Yet another neurologist.
The appointment had been swapped and changed around a couple of times, because it had been begged as a favour. Together with the fact that the previous 5 weeks had been mostly bed-bound, and that I couldn’t help but do the usual thing of putting all my hopes on this one appointment, I was pretty anxious going in to the clinic.
I needn’t have bothered getting worked up. He asked me questions – questions that I have never been asked before about my headache history, my lifestyle, how it feels when I’m in pain… Imagine that – a doctor who listened to my answers. And not only listened, but seemed to read between the lines, too.
He told me of a patient that he had seen previously with very similar symptoms. He had diagnosed her with a tension headache with migraine symptoms. He had treated her with an anti-depressant that is used, in this case, as a muscle relaxant.
I’m a little embarrassed to say that I started to cry!
“Why are you crying?” he inquired.
“Because I have been prescribed an anti-depressant before, and I had a terrible time.” I explained that the ENT consultant I had seen had given me 6 weeks worth of pills, but did not tell me that they were an anti-depressant, and gave me no warning of the dangers of stopping them abruptly. [Read about my experience.]
He reassured me that we would increase and decrease the dose gradually, as should always be done, so that that would not happen again.
But then he said, “You got upset before I mentioned the amitriptyline, why was that?”
Unbelievable! Not only listening, but observing and reading between the lines – this is unheard of!
“Because I’ve heard those terms before – headache, migraine – and it doesn’t help me – I don’t know what to do about them.”
It’s true – those terms have been mentioned before, both in terms of them being suggested and of them being dismissed as causes. I have left many consultations thinking, but if that is the cause, what next? Who is going to help me to manage it or cure it?
I spent the next couple of minutes apologetically breathing back the tears to regain some composure, during which he talked about how very seriously he takes headache, that he knows it can be life-changing, and of the cases he has seen before. Hallelujah! That is the first time I’ve heard any of those things!
We discussed the role that anxiety plays in illness, and I guess I had to concede that my response to whatever started the headache has been tension and anxiety (understandable, I think, given what it’s done to my life!).
I have started a course of amitriptyline, moving up a dose each week. The strange thing is that, now the tension over my right eye has been identified by someone else as causing the pain and nausea that I live with daily, I’ve become super-aware of how tense that muscle is, and I’m able to see a way forward in the task of un-tensing it.
He explained that the white “structural damage” seen on my MRI is not uncommon in migraine sufferers and, for now at least, we won’t investigate this further.
Two further appointments – to an optometrist and a reading clinic – will, I hope, explore if there is actually anything wrong with my eye / reading ability. Maybe I will have to accept that it is entirely tension – although the fact that this started very suddenly at a time when I was at my happiest leaves me with a seed of doubt (one which I will happily admit that I’m wrong about if the amitriptyline helps me and returns me to a normal way of living!).