Quick Neurologist Update

I don't have a lot of time because it's almost Shabbos (the Jewish Sabbath), but I did meet with the neurologist today. He had a fair bit to say, most of which boiled down to the fact that I have limited options. He agreed that even though migraines aren't life-threatening that the risk/benefit ratio still plays out that I need some kind of prophylactic treatment even during pregnancy. He acknowledged that my pain-relief options were limited, particularly since I've stopped responding to codeine (he said it's easy to build a quick tolerance to codeine). He did not like the idea of calcium channel blockers because they don't do me much good. He in particular said that nifedipine is a very not-good choice for migraine treatment. I didn't ask why.

Anyway, the long and the short of it is that he's recommended I take Topomax, which surprised me, but he said that the greatest risk with Topomax is neural tube defects in the first trimester. Since the neural tube has already been formed, this is no longer a risk. He put a call into my perinatologist, and in the meantime gave me samples and a script for Topomax, but said not to take it until I'd heard from them that it was okayed by the perinatologist. If the perinatologist didn't agree, they'd work out another option and he'd call it in for me. Much to my surprise, Dr. G said he was fine with me trying it.

Neither doctor wants me to get to a truly therapeutic dose while I'm pregnant, so the neurologist made sure to note that I'm not likely to have full relief. That's okay. If I get 20% relief until September, I'll be thrilled. After that, I can work on more complete relief. So I start it tonight. I took Topomax years ago with a fair bit of success (admittedly at a much higher dose). It wasn't perfect, which is why I changed, but in retrospect, the Depakote that I switched to was somewhat better but with far more unbearable side effects. So hopefully this will at least take the edge off.

A couple random migraine notes in response to comments:

I have tried both chiropractic care and accupuncture, with little success. Accupuncture in particular was not only not useful, it left me feeling worse than I started. Chiropractic care was fine for other reasons, but had little effect on my migraines. As for the vinegar trick... I've heard that one before, but have never tried it, because the smell of vinegar (except balsamic) makes me very ill. I imagine in pregnancy it would be far worse!

I totally get that this is an infertility/pregnancy blog, not a migraine blog, but frankly, it's hard to separate the migraines from everything else, because it is a constant state of my being. I have another perinatology appointment on Thursday, so maybe I'll have more interesting things to say then. :)