoms I had been having - irregular heartbeat and tremors - and he saw from my call in yesterday that they've cleared up. Well, the heartbeat has. I told him the tremors only seem to come on at night after I've overexerted myself.

I explained to him my reluctance to try any new preventive meds, because of all of the awful side effects I've been having. He seemed to understand that and we discussed it for a bit. He also asked about my stress at work (somewhat stressful but I don't take it home with me) and my general emotional state (not so good). He asked straight out about any Anxiety/Depression issues, both of which have been worsening as my Migraines continue. I was relieved he brought it up without making my Migraines/CDH into an emotional problem. He recognizes that they feed each other, a sort of chicken-and-egg problem.

I asked him about supplements as preventives (in particular, CoQ10) and any alternative treatments I could try (I've tried acupuncture and biofeedback/relaxation in the past). He's not convinced that any supplements will be enough for a complex chronic case like mine. He thinks I need the more aggressive meds, but recognizes that I then run into trouble because of my sensitivity to side effects. But he is willing to go that path if that's my preference.

He gave me the option of a referral to an internist in the area who also has a degree in herbology. He trusts her, and I like that she has a background in both eastern and western medicine and uses them together.

So, I have a few options. I can try the propranolol that he prescribed for me last month (very low dose). He's a bit hesitant about this because of the potential side effect of depression. He also suggested I try an SSRI (Celexa) at a low dose, instead of the propranolol, to help ease the Depression/Anxiety and hopefully work as a preventive as well. I have the option of taking a med holiday until I feel ready to try something new. I can also get the referral to the internist and try the supplementation route. If I decide to try acupuncture or biofeedback again, I'm sure he will help out with a referral for that as well.

What I'm going to do is sit on these options and think about them over the weekend. I feel much better after talking to him. He really seems to understand my reluctance about meds and didn't at all push any drugs on me. And I appreciate that he understands my need to think over all of these options before I decide what to do next.

I still have a long way to go treatment-wise. My Migraines are less severe with the Botox, but I still have Migraine/CDH pain constantly. I know it will take time to find a way to break the pain and get the frequency down. But I have confidence that Dr E can work with me to find a successful treatment regimen. When I got the call back from his NP telling me to see my PCP for the irregular heartbeat, I was worried I had been brushed off and he was giving up on me. I feel very relieved after my conversation with him this morning. It's obvious he genuinely wants to help me and is willing to work with a difficult case.

I hope to be posting more frequently again. Over the next few days I'll be catching up on everyone's posts. Hope all are AWAP!


Be well,
MJ

asking for help

Growing up with a mother as a therapist, I never doubted the efficacy or necessity of therapy, nor did I ever attach any sort of stigma to therapy.

Why, then, can it still be so hard to ask for help?

I've seen therapists four times in my life now. The first was over a summer while I was in college, to cope with some issues I had with my father. The second and third were during college, for much the same reason. The fourth was last summer, when I saw a counselor through my Employee Assistance Program (EAP). I had three sessions covered completely by my insurance, and needed a "boost" to get through the combination of neverending illness and the big life change of DBF moving in with me.

I have no doubt that traditional psychotherapy has helped me very much in the past. I have mild depression when my migraines are in a bad cycle, which has been particularly tenacious now that my migraines are really out of control. But I still put off calling my new EAP for a therapy referral for months.

It can be really difficult to ask for help. It's hard enough to ask DBF for help, to get me a glass of water, to make me some tea or even to come to the doctor with me. It's even harder to make a phone call to find a therapist. Is there something wrong with me, that I can't cope with this on my own?

Of course not.

Chronic illness is difficult to cope with because of its chronic nature. Chronic means, it isn't just going to go away after one treatment. It means, in my case, I will always be a migraineur. This disease is something I will always have to manage, whether with aggressive treatments and preventives, or simple relaxation techniques and acute treatment.

My particular situation has been difficult because I've had constant, daily migraine pain since sometime in November. Before that, I had daily pain from migraines or chronic daily headache. I've been in some sort of daily pain for two years now, since I first titrated off the Topamax I took all through college. Daily pain and generally feeling sick from my other migraine symptoms is enough to wear anyone down. The depression hand-in-hand with the migraines is, well, depressing.

Plus, I'm young. I'm at a time in my life when I'm establishing my career and social life. I moved to a whole new state just two years ago, where I've had to establish new ties and a new life. Balancing this with coping with chronic illness is too much for me at times.

Nothing I'm saying here I didn't know. It was still difficult for me to pick up the phone and call my EAP. But I've done it, and I feel better already. Hopefully I can get my first therapy appointment before DBF and I leave for vacation on Thursday.

Ah, yes. Vacation. DBF and I are going away for a week to our company's timeshare condo right on a lake only a few hours from here. We plan to have a relaxing week away, and since it's just the two of us, there's no pressure. The condo has a kitchen, so sticking to my restrictive diet shouldn't be too much of a problem.

So that's where I am. Therapy = good. Vacation = awesome.

Be well,
MJ

grieving my past life

I'm going to say it right now: I resent migraine disease, and everything it has taken away from my life.

I graduated college two years ago, a carefree, optimistic, idealistic young woman, about to embark on a promising career in architecture. The economy at that time was much better than it is now, and the job market for new intern architects was excellent. I had my pick of where to work, so I chose a firm whose mission and vision seemed to echo my own goals. I packed up and moved clear across the country, taking a chance on a new life. What better time to do it?

My first neuro, who saw me all through college while I was on Topamax the first time, suggested I try titrating off to "see how I would do". The tapering schedule he gave me meant that I was finished with the Topa before I even got to the West Coast. Fitting, I thought. A new life, no longer a slave to the little Topa pill I hated so.

An immature view, I realize now. Now I know the necessity of good preventive medication. When I was in college, I knew nothing about chronic daily headache or about migraine disease. I just knew that my head hurt all the time, and taking 50 mg of Topa every day meant my head only bothered me about twice a semester, but it also meant I couldn't consume alcohol with the same carefree attitude of my friends.

But what I realize now, what I have realized over and over again in the two years since I came off the Topa, is that that stupid pill that I hated so much is what allowed me to finish college on time, with an honors diploma and double-minor. It gave me a life I wouldn't have had otherwise. There's no guarantee, of course, that staying on the Topa would have meant it would have kept working for me - and that's what I tell myself every day. Because now Topa doesn't do anything for me other than randomly give me new side effects and make me depressed if I take too much of it. I thought at one point that it may have been working, but I no longer have that delusion.

Within a month of titrating off the Topa, the ambiguous dizziness and nausea, that I now recognize as my primary symptoms of CDH, were back. I blamed this sickness on everything: homesickness, adjusting to my new life, allergies, an ongoing fight with my father. It took until December, six months later, to schedule an appointment with my PCP. She treated me for a sinus infection; those antibiotics did nothing, of course, to actually fix my head. By February 2007 I was referred to a neurologist.

Nine months I had already given to this disease, convincing myself it had to be something else. And during that time, I was trying to establish a new life for myself. The weak social ties I had started to forge over my first summer here had already fizzled out. I just didn't feel well enough to go out and drink on weekends. I didn't have enough energy to make plans with people, or join community groups. I did a brief stint, playing clarinet with a local university band, but after a year of that, I simply didn't have the energy anymore.

From February until now has been one preventive after another, in various combinations. Topamax, nortriptyline, cyproheptadine, verapamil, gabapentin, Topamax again. Meanwhile, my CDH and frequent migraines turned into weekly migraines, then daily migraines, and now an ongoing migraine since November that's only becoming harder and harder to treat.

It's not that I resent the time I've spent trying to treat my migraines. I understand the trial-and-error nature of migraine treatment. I resent everything I've had to give up.

I no longer can go shopping or run errands for the most part. Fluorescent lights are a huge trigger for me. Not only do they aggravate my migraine, but certain tints of fluorescents - the kind most retail stores use - trigger diarrhea within 15 minutes of going into a store. Not so conducive to shopping.

I no longer go to see movies in the movie theatre. Seeing movies, especially action movies, in the theatre is both one of my favorite pastimes and biggest triggers. Seeing Pirates 3 triggered one of the first acephalgic migraines that I identified as such.

I no longer drive, except on very rare occasions when I absolutely can't avoid it. I don't feel safe on the road, since I know my concentration is impacted from this ongoing migraine.

I no longer drink. Alcohol seems to be a stackable trigger. It interacts with almost every medication I take anyway.

I no longer eat gluten, dairy, caffeine, MSG, preservatives, artificial sweeteners, high fructose corn syrup, and have severely reduced my sugar and salt intake. MSG and artificial sweeteners are confirmed migraine triggers. The rest do bad things to my digestion so I've cut them out.

I hardly ever eat out, because of my strict diet and because I hardly ever feel up to it.

I no longer do my computer-based design work. Computer screens are a migraine trigger. Working in front of a computer at work is all I can tolerate most days.

I no longer use a desktop computer at home. This doesn't sound like it would be a big deal, but my desktop is much more suited to do most design work. Since I can't do it anyway, DBF and I decided to buy a new laptop for me to use in the living room.

I no longer go to the library. This one makes me very upset. But our gorgeous library has fluorescent lighting, so I can only stop by long enough to pick up books I have on hold. No more Saturday afternoons spent reading there.

I have almost no social life to speak of. Since my migraines have gotten progressively worse as I've tried to start a new life here, it's been hard to form new social ties. DBF and I are going to make more of an effort to have people over this summer, but we'll see if that actually pans out.

But most of all, I no longer just "do" things without considering their consequences. A coworker invites me out to lunch; is there something at the restaurant I can eat? What kind of lighting does the restaurant have? I have to buy a new pair of jeans; do I order them online and risk them not fitting or do I try to buy them in a store and risk fluorescent lighting? We're out of cat food; I have to ask DBF to go buy some - I can't drive to the store and I can't go in there once I've gotten there.

There is a lot about my life that is positive. DBF, for one. A girl could not ask for a more supportive boyfriend. Without him, there is no doubt I wouldn't have been able to make it this far. I would have already had to move back to the East Coast to ask my family for help.

My job, for another. It's been a huge struggle to keep a full-time schedule with my health in such bad shape, but my job has excellent health insurance and benefits, not to mention is a great way to start my career. My firm and my boss have been pretty understanding of my situation and have given me a lot of leeway.

And of course, there's my family. My mom and sister are both migraineurs, and while their migraines have never been as severe as mine, they understand my pain.

Last but not least is my doctor. Without a good doctor I surely would have lost hope by now. I've just started seeing him, but I feel more confident he can help me than the last doc I saw.

It is just so hard to nurture hope in the face of so much failure. Five preventives I've trialed; all have failed. While there are many more to try, it takes a lot of courage to keep trying. And while I've been trying, my migraines have only gotten worse.

And more and more, I find it hard to suppress the question in the back of my mind: what if this migraine never breaks? What if I am always stuck with this pain?

Today I don't have any answers, or any insight to wrap this post up with. So I'll leave you, instead, with a quote from a book I recently finished:

"What will you do, if it does not turn out how you expect?"
"I do not know. Nor shall I worry about it until it happens. I still have an action left to take; until I have exhausted it, I shall not despair." - Robin Hobb, Assassin's Quest

Be well,
MJ

my torrid love affair with Topamax

I'm currently on my third trial of Topamax, one of only four medications that has been approved by the FDA for use as a migraine preventive medication. I have taken Topamax twice before. The first time was for two and a half years in college, which was a great success, and in fact is the reason I was able to finish college on time. The Topa got rid of my chronic daily headache within a week of me starting the 25 mg dose, and when I increased to the 50 mg dose I only had one or two migraines a semester. The difference in my quality of life was amazing. After I graduated, my neuro at the time suggested I titrate off of it to see how I would do.

I didn't do very well, and I've been looking for a preventive regimen ever since.

Neuro #2 had me try Topa right off the bat. This trial (#2) was for two months in the beginning of 2007. I had a few days where it seemed the Topa might be working, but my CDH came back, and my neuro and I decided to discontinue it in favor of other drugs.

When I saw neuro #3 at the beginning of this year and she reviewed my history, she noted that I had only been on the Topa for about two months, which wasn't long enough for a fair trial. Preventives can take up to three months to start working. A long time to wait while you're in pain. At the time, I didn't know it could take that long so I didn't push the issue. Knowing more now, when neuro #3 suggested I give the Topa another trial, I was willing to do it, since I had such great success with it in college.

Well, I started the Topamax in February, and it's been a bit of a wild ride.

Neuro #3 had me on a pretty standard titration schedule - start with 25 mg, increase to 50 mg after the first week, then 75 mg after another two weeks. At 25 mg, I didn't notice many side effects. At 50 mg, I noticed some, but they were expected: taste changes, dry mouth, cognitive issues after a few weeks, lessened appetite. At 75 mg, new side effects cropped up that I never had had before: tingling, hair loss, tremors, nausea, stomach pains. Nothing intolerable. I stayed at this dose for about five weeks, as my migraine cycled worse and I generally felt unwell. The side effects seemed to level out, so I kept with the Topa.

After I fired neuro #3 and had a particularly bad week of pain, I called my PCP out of desperation. She suggested I increase my dose to 100 mg to see if that would make a difference before my appointment with neuro #4 next month. I decided to give that a try, but after a weekend of new and frightening migraine symptoms, I decreased the dose again to give my body a break. This was ten days ago.

Since then, I've been developing new side effects. The tremors and tingling that started at 100 mg haven't completely gone away. The nausea and lack of appetite have gotten worse. Still I stuck with it, hoping the side effects would ease, especially since the last few days have been relatively low-pain.

Except the last few days, I've started to wonder if the Topa is contributing to my moodiness and depression. Last night, when I had a weird and very out-of-character anxiety episode, I knew it was the Topa. So today I decreased my dose to 50 mg once again.

It's really amazing to me that a drug that my body once tolerated so well, and that was so successful for preventing my CDH and chronic migraines is now treating my body so poorly. Hopefully I'll feel better in a few days after the higher dosage is out of my system.

When I see neuro #4 in three weeks, I plan to tell him that I don't want to continue on the Topa (or the nortriptyline I'm also taking - but those side effects pale in comparison to the recent issues with the Topa). I hate giving up on a drug like this, but I can't put up with these side effects.

While I know that every medication that doesn't work is one step closer to finding one that will, it's hard not to feel at least a little bit like a failure when one doesn't work out - especially when it's such a spectacular failure.

terminology

The end of last year, when I was still seeing neurologist #2, I remember questioning the need for an accurate diagnosis. After all, chronic head pain is chronic head pain, and I need to find an effective preventive regimen regardless of what kind it is. It was about this time I began to wonder if I needed to consult with an actual headache specialist - someone who dedicated their practice to the study and treatment of headache and migraine - rather than just a neurologist. Since neuro #2 began to run out of ideas, I decided a fresh pair of eyes on my case wouldn't hurt, and I asked for a referral to a specialist, AKA neuro #3.

I was fortunate (I thought) to get in with neuro #3 in about two weeks. She was just coming back early from maternity leave since the other neurologist in her practice was leaving, and had not scheduled any patients yet, so I was at the top of the list. So I had virtually first pick of appointments and was able to schedule fairly quickly. The first appointment went well, and after looking at the list of five preventives I had trialed and failed, she wanted to try me on Botox, her main interest and area of research. If that didn't work out, we would retry me on Topamax, since I hadn't given it enough of a trial the year before.

After two months of waiting around, my insurance rejected the pre-authorization claim for Botox, labeling it "experimental". After a number of phone calls, she had finally agreed to write me a script for the Topamax, and once the insurance rejected the Botox I scheduled another appointment with her to discuss my options.

I had this appointment with her about a month ago. I went in well-prepared with a list of questions, and brought DBF with me in case he had any questions. For some reason, this appointment didn't seem to go as well as the first. Neuro #3 went over all my questions with me, but was completely unwilling to even discuss the possibility of rescue meds - saying simply that "they don't work" - and didn't want to discuss any treatment options for my daily migraine pain. When I asked her the difference between chronic daily headache and transformed migraine, she said they were different terms for the same diagnosis, and implied that my ongoing migraine is simply a headache - an implication I did not pick up on right away.

After the appointment, I had a weird sense of hopelessness I couldn't immediately pin down. The following week, my daily pain spiked again, so I decided to call in to try for an IV treatment, which neuro #3 had reluctantly offered to me as an option when I questioned her about it, with the caveat that it wouldn't do much for my "regular daily pain". It took me five days to get in for this treatment because of her irregular schedule: she typically only works three days a week. This scheduling mess, coupled with the feeling I couldn't shake that she had given up on me when the Botox was denied, finally pushed me to fire her. (My mom later pointed out to me that since I couldn't do the Botox, my doc had demoted me to her B-list of patients.)

Fast-forward to this past weekend, with all these strange symptoms I've been having. I called into the nurse's line early Monday morning to leave a message about the new symptoms that cropped up over the weekend. I got a call back - which I missed, of course, so the nurse left a message - saying that they would pass the message along to my doc on Tuesday when she was back in the office.

Tuesday (yesterday) afternoon, I finally got another call back - which I missed again, because they only ever call when I'm in a meeting at work - with a message from a different nurse. Neuro #3 said the symptoms were probably not from the latest IV treatment, and "may be" related to the "headache". If I still had some concerns, I could schedule an appointment with her nurse practitioner, and here is her phone number. Click.

Are you kidding me??

This short message confirms my instincts in firing this doctor's sorry butt were correct. She will not even call this migraine a migraine, only a headache. But now it makes more sense why she was so unwilling to offer any treatment for it, since she thinks it is only a headache, not worthy of any treatment.

So, it's on to neuro #4. I have an appointment scheduled with him on May 21, four weeks from today. I am much more encouraged by his office than by that of neuro #3. His staff is much more polite and helpful. I received my new patient information packet in the mail within a few days of my appointment being scheduled - rather than the day before my appointment - and the forms are much more detailed, including a depression screening form. I'm just very glad I didn't wait to move on to a new doctor and went with my instincts about neuro #3.

Now, I just need to get through the next few weeks.

betrayed by my own head

A few months ago, I read a book by Michael Stein, MD, called The Lonely Patient: How We Experience Illness. While much of this book is framed in the author's experience with terminal illness (not his own, but that in his family), he does speak to chronic pain throughout. He divides the book into four parts, corresponding to the four reactions he sees to chronic illness: betrayal, terror, loss and loneliness. Betrayal is certainly one of the emotional reactions I seem to revisit frequently on my journey toward acceptance of this disease.

This weekend - Saturday night, especially - was another visit of betrayal.

Over the past two years, my chronic daily headache has gradually become daily migraines, and now a continual migraine since about the end of November. On one hand, this has taken away the unexpected and often frustrating aspect of episodic migraine, which is you just never know when it might strike. I always know when it will strike, which is always. I wake up with the pain, I eat, breathe, work, think, walk, do and sleep with the pain. It's there, a constant resident in my brain, whether I like it or not. I'm doing what I can to dislodge it, but in the meantime, I'm stuck.

My brain decided to play a new trick on me Saturday night.

DBF and I were curled up on the couch after dinner, watching tv, when I had this weird wave of dizziness pass over me, followed by pins and needles all over and a sort of hot flash. Then the tingling settled in on just the left side of my body (arm and leg). After a few minutes, when it didn't pass, I started to get rather scared. Something isn't right, my instincts are telling me.

You see, a migraine that lasts longer than 72 hours, without at least a 4-hour break in pain while awake is status migrainous, considered a medical emergency because it puts the migraineur at increased risk of migrainous stroke. Having had this particular migraine since last November, I pay extra attention to new symptoms. And like any educated migraineur, I know the symptoms of a stroke.

So, I told DBF what was going on, that I was scared. We decided to call 911. He told the dispatcher what was going on, described my symptoms and told them how long my migraine had been going on. The paramedics got here relatively quickly - though it seemed like an eternity, of course - and checked my vitals while they asked me some questions about my symptoms. They left the decision up to me whether they would bring me into the hospital or not, but they saw nothing life-threatening that concerned them. They did remind me that they are only firemen, of course, not doctors. I decided not to go with them.

I did call the doctor on-call at my fired specialist's office to see if he thought I should seek emergency attention. He spoke with me for probably ten minutes, asked some questions about my symptoms, about my IV treatment on Friday, including which drugs they had given me, when, and if I had had them before; as well as if I had had these symptoms before. He also checked to see if I had had an MRI before (I had one a month ago that came back normal). He believes these new symptoms to be another manifestation of this ongoing migraine and described it as "complicated migraine", which is a descriptive term (not a standard diagnosis). He did not see any need for me to seek immediate care, but did encourage me to call my doctor today.

As unpredictable as this illness often is, we still expect it to follow a certain pattern. My pain is usually here, I usually have these symptoms, I usually get a migraine after encountering these triggers. Whenever our disease breaks the pattern, it's frightening for one thing, but we are also left with a sense of betrayal. Migraine beast, it's hard enough to cope with you on a normal day, but why do you have to change your pattern?

The tingling has not gone away since Saturday night, but I also have not developed any new symptoms. The doc on call told me some specific things to watch for that would indicate a need for immediate medical attention. I called into the nurse's line this morning and left a message about these new symptoms; I got a call back asking for some more information, and letting me know the message would be passed along to my (fired) specialist tomorrow since she was already gone for the day. (Another sign that I know I made the right choice in firing this doctor - unfortunately she's all I've got until May 21 when I see the new guy.)

The good news is, I know I can rely on DBF in case of emergency. He took me seriously and didn't question the need to call 911. He kept me calm while we were waiting for the medics and when it was all said and done, gave me a big hug when I started to cry. And cheered me up by making me laugh. Because this whole thing freaked me out.

So, a reminder to all of you fellow migraineurs out there: if any new, unexpected or worrisome symptoms crop up - even if they are just new symptoms - please check with your doctor at the very least. When we are dealing with brain issues, it is much better to just have things checked out.

-MJ