This week I had my regular appointment with my Migraine specialist. I only had two things on my list of questions for the appointment:
- I want a better way to track my Migraines, and
- I wanted to ask him if he thought going to specialist for my TMJ would be beneficial.
At this appointment I also I received my third round of Botox injections. For some reason, this time was the most painful for me. I also bled more than the other two times. My doctor even asked me if I had taken an aspirin. Of course, I had not. It seems strange to me that this time was the most painful, and I bled. The other two times there was no bleeding to speak of. Not a big deal though. It’s over pretty quickly and the pain is definitely tolerable.
At the beginning of the appointment, I filled out a questionnaire called the HIT-6 Headache Impact Test. (I wrote it down so I could remember to Google it later.) This questionnaire seems very simple, but my Dr. told me that the number (score) shows how I am doing from appointment to appointment. There are only six questions. The first question is “When you have headaches, how often is the pain severe?” The answers are Never, Rarely, Sometimes, Very Often, and Always. I think I had five “Sometimes” and one “Very Often.” According to the “What does your score mean?” section online, my score put me in the category of “Your headaches are having a very severe impact on your life.”
During the appointment, I told my doctor that I was frustrated that I don’t have a really good way to track my Migraines to see how I am doing overall. He assured me that this test score shows him how I am doing. I think I will start writing down just a little something every day that goes along with the questionnaire so I know when I go exactly how I should answer the questions. I’m still trying to figure out a simple way that would prove very helpful. This would be just for my use to help me with the questionnaire.
We then just basically talked about how I am doing. Am I seeing a significant improvement since starting the Botox injections? For some reason, this is hard for me to explain. Living with chronic Migraines for over four years, I have learned to be as positive as possible. In the early days I would write down exactly how the pain was every day. Even to the point of where in my head it hurt. Well, that's a lot of notes and when you go for a an appointment of course the doctor isn't going to read three months of daily entries. So, I quit doing that. My previous doctor used a one to three scale. With three being severe, I was to write a one, two, or three on my calendar. Or a zero if there was no pain. I haven't had any zero days yet. (But I'm still hopeful that I will have a zero day!) For me, almost every day is a two. This doctor doesn't require me to do that. He only wants me to fill out the questionnaire so he can get my "score." So the rest of the evaluation is based on what I tell him during the appointment. I told him that I was able to enjoy my summer vacations more this year than last year. That’s an improvement! I told him I can sometimes slow way down in the evenings if the Migraine is really bad vs. having to stop completely and go to bed early. Another improvement! Now I need to find a simple way for me to know how I am improving. I have some ideas. I just to implement them. I don't want to go back and be wishy washy about whether I am better or not. This is too important for me to not be able to give a clear answer. Being positive is very helpful during my every day life, but when I am talking to the doctor, I need to be honest. Actually, I think this may have been my problem all along. My previous doctor once commented about how positive I am. She even said I would make a great next door neighbor / friend, but I am difficult Migraine patient to treat? Well, I'm thinking now I need to not focus on being positive and upbeat when I am at the doctor's office. Positive and upbeat is a good thing to strive for (and very challenging to do with chronic Migraines), but when I'm explaining my Migraines and how they affect my every day life, I need to be honest.
