This is the second in my what are you thankful for series. The first was a WHAT - Botox!
Today I turn to a WHO. Actually, a couple of who's. Neurologists!
1. Dr. A.
I made the acquaintance of Dr. A. while lying in a hospital bed in Kansas. I couldn't make out his features very well, as I was almost completely blind at the time - a consequence of the stroke I mentioned in the last post. Dr. A. was responsible for puzzling out why an apparently healthy young woman had had a stroke. He carefully ruled out every possible cause; the test results and my symptoms left us with no conclusion other than that it was a rare migrainous stroke. I was truly fortunate to draw Dr. A. in the hospital; he was experienced, wise, and compassionate. Over several months, my vision began to recover, the migraines came back with a vengeance, and he did his best to treat them. He suggested a break from work to allow recovery (that "break" has now gone on seven years). He did a lot of good for me, but the very best thing he did for me may have been this: One day he said to me, "Your case has become too complicated for me to adequately treat you the way you need. You need to see a neurologist who specializes in stroke and migraine. I have someone in mind for you. It will take you a while to get in to see her, but it is worth the wait. She will be able to help you." And that is how I went on to see...
2. Dr. D.
It took over a month to get in to see Dr. D. but it was indeed worth the wait. She was a whirlwind, and she gave me hope that at least pain relief would be mine, if not a cure. Together we began working our way through a variety of preventatives - always hopeful for each one, often disappointed when I experienced intolerable side effects. I don't know how to tell you all that this doctor did for me, the thousand extra miles that she went for me (and, I suspect, for all her patients). When we felt we had exhausted the pharmacy of preventatives and the migraines had still left me bedridden, it was she who offered me botox for the first time, and so gave me my life back. On top of this - this was in 2004, mind you - she and her staff had somehow managed to get my insurance company in Kansas to pay for at least a portion of the cost of treatment. I really would have done almost anything for this doctor. In addition to being The Doctor Who Gave Me My Life Back, she was funny, witty, sassy, stylish, warm, compassionate, fierce, and a total force to be reckoned with. When Mr. Z and I had to move from Kansas to our present home, I grieved many things that I had to leave behind, but having to leave and end my relationship with Dr. D was one of the most heartbreaking losses of all. Dr. D didn't just say bye-bye, though. She knew where I was going, and she knew what doctor she wanted me to see in the new place - Dr. Y. On my own, it might have taken months and months to get in to Dr. Y's practice. But Dr. D made it happen right along with the timetable of my move. (In doctoring as in employment, I guess it is who you know.)
3. Dr. Y.
Dr. Y is my present neurologist. Under his care I have continued the improvement that began with Dr. D. Dr. Y is truly amazing and is a rock star of the neurology migraine world. You'd never know it when you are in his office, though. He is gentle, almost shy in his demeanor, putting patients at ease along with his quiet voice perfectly designed for those with throbbing skulls. He works in a teaching hospital, which means that visiting doctors or interns and residents are frequently present at one's appointment, but he knows how to minimize the intrusiveness of this. Maybe it's the teaching hospital environment, or maybe it's the teacher in him, but he helps you understand, in as much detail as you want, what is going on in your brain, how your treatment is expected to work, what the limits of medical understanding are. And at the end of every visit he takes some time to ask: now what will you do to minimize stress and get some exercise in the next couple of months? What can you commit to, to your doctor and to yourself? He shares with you what he is doing to minimize stress and get some exercise. He says, you can do it. You know that he is A Very Important Doctor and A Very Busy Person but when you are in his office and he is focused on you and your medical needs, you have the impression that he really has nothing else to attend to the rest of the day, and that there's nothing much else he'd rather be doing anyway. Getting a botox treatment from him is a collaborative effort. He teaches you how to give him the feedback he needs to best target some of the injection sites. He is awesome, I am grateful to be under his care, and I am grateful that people like him, Dr. D., and Dr. A. put in the hard work in medical school, internships, and residencies to take care of people like me.
I wish I could thank these neurologists on my blog by name, but since botox has recently been approved by the FDA, many neurologists are being swamped with calls from migraine sufferers begging for a miracle cure for their misery. I don't want to add to the volume of calls they are already getting. People with migraine interested in botox should be aware that: it has not yet been sorted out how insurances will pay for botox, if all insurances will pay at all, and how much they will pay if they do (likely will be a stiff copay). The FDA approval is for chronic migraine, i.e. patients who experience migraine most days of the month (14 or more).