I'm still not certain about the effectiveness of the treatments recommended by the neurologists I've been seeing for my migraines.
Dr. Wogenson ran a bunch of expensive tests, and upped my Neurontin dose from 2-3 per day to 6 per day, but otherwise had little impact on my headaches. His response to my complaints about the side-effects of the Neurontin was that I needed to give my system more time to adapt to the medicine. At an appointment about four months in, I brought in a list of alternative treatments to review with him, including acupuncture. When I told him that Carole had mentioned that I occasionally stop breathing for short periods of time during sleep, and that my reading had indicated this might be related to my migraines, he agreed immediately and referred me to Dr. Shubin, a sleep-disorder specialist in the same practice. I'm not quite sure why I was the one that had to bring it to his attention - he's the neurologist, right?
Dr. Shubin seems like a nice enough guy, but there's three things that bother me about him: 1) his "bedside manner" leaves a lot to be desired; 2) it takes a minimum of six weeks lead time to get an appointment with him; 3) like with Wogenson, it's almost always 35 to 75 minutes after my scheduled appointment time before I'm called back to the treatment rooms. This last one drives me buggy, to the point that I left an appointment scheduled for last week with Shubin's RN Gail when I was still waiting after 30 minutes and had somewhere else to be. I have complete respect for the training and sacrifice they made to become health care professionals, but the only way to indicate that it's unacceptable to make people wait so long is to leave.
Anyway, after waiting six weeks for Shubin to have an opening, I went to see him. He did a perfunctory poke-and-prod neurological exam, and referred me to the Sleep Center at Huntington for a sleep study.
Six weeks after the first appointment, I went back to see Shubin. He said the sleep study had shown some problems that would be best treated with a mandibular repositioning device. (Many people with breathing-related sleep disorders use a CPAP device to maintain a certain level of pressure in their airways, but my results pointed in a different direction.) He referred me to a dentist that specializes in treating sleep disorders. I also told him I had weaned myself off the Neurontin, and he prescribed Topamax as a replacement.
In researching Topamax, I found a lot of info that made me very reluctant to begin taking it. My big problems with Neurontin were the general feeling of fuzzy disconnection in my brain, along with occasional episodes of cognitive failure - not being able to come up with the word you're searching for, that kind of thing. Except for the increase in migraine episodes, I was feeling much better since stopping the Neurontin. My research on Topamax indicated that a lot of people had similar, if not worse, cognitive impact than Neurontin. Things like the taste of foods changing, village idiot syndrome - not things I wanted to experience. I decided not to begin the Topamax.
I visited the sleep disorder dentist, Dr. Contino, in mid-July. He was very nice and professional, explaining the process and answering my questions. He took a mold of my mouth, and said he hoped to have the device back from the lab before I left on my trip to BC.
The device didn't make it to Dr. Contino until the middle of last week. I picked it up this morning at 8:30am (sharp!). It will definitely take some getting used to, but in theory it's supposed to improve my sleep, which in turn will improve my headaches, energy levels, and all kinds of other good things.
After leaving Dr. Contino's, I headed over for my make-up appointment with Nurse Gail at Dr. Shubin's. We went over everything - the new dental appliance, why I'm not taking the Topamax that Shubin prescribed, etc. In the end, we (I) decided to see how things work with the dental appliance, and will continue to wait on new prevention medications. I mentioned that the Imitrex works well in treating my headaches, but almost always makes me so fatigued that I go to bed around 9:30pm or 10:00pm on days I take it (and often the following day as well). She gave me four samples of Relpax, an Imitrex competitor, to see if it's side-effects might be less harsh.