Thursday, May 11, 2017

The Relationship Between Muscle Tension and Migraines

This has been a rough week so far. I've been battling a terrible migraine and now the muscle spasm in my neck, shoulders and upper back is redeveloping. In an effort to get on top of this spasm before it gets out of hand, I've started using the Thermacare Heat Wrap and am working hard to keep the area relaxed. 

Relaxing these muscles is a huge undertaking as they tense up in response to the migraine. The worse the pain the more of my upper body becomes tense and the harder it is to relax them. This tension seems to then make the pain worse, which makes the tension worse. 

I don't entirely understand the relationship between my muscle tension and my migraines but there is no doubt one exists. 

The first neurologist I saw for my migraines told me I had a lot of tension in these muscles. At the time, my migraines were constant - 27/7 migraine. He seemed certain that this tension was retriggering my migraines. Before one would resolve, another one would be triggered causing the constant migraine. He put me on the daily Baclofen (muscle relaxer), which has brought the frequency down to an average of 18 per month. I honestly think I would have lost my mind years ago if not for the Baclofen.

The migraine specialist I was seeing at Mayo insisted Baclofen is not a migraine drug, which is what prompted him to send me to physical medicine. It was this referral which lead to me getting the diagnosis of Fibromyalgia. As much as I was relieved to finally have some answers about the other non-migraine symptoms I was having, I was also frustrated that nobody seemed to be looking at the big picture. The truth is that before the Baclofen, I constantly had a migraine. The two ARE RELATED. 

The compartmentalization that can occur within these specialties can make it difficult to sort through any sort of relationship between symptoms or conditions. I'm feeling trapped in this crack in the system, unsure where to turn to get help; but in need of help as my muscle tension is becoming a bigger problem. Interestingly enough, I'm also seeing an increase in the severity of my migraines. 

Thursday, May 4, 2017

Repeal and Replace Panic

Are any of you as worried as I am about this repeal and replace business? I was so relieved when the bill was pulled last time and Trump was pitching a fit, saying we are stuck with what we have for the foreseeable future. But here we are, several weeks later, and the house is getting ready to vote. I guess he can't see more than a week or two into the future at any given time.

Then I see something like this and my worry turns to a feeling of panic.

This man is a lawmakers!?!?!?!

The stakes are high and I'm troubled that none of the discussion are about what will bring down costs and provide better coverage. Instead all we hear is about the politics of it. How important it is to repeal and replace because that's what they were elected to do. How important it is to keep some popular parts of the ACA because constituents demand it.

Nobody has read the current bill, we have not had an opportunity to review and discuss it, we don't know what it will cost and what the effects will be. But it's in the republicans best political interest to say they repealed and replaced Obamacare even if millions of people lose coverage, costs go up and people with preexisting conditions get priced out. They don't care at all.

As far as I'm concerned both parties are guilty of not being honest about what it will take to provide affordable health care to everyone because the special interest have unfairly branded the notion of a single payer system in a way that makes it seem dangerous and anti-American.

The instability and the constant effort to take away what little bit of progress we have made in the healthcare arena is hard to cope with. The USA stands alone in making health care a privilege instead of a right. We spend more and are sicker than any other industrialized country. What will it take to turn the tide?

Wednesday, May 3, 2017

Another Doctor, Another Dehumanizing Experience

Well I tried a new primary care doctor yesterday and it didn't go well. Yet another dehumanizing experience. This doc wanted me to justify why I was taking the medications I take. I don't mind explaining who prescribed my medications, how it came about, what the medication does for me and how long I've been on them. I'm not on any opiates. All of the medications I'm currently on have a direct benefit to my quality of life. The dosage was dictated to me by specialists and I'm just looking to maintain the status quo. I have nothing to be ashamed of and nothing to hide so discussing them with a new doc is no problem.

But I took offense to her response to all of my medications. She told me that I'm not using any of my medications as they are designed. She said it is all outside of her comfort zone because she is an internist (the website had her listed as a family doc so I was surprised to learn that was incorrect) and when people are presenting with conditions that require that kind of care she likes to defer to specialists. 

I explained that all of these meds were originally prescribed by specialists and that I'm just looking to follow their plan and maintain the current level of benefit. She told me that she wants me to go back to see all the specialists so that she can develop a relationship with them and they can coordinate my care. I do actually want to see a migraine specialist again to tweak my rescue meds and begin a relationship so that when this new preventative hits the market in a few years I can give it a try. But there is zero benefit to going back to these other specialists because I'm currently on a treatment plan that works. The rest is up to me. 

She seriously wants me to spend hundreds of dollars and waste precious time and energy going to specialists so SHE can feel comfortable with my medications. If I go to all of them every year then I don't need her at all. They can just provide the prescriptions. But that not how this is supposed to work. If I don't need ongoing care I don't need the specialists anymore. I should be able to continue my care with my primary care doctor. 

Another thing she did that bothered me is that she asked me if I had filled out a record release form. I answered. Then a couple minutes later she asked again. I answered. Then she asked again. I answered. She continued to ask me this same questions over and over throughout our appointment. She clearly wasn't paying attention, which makes me wonder what else didn't she hear me say. Then I wonder what she put in my chart. Was that correct? Did she give me some negative label that will follow me any time I see a doc in that system?

Clearly, this is not the doctor for me. I'm trying to simplify my medical care not complicate it and spend more money on it. I just want to cry. I feel so defeated by the continued failure to find a good primary care doctor. What I wouldn't give to be rid of them entirely. I wish I didn't need medications or doctors. I wish I could just have a yearly exam and go on about my business. I wish there weren't so many shitty doctors. I wish the good ones weren't so hard to find. I wish we could have more say in our treatment. I wish there was a way to interview a doctor or otherwise determine if they would be a good fit prior to making an appointment.