Wednesday, May 6, 2015

I'm getting my words back

Almost a month ago it was time for my next follow-up with my neurologist. I was also running low on Topamax. However, Brain Doc was on sabbatical! Rather than renew my prescription one more time, I decided to see Brain Doc II.

It was a good visit. He showed me my brain scan, which geeked me out. Then he went over some headache management points that Brain Doc I had also done, but this time I got a printout. The printout was super helpful and had more suggestions for how to deal with headaches. Then, we agreed that when my Topamax ran out, I should just stop taking it.

It's been 2.5 weeks completely free of Topamax and I am happy to report that my brain is feeling good. I haven't had too many headache episodes though I still do sometimes feel like someone smacked me on the back right side of my head.

In terms of brain function, I find that my vocabulary has increased and there are many less times when I struggle to find the correct word. For example, when I went to see Mr. PT, he asked about my pain and I was able to say "it stings" instead of "it's kind of sharp, but not sharp, like I scrapped it or something" which is what I would say before because the word "sting" would fly out of my brain just as I was about to speak.

So that's good.

I'm still overly absent-minded/forgetful. Some of this is due to too much multitasking, I'm sure. And a bit is probably age. But the rest I am sure are the drugs. Plus some study was just released where they followed thousands of people for seven years and found out that certain OTC meds increase the risk of dementia if taken every day for a long period of time. Most of those drugs, I don't take much at all,  certainly not every day. But one of them was the bladder med that I was on for a while that I hated. I don't remember how long I was on it but it was at least 6 months, probably more than a year. Great.

I'm also about to run out of B2 and, as agreed with Brain Doc, when the B2 runs out, I will not go buy some more.

In the meantime, I've been looking over the Headache Management form and making a few changes to optimize not getting headaches. This is the list, in case you suffer from frequent headaches:

Attention to Lifestyle Factors

-adequate sleep and constant schedule
-frequent small meals
-adequate fluid intake
-stress reduction
-aerobic exercise
-avoidance of specific triggers where possible

In this area, I'm already doing these things in order to optimize recovery from endurance training. Well, that stress reduction thing is probably not happening, what with my kids having problems and working at a startup, but all the rest are.

Non-prescription Supplements (migraine preventatives)

Riboflavin (B2)                                 200 mg twice a day
Magnesium (dicitrate form)              400-600 mg per day
Feverfew (Tanacetum parthenium)   125-300 mg per day
Butterbur root (Petasites hybridus)   75 mg twice a day
Co-enzyme Q10                                100 mg three times a day
Combination preparations such as MigreLeif, Migrevent
Melatonin                                          3 mg at bedtime

In this area, I've been taking the B2 in 100 mg doses, 4 times a day which is actually better than 200 mg, twice a day. For the magnesium, I've only been taking 350 mg and not always in dicitrate form. I think I'll start taking my 250 mg pill twice a day. Add that to the 100 mg that's in my multivitamin and that's 600 mg. 

I have been taking Co-enzyme Q10 or Ubiquitol for other reasons but only 100 mg. So I recently upped that to three times a day and I'll continue to take it. This is one supplement that I go back and forth on whether or not it actually does anything for me, but now that I know it's supposed to prevent headaches, I'll keep taking it.

I also do take melatonin once in a while to help me get to sleep. After reading this, I decided to take it every night. However, it seems like if I take 3mg every night, I find myself either waking up more often or feeling kind of groggy when I do wake up. So I think I'll go back to just taking it as needed.

Complementary, non-pharacologic approaches

-acupuncture
-meditation
-yoga
-biofeedback training
-other forms of relaxation training
-cognitive behavior therapy

I don't really see any of these in my future. Maybe yoga. Or something the Y calls "yogilates" anyway. I tried acupuncture once for my calf and it was expensive and didn't do squat so I think I'll skip that one. But I find swimming and running to be fairly meditative. And that will have to do.

Other stuff

The rest of the sheet talks about stuff you have to get a prescription for such as my topamax as well as botox and OTC headache medicines. I try to limit the NSAIDs and acetaminophen I take because they minimize your fitness gains but I do sometimes take them and I have found Aleve (naproxen) actually helps while ibuprofen and Tylenol are hit or miss.

There is also a recommendation to keep a headache diary as this is a good way to see if you are getting better or worse and also identifying triggers. During this entire process, I had the good intention of starting one but never did.

The sheet finishes with a link to the National Headache Foundation and the American Headache Society where you can get more information.
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