-The Great Triplet Saga
- I hadn't consistently read LJ in about a week and a half. I am finally caught up, but commented only sparingly. My apologies if I missed anything important; I admit to having done a fair bit of skimming.
- I saw the neurologist on Friday. He had a fair bit to say and wasn't nearly as egotistical as I remember him being. Maybe my impression was wrong. Maybe he's mellowed. Maybe both. Anyway, he had a fair bit to say, but acknolwledged that my options were limited. The most interesting thing I found out was that apparently I do still have some lingering weakness/slowness on my left side from the TIA-thingy I had in college. My left side droops a little when I'm not paying attention (e.g. if my eyes are closed) and it's not as quick with the reflexive actions and such. Interesting. Anywhozit, pain relief options are pretty much non-existent at this point. He's not surprised that the codeine isn't doing much good as it's easy to build a quick tolerance. Triptans are contraindicated not only in pregnancy but for anyone with hemiplegic migraines or a history of stroke/TIA so I can't take them anyway. Therefore, although migraines are certainly not life-threatening, he still thinks that even in light of the pregnancy, a prophylactic option is best. What surprised me was that he did not feel that a calcium-channel blocker was a good option (I've used them before with limited success, but they do have the added benefit of having a tocolytic effect, so I thought it might not be a bad idea). He didn't think it would do me much good and felt that there were better options out there. He did ask if I'm cautious about food triggers (I am) which we discussed at length*. "Okay, so you're not going to give me the easy out on that one, are you?" Nope. Been there, done that. (Eliminating food triggers and other lifestyle triggers is the first line of defense against migraines during pregnancy, which I already knew) So he ultimately surprised me by recommending Topamax. So long as the perinatologist approved it (he did), the neurologist felt it was my best option for getting some relief during the pregnancy. He did not expect I would get complete nor even near-complete relief as he wouldn't want me getting to a truly therapeutic dose until after delivery, but at least it has the potential to make things livable. I was surprised that the perinatologist approved it, but the biggest problem with anticonvulsants in pregnancy is the possibility of neural tube defects... the neural tube is fully formed before the end of the first trimester, so that's not a concern at this point. So I'm taking 25mg of Topamax for a week, and then 50 mg of Topomax until the end of the pregnancy. The last time I took Toaomax I took 150 or 200 mg per day and it did do a fair bit of good, so I hope that I'll at least get some decrease in migraine severity through September. After that, we can re-visit higher doses for a therapeutic level.
- The bad news is that I have a raging, horrible, painful, awful, debilitating ear infection. The good news is that it's rather keeping my mind off the state of my migraines. It's really all about perspective. It does feel like a bit of a slap in the face to have YET ANOTHER ear infection on top of everything else. Even more annoying is that it started Friday evening on the start of a long-holiday-weekend, which means no doctors to be had. The two doctors in my community that I normally turn to for weekend ear infections (because they ALWAYS seem to happen on the weekend) are both out of town, and if I call my doctor, they'll just tell me that they can't diagnose an ear infection over the phone and that I should go to the ER if it's that painful (it is), which is stupid. I have 3-4 ear infections per year. I know exactly what's going on without going to the ER. Going there will not get me any new knowledge, though it might get me better drugs. Bah.
- There's not much else in The Great Triplet Saga, actually. At my last ultrasound, they were growing brilliantly, even though I feel like hell. I think I might actually have gained a pound, which is a miracle. That means I'm still down 16 pounds from my pre-pregnancy weight, but that's okay. I have another ultrasound scheduled on Thursday and then I have to think about scheduling the "Level II" ultrasound, which I'm told will take HOURS because it's triplets. Holy Cow. Oh, and I'm leaving my OB's office and transferring my care solely to the perinatology office. That is, when I get up the guts to make it happen. I have a fear of confrontation with doctors. It's completely irrational. I love my OB, but it seems to make the most sense to only see one set of doctors and to make sure that I see the set of doctors that has the most experience with triplets. So... yeah.
And that's pretty much all the news from here.
* Interesting note about food triggers... I noted that soy sauce seems to be a recentish trigger for me, but not soy products in general. He said that's because soy sauce is fermented, which had never really occurred to me, but makes sense now that he puts it that way.