I slept and feel better now.Yes, I remember he said this. :) ... not useful at lower doses, though. As the dosage increases, the increase in benefit is non-linear (and sometimes unpredictable).

For migraines I needed 1200 mg. I also used that much for my back/shoulder for partial but adequate relief. 900mg gave less relief.

With the current problem, 300 mg every 6 hours works. The frequency might be important -- I could try 200 mg every 6 hours.

Taking 300 mg every 8 hours (total of 900mg)I have a window where sx are not controlled. They are quite noticeable about 7 hours after, and they increase until about two hours into the new dose. So I am covered about 5 out of 8 hours. Not great but an acceptable compromise IF I am significantly less encumbered by the drug. If my doc is willing to give me more, I might ask for the 400's so I can try 200 QID. I might ask him about pregabalin also which is faster acting but I've never taken it so he might not want to. Gabapentin was prescribed by my pdoc originally so he feels safe with it. Looks like pregabalin is more expensive too.

Sx are not completely unilateral which I believe rules out a tumor. Whew. :)

Sx on the left are very mild compared to the right and the distribution severity differs between sides. This could be indicative of problem scope, but it could merely be a consequence of lateralization/assymetry in trigeminal nerve function. Anatomical left/rright differences have been shown and I've I read that these are thought (but not proven) to explain the greater frequency of right-lateralized presentations of trigeminal neuralgia. My sx are also worse on the right... consistent with that theory.

Certainly related.
Wonder if looking into thigns that went wrong conditioned him into pessimism, or if a priori pessimism and suspicion of others made him a natural fit for review boards.
Wow, strong assertion!
There was an NP at my first college ... she was ok. I don't guess they teach manner in the medical schools here...sigh.
He had his kind of flexibility, I guess. :)

:ROTFLMAO: Love the image. And love the image of my mother going berserk seeing them. And that of my father stacking them into a single precarious tower, with his tidying tic.

I should be ok if I do stop at 4. I have to be very cognizant of the 3rd becausee I think that's where I tend to lose count. Pretty much after the 3rd cup, they are all 3rd cups. :D:cool:

waves

Bad, bad, head/face pain today
 

It didn't quite feel like a migraine, but I've had ones that seemed odd but responded to the migraine med, so I assumed this was one and treated it like a one.

To complicate the treatment attempts, my stomach was upset. It was not just nausea, I was having actual problems prolly coz I had a bunch of cereal before sleeping. I sometimes eat before sleeping with no problems, but I usually don't have THAAT much food before lying down. It was a seriously bad idea.... with bad results. Duh.

Anyway... treatment:

1. Migraine med/abortive: It seemed to do a little, but very little. Does not rule out migraine -- this happens if med is taken too late.

2. Ice: Helped very very little and sometimes seemed to make things worse (not sure -- the pain was weird). Ice usually helps migraines, and never feels worse. This is starting to be weird.

3. Patience: I had to survive most of the day with the ice fwiw because all other medicines involved stomach impact. (I didn't think of acetaminophen which usually doesn't work.)

4. Indomethacin: Eventuallly the stomach settled, so I could eat/take indomethacin. I took 100 mg instead of 75 mg, then slept. It worked about 95% leaving residual stabs of mild pain.

Today's head/face pain different than usual migraine:

1. Pain quality: pain came in waves of stabs. It had kind of a throbbing-ness like a migraine, but more in the form of acute, rhythmic stabs -- different quality.

2. Pain location: bilateral with asymmetrical foci. I occasionally have this in migraine, but not often. There was a "main", dull-ish focus per side, which mostly stayed active, so there may have been an actual migraine PLUS something else going on.

3. Pain distribution: I had multiple foci -- 3 or 4 per side, not just the "main" two. The pain waves came hither and thither with this or that place stabbing me. The "foci" kind of took turns being active but overlapped. It was kinda chaotic. One of the foci was in the sinus area where I've had burning.... very suspicious. :(

I might go drop in on the doctor tomorrow and ask him about this. I don't know. I don't want to seem like I'm too preoccupied. But I kinda want to know if I should be preoccupied, or not yet, given the neurological semblance of the prickling/burning sinus stuff.

I just took another dose of indomethacin. I am having slightly more stabs and I don't want to wind up tomorrow like today. My last dose of gabapentin was last night about 4am (23.4 hours ago). I didn't take any today so as not to confuse things.

I mostly need this for my own memory which is likely to lapse on the details.

Thanks for putting up with me. Softly I go now, pad, pad.

waves

No no, I was glad you mentioned it, and was only acknowledging and saying it wasn't worrying to me.
That's a good thought. Let's hope. And thanks. :):hug:

waves

go to the doctor
 

Waves, :heartthrob: :heartthrob: :heartthrob:

I sighed and cursed aloud when I read this. It was not a good day.
Crap.

. . . but bear with my will I make sure i have it right.
Stomach was a problem perhaps because of the timing and the what of what you had to eat before bed. This was unusual.

Q? Did you sleep on a different side or a different way? Did you eat anything earlier in the day that was different -- possible combination issue?

The migraine med worked, but you could only take it after the stomach settled down. I am happy when a med works and thank goodness.


The head /face pain is disturbing both because it is pain and pain in a weird place and from an unknown cause.
My recommendation (for all it is worth) is to see the doc tomorrow.

Well, the truth is that you are preoccupied and for good reason. I am glad that he (the ENT?) just saw you.
Sometimes docs expect things to get better on their own. Going in will let him know that this is not the case. It will cause him to put on his thinking cap again and think through a solution. This is a better idea than your sitting at home.
Even if he cannot do anything short term, you and he have the visit and the reporting of symptoms on record. Think of this as building a case.

Good luck without the Gabapentin.

Mari

Thanks, Mari.

Ok, I will edit your makings sure...
I ate normal stuff. I sometimes eat before lying down. The quantity I had before lying down was unusual. I woke up feeling overly full, nauseous, and had gas (burping) ==> stomach congestion /indigestion.

No. I am pretty sure it was an unfortunate coincidence ... which interfered with me being able to take meds.

The migraine-specific med -- Zomig / zolmitriptan -- did not work.

The indometthacin worked. And yes, I was really happy about that! :excited.
Just to clarify, indomethacin is not a migraine med, exactly. I do usee it with migraines when the migraine med fails, but it is a general-purpose NSAID. Note: it would treat neuralgia or most pain syndromes, while migraine med would not. :o

OK. Thanks for the feed back. His office hours are 10-12 tomorrow, walk-in only. If I sleep/wake up by then, and am not in pain like today, I will go. Otherwise, I'll call Wednesday to see him that evening (you have to call same day).

If you are asking, I'd be seeing my GP not the ENT tomorrow. But I saw my GP only a short while ago.
Mostly, it would be in case it is worrisome. If it is he might refer me to a neuro rather than wait for the ENT to say the cat is clear. GP's here don't keep records of visits and don't write down or type in anything you say. But it will stay fresher in his head, I suppose.

I was planning to see GP later this week about the Neurotin -- I am running out.

I also want to revisit my symptom analysis with him -- new information.
Thanks, I am ok-ish. The indomethacin also helps somewhat with the pricking/liquid, so it is mostly covering for the gabapentin. Gabapentin is safer/better for chronic use despite the grogginess, so I'll resume it when I feel safely clear of the pain crap, and stop the indomethacin.

Bunches and bunches of thanks for the support and feedback, Mari. You are helping me so much, to think through this and to get through it. :hug::hug:

waves

outline for GP
 

OK so plan for GP:

== update on ENT
----- cat in progress but expected to be clear
----- reflux found -- ENT does not see it explaining the pricking problem
----- ENT thinks burning/pricking is a cranio-facial pain syndrome (neuro)

== discuss reflux
---- symptoms it might explain -- kinds of chest pain? coughing?
---- diet -- how necessary?
---- do I need a PPI right now, given the on-and-off indomethacin use?

== update on sx
----- liquid does not burn under gabapentin (liquid probably normal, nerves probably not)
----- mouth burns (previously thought to be toothpaste)

== Gabapentin
----- ok to usee as palliative while they figure this out?
----- need scripts: 300mg + 100mg, for flexibility

It might be good to see him before I have to add the cat result.
There's already a lot here. I need to print this out.

Waves,

I have to get off the computer.

I want you to know that I am happy that you will be seeing the doctor. :)

Mari

Hi Waves. That word patience is what we have being suffers of mental health issues. We have to be patient over a long period of time with ourselves,people,doctors,medications,parents,teach ers,time in the day,and night. That is something that we can feel good about is that we have patience. BF:hug::hug::hug:

Thank you, Steve. :hug:

I don't have a lot of patience, but that is what is required, sure enough.

Thanks, Mari. I went. :)

About the headache-with-face-jabs, he didn't say much. I asked if I should just see if it happens again (:eek::o) and he kind of nodded. Oh, he did add, finally, that for that kind of problem, he would suggest indomethacin first thing. So that was useful. And thinking about it now, I might deduce from that that he suspected more than a migraine. Wish I'd thought of it while I was there -- I would have cornered him for a confirmation.

He got up in arms about the reflux. He wants me to have a gastroscopy -- whenever I am ready. I said go ahead and script it since it takes ages to get appointments. He gave me a PPI which I was going to request anyway, so, for now, that's ok.

waves