Last week I made the trek out to Chicago to have my annual visit with my neurologist. I have been seeing him since 2001 (or 2002 – I just can’t remember). Anyway, even though he is located in Evanston, I continue to see him because he’s just so wonderful. He sits and listens to me. I never feel like he’s rushing to get to his next patient so he can go home. And every time I leave his office, I leave with a plan – not just a bunch of medication.

So, the bad news first: The preventive medication I am currently taking is not working. I knew this months ago and my doctor gave me the look that he also knew this would be the outcome. I’m glad he recommended this treatment and I’m glad I gave it a shot. The next step up from the class of meds I was taking are beta-blockers. Unfortunately, I cannot take these since they will aggravate my asthma. The next, and much more aggressive, step are anti-convulsive medications. These are serious, serious meds and have some not-so-great side effects – something called “cognitive deficiency” (short-term memory loss, difficulty finding the right words, confusion, lack of concentration). Doesn’t sound too appealing, and inside my head I was debating whether or not I would take them. Turns out I didn’t have much choice. My doctor informed me that the kind of migraines I get – menstrual migraines – do not respond to preventive meds. This means that I must rely on abortive medications – anything from Excedrin all the way up to Demerol.

Definitely not the news I was expecting to hear. However, the good news is that I discussed pregnancy and migraines with my doctor. I explained my fear of being “trapped” if I ever got pregnant – without migraine meds, I would seriously lose my mind. I’ve had the 18 hour migraines. The ones that don’t respond to my meds. The ones that make me go to the ER. How would I ever handle it without anything other than Tylenol? That’s like putting a Band-Aid over a bullet wound. My doctor informed me that while I was not allowed to take any of the migraine meds (Relpax, Imitrex, Frova, Maxalt, etc.), I could take Tylenol, aspirin-free Excedrin, Fioricet (my favorite painkiller), and he said he would be more than happy to write me a prescription for Vicodin. It sounds crazy, but he assured me that the most effective and the safest meds for me to take while pregnant would be narcotics. I’m still a bit concerned about that, but I did feel much better knowing that if I ever did get pregnant, I would not be trapped.

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