Tuesday, January 22, 2013

New Doctor - New Stuff and Things

It's been over a year, close to two years, since I've been to see a neurologist. In case you don't know the story, I went to one, was very very unhappy with him (he basically said "I can't help you" after 1 visit), went to another neurologist that I really liked, got the ball rolling on some things and then for a reason I don't know, she left town. That left only the first neurologist that I went to as the "only game in town". There was a replacement coming for the second but all we could do is wait. And wait. And wait.

Finally they scheduled an appointment. Then they moved the appointment up a few days. Which we found out yesterday was today. Rather than wait any longer, Anna made the changes in her schedule and made it work.

So here we go. New doctor. In a nice shiny new building with cobblestone floors and a fountain and Anderson Cooper playing on the TV. Appointment was at 11:30, so of course it's was noon before I got called back. The assistant went through all my history and medications and all that stuff and then we wait some more. Like almost an hour I think.

But then there she was. Dr. Michelle Raphael. Very young. Very tiny. But she dove right in. We talked for a long time about my condition and my history with it and everything that has happened and everything that is happening. We talked and talked. I didn't feel rushed and felt she was very patient in getting all the information she wanted.

Then we do the standard tests. Poke. Pull. Look here. Look there. Push.

"So, doc, what you do think?"

And here's where the rubber meets the road. This is the time where you listen to what your doctor says and you find out if you are really going to get help from this person or if they are just going to run you through "the usual" and get you out the door. Here's what she said in a nutshell:

We're going to do more tests. We are going to schedule and MRI and an EEG right away (and they did, day after tomorrow - last time it was a 3 month wait.) Based on your previous MRI (which thanks to modern technology she was able to pull on on the computer right there) there is some plaquing and there are slight changes from one to the other so we need to get a new one and see where we are. Boom. Done.

Also, we're going to try some new medications for your headaches. Right now we don't care what's causing them, we just want you to try to live and function somewhat normally. So here's a new one that you will take every day to prevent them from happening, and here's one you will take as needed at the moment you believe you have one coming on. We'll ease you into these, so you won't see any change for many weeks, but once we get you up to speed we'll see if these are helping or if we need to get something else. Boom. Done.

So here's the gist. It doesn't look like your condition is deteriorating as much as you think. You're actually doing better than you think. I know you have pain and I know you feel weak, but it seems everything is tied to your headaches. It's probably not MS or anything else that is deteriorating as much as it feels. You just get bad headaches. And while that is serious and it sucks, ultimately it is something we can fix or at least help. We're going to grab you, and flip you, and poke you and prod you and pretty much torture you until we figure out what is causing your pain and make it stop. (I'm totally paraphrasing here, but this is the gist...)

And then she was gone. We waited about another 45 minutes while her assistant set up the MRI and EEG and faxed the prescriptions to our pharmacy.Then we went and got some lunch because it was almost 2 o'clock.

So how do I feel about my new doctor? At the moment a little overwhelmed. In spite of the waiting, I feel that she took the time and listened. I think she was very patient as I rambled about my condition and kept looking to Anna to help me fill in the blanks. I think she was very understanding of the pain and the need to do something RIGHT NOW. I also feel she was very sympathetic at our frustration with the previous doctors and feeling put "on hold" for almost 2 years.

But I think I feel just a little cheated. And maybe that's not the right term, but let me explain.

I've been in this condition for 6 years now. I can point to when it started. I can tell you how I felt then and how I feel now. I can tell you my symptoms then (well, Anna can) and I can tell you my symptoms now. I KNOW things have gone down hill. I KNOW that generally I've gotten worse. Her assessment that "I haven't gotten as bad as I think", that kind of .... I don't know. But it was just the first "get to know you" visit and all she has to go on is the records of the neurologists before and my primary care doctor.

BUT, I do feel good about getting the tests done right away. I don't know if that was more her influence with the offices to get it done NOW, or if it's the fact that THIS time I have insurance, but I don't care. It's going to get done sooner rather than later and I feel good about that.

I also like her being very knowledgeable about the latest and greatest meds. The new stuff she gave me is really REALLY new and wasn't available 2 years ago. Targeted specifically at the head pain, regardless of the cause. And it's not a change from my current meds, it's on top of it. Which, on the one hand, good because the benefit I am getting from my current meds won't end, but on the other, bad because it's more stuff I've gotta take.  But if it works as she described, I am optimistic of more pain free days.

So, generally, overall, I feel pretty good about her as a doctor. I like that we're diving right in and working right away to get to the root of the problem. Time will tell, I guess, whether she really will go to the mat for me, so to speak, or if we'll just coast again.

And now that  I've written all that, I feel a headache coming on. So I'm going to close the curtains and try to rest.