My Experience At a Neurologist

Happy Thursday everyone and I hope wherever you are at in your day (or even if you’re not reading this on a Thursday) that you have some gratitude for where you’re at. Whatever you’ve accomplished today – big or small – just…great job.

Heehee – I’m not the best at the motivational speeches, but I just felt like I wanted to put that out into the world.

I wanted to recap my most recent nuerologist visit, and I don’t mean to be all melodramatic, but I seriously feel like it was LIFE CHANGING.

It can be so amazing when you finally meet with someone who is just really friggin smart and sends you home with actual, tangible advice and different things to try. Shouts to all those good-hearted clinicians out there. Dang, it must be hard work, but there are people who are really thankful for you.

So as I’ve mentioned pretty much everywhere because I don’t like to wallow in self-pity alone, I have been having really consistent migraines since our move. (This is our 4th week in Austin – whoa that was fast!)

Now, I do suffer from migraines, but during a really good month, I’ll have like 3 or 4 bad ones and several headaches, but nothing that really is debilitating day after day. That’s kinda my baseline for the year.

But yeah, the past few weeks? Migraine after migraine. Were they really going away or was I just falling asleep? Lol. Because I would wake up right where I left sometimes – in pain.

So, to help my body out a little bit, I did what I normally do and went to Urgent Care to get a taradol shot and also a shot of Imitrex. (It’s my normal medicine, only stronger and goes right into the bloodstream, so it’s fast-acting and works better.)

I did feel a bit better after the shot, but knew I had a ways to go. I really needed to talk to someone about preventative care, and how to manage my migraines specifically. (No one person’s migraines are alike, so it’s important to see a credible neurologist.)

I am really thankful that rather than just order me up a shot and send me on my way, the nurse at the Urgent Care referred me to a neurologist in the area.

This was amazing because #1 – I’ve never gotten a shot and a dose of hope, haha. I was stunned and grateful. Really good service at that Urgent Care 🙂

#2 – Having just moved, I don’t know any of the neurologists in town – who is good, who is not, etc. She referred me to the Austin Neurology Clinic where 3 different neurologists practice, and she said that any of them would be really good for me to see.

I called after the weekend and set up an appointment with whomever had the next available. The nurse said that Dr. Werchen had a cancellation for the next morning, and even though my anxiety started whirring up in my head, I agreed to the appointment.

(Obviously, no one paid me to write this post, but I am sharing doctors’ names and stuff like that because if you are in the area – I would highly recommend!!)

So, the next morning, I find myself at the clinic, lots of snacks in my backpack as well as 2 books. (You never know how long you might wait.)

I ended up getting called back exactly at my appointment time – 8:40 AM. Has this ever happened to anyone in the universe?! A first for me.

The doctor came in by 8:45 to begin our meeting.

I think one thing that I do when I go to the doctor of any kind now, is I am PREPARED. I mean, I bring the receipts, haha. Printed off old lab results, a headache spreadsheet for the last 4 months detailing how many migraine days I had, and a persistent attitude to not leave there until I am satisfied I have a plan of action.

It can be really scary to go to a doctor’s office – by yourself or with someone. Especially if this is a first time visit – this person does not know you from Adam/Eve. They don’t know your history, they don’t know your day-to-day life, and they really don’t know the unique workings of your body. I try my best to fill out the initial paperwork really thoroughly. I always share medical conditions, etc.

Note: Even if you’re at like the dentists’ office or something – be thorough with the paperwork! It may feel weird to check off that you have anxiety or depression when at the dentists’, but think about it – maybe that could end up being the cause of your jaw pain (teeth grinding) and it’s not an issue with a tooth. I just always put everything because you never know!

So, aside from being really transparent on any intake paperwork, I also sit there and spill my guts out about how I am feeling. Some things I touch on, specifically for a neurologist appointment (but this could apply to anything) are –

How long I have been experiencing pain.

How do I rate the pain. (I use Mindful Migraine’s 1-4 rating system.)

What the pain feels like.

What other symptoms are associated with the pain. (Lightheadedness, heat sensitivity, fatigue, etc.)

What helps the pain.

What aggravates the pain.

What remedies I have tried that have helped/not helped.

Historically, giving all of this information up front really helps my appointment go smoothly. I’ve noticed that this helps doctors get to a prognosis faster. I’m not saying you need to go in there with a speech memorized, just that if you hit on some helpful key points, it can help!

As I started to explain all of this and he started asking me questions in return, I saw the wheels turning in his head and everything clicking for him.

“Wait here! This is exciting.”

I have been in enough doctor’s offices to know that when they some something like this, it actually is exciting and not as cheesy as it sounds. They are coming to a conclusion for you and you’re gonna get some relief! (At least – that’s how it is in my experience.)

So he came back in with some paper work and showed me an drawing of a head.

“You have migraines – no doubt. But the root of the problem is that you have something called occipital neuralgia.

In layperson’s terms – this means that the nerves that run along my neck up to my scalp are inflamed and/or injured.

The spine at my neck has scooped over time – likely due to looking down to type on a laptop or work/study and it’s pinching those nerves in my neck which immediately starts the migraine. There’s little to no relief in between because I’ve been doing nothing to repair those nerves or repair my posture, and if I just ignored it forever – I’d eventually need surgery.

It’s also somewhat genetic because I know my sister and I have always complained about the way our upper back swoops and how it is actually painful to “sit up straight”. We always got yelled at in dance class for our shoulders being hunched, but it’s just kind of our natural body shape.

So I basically need to retrain my spine – especially in the neck area – to go back into place. It swoops out right now – imagine being angry with your dog who just chewed your shoes. You put your hands on your hips and you stick your neck out to look down at him and yell “No!” That’s pretty much my natural posture now, so I need to retrain my spine to be straight and my chin to be tucked in in line with my neck.

So – that’s the spine degeneration/occiptal neuralgia portion of it.

This is the part we attacked first with a plan of action. Goes a little something like this:

Do PT exercises….forever.

My neurologist recommended I get the book “Treat Your Own Neck” by Robin Mckenzie and do the exercises in part 1 and part 2 twice a day for 10 minutes each….forever. (When I remember, lol.) I found it on Amazon for a great price!

I need to watch my posture. I’ll be paying more attention to it at all times, but I am also going to be using this ergonomic laptop stand for typing on my laptop (something I do for several hours most days of the week). A yoga ball to sit on is also recommended, and if you feel lower back pain, you can try an inversion table.

I’ve also bought something off of Amazon called a cervical traction device, which is essentially 3 donut-shaped pillows that go around your neck. I can wear this at home when I am just relaxing to keep my neck stabilized and give myself a break from trying to balance it in the place it’s meant to be.

The doctor advised me to avoid high impact exercises – running and jogging included.

I would have expected myself to be upset at this and be a little resistant, but pain really changes you. I am so tired of hurting and I want so badly to live life to the fullest, and if that means I really need to say goodbye to running – I don’t think it would be the worst thing. I’ve been advised not to run by my ED treatment team because it is really not always the healthiest thing for my mind, but it’s hard to give it up. I don’t love running all year round, but I do sincerely LOVE it in the fall/winter time here. Nothing like a crisp morning run….though I am going to really commit to saying goodbye to it. For me, it’s like a bad relationship. I keep “running” back…pun intended. But if anyone is up for power walks around Lady Bird Lake, hit me up!

Now movement is not a no-go all together. In fact, it can be really helpful for me. His top recommendations were yoga and swimming. I already am a self-proclaimed yogi, but I do want to get into lap swimming. I used to do it when I was little!

I actually toured my local YMCA on Monday and bought my membership Tuesday morning. Yup – me at a gym after 2 years out of the gym after my relapse. (A whole blog post coming on that next week and why I decided to go back!)

Really any core strengthening and cardiovascular exercise would be ok, so barre and pilates but need to be careful with the weights and arm movements, stationary bike, and elliptical.

I also shouldn’t sit for more than 30 minutes at a time. So please hold – need to get up and stretch from my current writing space haha.

Ok, I’m back.

Those are all of the preventative care items for my O.N. I did get a steroid injection in my neck (!!!) right there in the office to give me relief from the current string of migraines I was having. (IT WORKED!)

It was actually pretty funny. He brought a medical student in to observe and I heard him talking about me in the hallway – almost like I was a rare exhibit at a museum or something, haha. Totally didn’t mind! I always let medical students sit in on different appointments when the doctor asks – I realize it’s probably a good learning experience for them….even though I do feel a bit like a zoo animal 😂

(Also: the neck shot wasn’t bad. You feel a pinch, but then lidocaine is injected so you are a bit numb for the portion where the push the medicine in, which I imagine would be uncomfy if you weren’t a bit numb.)

Ok so that’s enough for neck – let’s move on to the actual migraines themself and what he recommended:

I am no stranger to allergies, and having clogged sinuses does really make my migraines worse and more frequent, but what I didn’t know was that Austin is the allergy capital of the world. (Great, lol.) So basically he told me to keep taking my daily allergy meds and don’t be scared to throw Flonase in the mix. If it ever gets really annoying, I can see an allergist and get monthly injections, so that I don’t have to take something every day.

I also got magnesium oxide (500 mg) to take every night. A lot of people through Instagram had recommended magnesium for migraines, but the neurologist’s opinion sold me on it. I got a bottle at HEB for less than $4!

I will added riboflavin to my Amazon order, since that’s a bit harder to find in drugstores, but it is just Vitamin B2! The bottle was about $14 on Amazon. I was told to get the 400 mg and take it at night. (In all transparency: this will turn your pee bright yellow/green. Hahahahaha! Don’t be alarmed!! But definitely ask your doctor if it’s ok for you to take.)

I was told to sleep 8 hours a day. Check! Currently I go to bed around 9:30 and wake up around 6 or 6:30, so that’s actually 9 hours. But I’m definitely going to make sure I stick to this and get quality sleep! (A cool room, humidifier, and essential oils help me with this. Also reading before bed!)

I was told to quit caffeine. (Gasp)

Ya’ll – I am the last person on earth to “quit” something that’s a food or drink. With my experience in getting a healthier relationship with food – I really don’t believe in “quitting” something (i.e. sugar, dairy, etc.) Hope that doesn’t ruffle too many feathers, but the fact of the matter is – that is just not healthy for me. Saying no to one food group a slippery downward slope into other, more serious forms of restriction. (IMO)

However, I’m going to see how I feel sticking to one cup of coffee. You can ask Cameron – I am a one cup gal and then I’ll often get a second cup if we happen to go to a coffee shop or something, but I’ll drink like 4 sips and then it’s a waste of $2.50. So, giving up that second cup is probably just a good financial decision, haha. I won’t miss it. However, if I really want something, I’m not going to deny myself it. (I see you, pumpkin spice latte season.)

Now, caffeine can help if you have a migraine coming on. The best thing my neurologist suggested? A coca cola. I definitely have found relief this way in the past, and with all other action items at play, I’m going to try this.

I also need to work to decrease stress. (Surprise, surprise.) When he started talking to me about CBT therapy, I was basically like “Oh – I’ve got it covered.” I currently do talk therapy and I actually currently have two therapists…heehee. One is part of my ED treatment team and then one I recently started seeing who works with me on more OCPD stuff (i.e. exposure therapy for obsessive compulsive responses). Oh yeah – and I also go to group therapy, run by a therapist SO TECHNICALLY I HAVE THREE THERAPISTS AND I AM A THERAPY QUEEN.

Felt like I got a gold star from the doc on this one.

We did discuss starting Aimovig for my migraines as preventative care. (A monthly injection to decrease frequent migraines.) I plan to get started on this soon if I am able to apply a discount card I got from the Aimovig website to the monthly prescription. Fingers crossed! If so, I will chronicle my experience throughout the monthly injections on the “Migraines” highlight on my Instagram.

And the last handy tidbit for migraines was to try some Tylenol instead of the Imitrex (also known as Sumatriptan….a triptan or “abortive medicine” that I take whenever the migraine is coming on.) Imitrex has never made me feel great, and personally it is super slow acting for me. I’ll have a migraine, take it, and basically still feel horrible all day. For all my migraineurs out there, Fiorcet has actually worked better for me lately.

The neuro recommended 1000 mg of Tylenol at the onset of a migraine. I tried this the other day and HOLY CRAP IT WORKED!!!!! Move over, triptans.

So those are the two bases we had to cover: the migraine treatment, but also the ever-present and root case occipital neuralgia. Wow. That’s a lot of remedies, huh? But I LOVE IT!

I’ve never been given this much information and this much HELP in one appointment.

Will reiterate here that I was not paid to say any of this. I just wanted to share because one – you guys have been so supportive and have been so sweet to be cheering me on in my journey. I really love all of the messages and it is honestly the most joyous thing to realize you have people – some that you have never even met – thinking about you and wanting you to feel better. And two – if you struggle with migraines and any of your symptoms were similar to mine .. I hope this post helps! Obviously, go get a professional’s help and also DO NOT BE AFRAID TO GET A SECOND OPINION!!!! This was technically a second opinion for me and the first guy wanted to cut open my eyelid and give me surgery so 🙂 🙂 🙂 🙂 🙂

If you’re in Austin or surrounding areas (well worth the drive) I recommend Dr. Werchen at Austin Neurology Clinic!

Dr. Werchen, if you ever see this post, what’s up and I am not mad at you for giving me a shot in my neck – even when my blood gushed all the way down my neck.

Cool thanks 🙂